The effect of a car seat reference card versus in-service education alone on sustainability of knowledge and skills over time of the Neonatal Intensive Care Unit nurses of the Morgan Stanley Children's Hospital
Creators: name: Koziakova, Adriana
Publisher: name: No Publisher Supplied
Year: 2019

description: Objectives: Motor vehicle crashes remain the leading cause of death in children under the age of 19. Despite the documented findings that car restraints significantly decrease the morbidity and mortality of child passenger occupants in crashes, 53% of all children killed in motor vehicle crashes are still found to be unrestrained at the time of crash. This study not only focused on the improvement of the healthcare professionals' knowledge and skills during a car seat safety in-service, but also presents the healthcare professionals with a guideline to use as a reference in sustaining the knowledge and skills over time regarding the child restraint and car seat safety. The purpose of this study was to standardize child restraint practices and uniform car seat safety information provided to the direct caregivers by the Neonatal Intensive Care Unit nurses. Methods: A 16-question survey distributed to Neonatal Intensive Care Unit nurses (n=70) assessed their knowledge regarding car seat safety. Based on the results, a car seat reference card was developed. The efficacy of the card was then tested by having a small number of Neonatal Intensive Care Unit nurses (n=28) participate in a two-hour long car seat safety in-service that focused on both car seat safety knowledge and skills. A pre-test was completed by all the participating nurses prior to the start of the car seat safety in-service to assess the level of their knowledge through 10 multiple choice questions. The first post-test was administered to all the participants immediately after the in-service. Participants were also asked to place a training doll into a car seat prior to start of the in-service and immediately after. Upon the completion of the car seat safety in-service, a car seat reference card was distributed to half of the nurses (n=14) which comprised the intervention group, but not to the other half (n=14) which formed the control group. The nurses in the intervention group could consult the car seat reference card whenever needed for the period of three weeks. After three weeks, a second post-test was administered to all the participants in both groups. Following the second post-test, the participants were also asked to place a training doll into a car seat. Results: Based on the 70 responses by the Neonatal Intensive Care Unit nurses on the knowledge level survey, a car seat reference card was developed. The card was then tested by having 28 participants attend a two-hour long car seat in-service and use of the card by half of the participants (n=14) in the intervention group for the period of three weeks immediately upon completion of the in-service. It was observed that there was a significant increase in knowledge between the pre-test (M = 53.2, SD = 19.1) and the post-test (M = 86.1, SD = 9.9), t (54) = - 8.1, p = 0.000. It was also noted that the in-service led to an increase in participant's skill level. Prior to the in-service, only five participants (17.9%) received a passing score, while after the in-service the number of participants increased to 24 (85.7%). In addition, it was determined that having access to the car seat safety reference card for the period of three weeks led to retention of knowledge and skills. The intervention group scored higher on the second post-test, with an average score of 85%. The difference in this score compared to the average score from the first post-test (86.1%) was found not to be statistically significant (p = 0.772), indicating that the intervention group was able to retain the knowledge overtime. On the other hand, the average scores for the control group showed a drop to 75.7%. The difference in this score compared to the first post-test was statistically significant (p = 0.012), signifying that the control group did not retain the knowledge over time. In terms of skills, it was noted that there was a higher percentage of the participants in the intervention group that received a passing score (12 out of 14 or 85.7%) compared to the control group (10 out of 14 or 71.4%). Conclusion: This study shows that a lack of car seat safety knowledge among Neonatal Intensive Care Unit nurses at Morgan Stanley Children's Hospital is similar to a lack of knowledge among health care professionals as described in a number of research studies. The same studies also pointed out that a number of educational interventions have been shown to help increase the health care professionals' level of knowledge and skills. This study confirmed that a two-hour car seat safety in-service can increase both the participants' level of knowledge and skills. In addition, this study determined that having a car seat reference card available for use whenever required can have a positive effect on knowledge and skills retention.