Intervention study for changes in home fire safety knowledge in urban older adults

Lehna, Carlee; Coty, Mary-Beth; Fahey, Erin; Williams, J P; Scrivener, Drane; Wishnia, Gracie; Myers, Joseph B.

doi:10.1016/j.burns.2015.02.012

Cited by 18 publications

(23 citation statements)

References 12 publications

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“…Again, educational campaigns to improve burn knowledge and home fire safety, as proposed by the studies of Tan et al . and Lehna et al ., might be an effective intervention strategy [ 30 , 31 ]. In addition, physicians outside specialized burn care should take this delayed presentation into account in their treatment decisions in order to reduce further delay to definitive treatments, including surgery.…”

Section: Discussionmentioning

confidence: 99%

Burns in the elderly: a nationwide study on management and clinical outcomes

et al. 2020

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Background In modern-day burn care, advanced age remains an important predictor for mortality among burn victims. In this study, we compared the complete treatment trajectory (including pre-hospital and surgical treatment) and the outcomes between an elderly burn population and a younger adult burn population. Methods In this nationwide study, data from the Dutch Burn Repository were used. This is a uniform national registration for Dutch specialized burn care. All adult patients that were admitted to one of the three Dutch burn centres from the period 2009 to 2015 were included in the analysis. Burn patients were considered as elderly when ≥65 years of age, and were then further subdivided into three age categories: 65–74, 75–85 and 85+ years. Younger adults in the age category 18–64 years were used as the reference group. Surgical management was studied comprehensively and included timing of surgery, the number of procedures and details on the surgical technique, especially the technique used for debridement and the grafting technique that was applied. For the comparison of clinical outcome, the following parameters were included: mortality, wound infections, length of stay/TBSA (total body surface area) burned, discharge disposition and secondary reconstructions. Results During the study period, 3155 adult patients were included (elderly, n = 505). Burn severity, reflected by the median TBSA, varied between 3.2–4.0% and was comparable, but aetiology and pre-hospital care were different between elderly and the younger adult reference group. Surgical treatment was initiated significantly faster in elderly burn patients (p < 0.001). Less selective techniques for surgical debridement were used in the elderly burns patients (hydrosurgery, 42.0% vs 23.5–22.6%), and on the other hand more avulsion (5.3% vs 7.3–17.6%) and primary wound closure (6.7% vs 24.5%). The most frequently used grafting technique was meshed skin grafts (79.2–88.6%); this was not related to age. Mortality increased rapidly with a higher age and showed a high peak in the 85+ category (23.8%). Furthermore, considerable differences were found in hospital discharge disposition between the elderly and the reference group. Conclusions In conclusion, elderly burn patients who require specialized burn care are vulnerable and medically challenging. Differences in aetiology, comorbidity, physiology and the management prior to admission possibly affect the initial surgical management and result in significantly worse outcomes in elderly. Elderly patients need optimal, timely and specialized burn care to enhance survival after burn injuries.

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Section: Discussionmentioning

confidence: 99%

Burns in the elderly: a nationwide study on management and clinical outcomes

et al. 2020

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“…In two previous studies by the authors on HFS education, the team studied 103 parents of newborns (with and without special needs) (Lehna et al, 2015a) and 125 older adults (community active and homebound) (Lehna et al, 2015b). Participants were asked to watch a 5-minute HFS DVD; complete a pre, post, and 2-week follow-up phone call.…”

Section: Introductionmentioning

confidence: 99%

“…Participants were asked to watch a 5-minute HFS DVD; complete a pre, post, and 2-week follow-up phone call. In addition, in-home fire safety checks using the Home Fire Safety Checklist were conducted (Lehna et al, 2015a, Lehna et al, 2015b). …”

Section: Introductionmentioning

confidence: 99%

“…With the exception of the two studies (Lehna et al, 2015a, Lehna et al, 2015b), assessment of HFS practices remains fragmented and disjointed. Researchers mainly focus on smoke alarm placement and functionality (Gielen et al, 2013, Miller et al, 2014, Parker et al, 2013, Sidman et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…The research team is attempting to shift the paradigm to prevention (eradicating unsafe practices) from a traditional reactionary approach (fire alarms). There was a need to further evaluate the effectiveness of the photographs obtained in the two previous studies (Lehna et al, 2015a, Lehna et al, 2015b) with both a local and a national group of burn prevention experts.…”

Section: Introductionmentioning

confidence: 99%

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Using photographic interpretation to evaluate the safety of home environments

Lehna

Twyman

Myers³

2016

Preventive Medicine Reports

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In the US there were 400,000 home fires resulting in 2755 deaths, 12,450 injuries, and $6.9B lost. The purpose of this study was to evaluate the content-validity of photographs taken in the home for use as an educational instrument to teach about “safe” and “unsafe” fire safety practice for adults and older adults. A total of 73 home fire safety experts were provided 27 photographs to evaluate home fire safety practice. Initially, a Krippendorff's alpha was calculated for the first 24 questions to evaluate inter-rater reliability, and differences in demographics were evaluated. Unique codes and themes for the last three questions were identified and inter-rater reliability examined. A majority of respondents were female (n = 43, 60.6%), college educated (n = 61, 83.6%), nurses (n = 25, 33.8%), or worked for a fire department (n = 21, 29.6%). Their mean age was 45.5 years and they had 11.05 years of experience. The first 24 questions had high inter-rater reliability (Krippendorff α = 0.831). No significant differences existed between the strata of the demographic variables (all p-values > 0.05). Similarly, based on the codes and themes identified, the last three questions had moderate-to-good inter-rater reliability (Krippendorff α = 0.764). Providing photographs as a ‘seek-and-find’ or ‘What's wrong with this picture?’ tools and simplified visual images is an excellent way to aid recognition of unsafe home fire safety environments. Education through non-traditional visual methods increases the possibility of change for diverse low-literacy populations.

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Nursing Management of the Burn Patient

Knighton

2019

Handbook of Burns Volume 1

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Intervention study for changes in home fire safety knowledge in urban older adults

Cited by 18 publications

References 12 publications

Burns in the elderly: a nationwide study on management and clinical outcomes

Burns in the elderly: a nationwide study on management and clinical outcomes

Using photographic interpretation to evaluate the safety of home environments

Nursing Management of the Burn Patient

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