Fire safety training: its importance in enhancing fire safety knowledge and response to fire

Fire-related accidents often result in injuries and sometimes death, which can be prevented through fire safety training. To estimate the extent to which fire safety training should be provided, it is essential to assess the current level of fire safety knowledge within the general community. Thus the objectives of the present study were to explore: (a) the level of fire safety knowledge among people of different age groups and investigate its relationship to the level of fire safety training, and (b) the manner in which people from different age groups would respond to a fire based on their fire safety training. Data from 158 participants aged between 18 and 80 years showed that fire safety training increases: (a) the level of fire safety knowledge and, (b) the accuracy of response to a fire. The results also show that middle-aged individuals would respond more accurately to a fire than younger and older adults. The findings demonstrate the importance of fire safety training in enhancing people's fire safety knowledge and their response in the event of a fire which could lead to a reduction in the rate of fire casualties. There are implications for incorporating fire safety training as part of health improvement programs to reduce the number of fire-related injuries and fatalities.

Applications of cognitive theories to children's fire safety education

Children under five have the highest rate of fire-related accidents (Australian Institute of Health and Welfare, 2001). It is therefore essential to develop effective fire safety education programs to prevent casualties due to a fire. At present, there are fire education programs conducted across Australia for primary school children. However, it is vital that these programs get their message across to the children in the most efficient manner to help children retain the information. The present study evaluated the effectiveness of the 'Fire Ed' program conducted in Victoria and assessed the retention of fire safety information in children in preparatory and Grade five levels. The findings suggest that the information is not retained over long periods of time. Suggestions are made to provide fire safety education in line with
theories of cognitive development to make it more effective.

Effectiveness of fire safety education in primary school children

Young children have been identified as a high-risk group in relation to fire-related deaths because of their limited ability to understand the intinsic dangers of fire, to foresee the consequences of playing with fire, or to manage a fire if it were to become out of control.  Children are also not equipped to respond in a meaningful way in the event of a fire.  It is therefore essential that fire safety education be imparted to children in an effective manner so as to equip them to deal with a fire efficiently.  The objective of the present study was to evaluate the 'Fire Ed' program conducted by the Melbourne Metropolitan Fire Brigade for primary school children to determine whether exposure to the curriculum will influence children's knowledge of fire safety behaviours.  Although the program has numerous positive features, its overall effectivenedd has not been evaluated.  It was hypothesised that: a) children will not be aware of essential fire safety information prior to attending the 'Fire Ed' program, and b) children will display a significant gain in fire safety knowledge after participation in the program.  Sixty children from six primary schools participated in the study and they were tested on their level of fire safety knowledge prior to and after partcipation in the 'Fire Ed' program.  Results show that the children's knowledge of fire safety procedures improved significantly after participation in the program when tested after three weeks, however, when their knowledge was examined after five weeks, a significant decline was seen.  The findings show that regular evaluations of fire safety programs are required and that they could be improved by considering the different stages of cognitive development in children.

Financial safety nets: reconstructing and modelling a policymaking metaphor

This paper explains that financial safety nets exist because of difficulties in enforcing contracts and shows that elements of deposit-insurance schemes differ substantially across countries. It shows that differences in the design of financial safety nets correlate significantly with differences in the informational and contracting environments of individual countries and that a country's GDP per capita is correlated with proxies for a country's level of: (1) informational transparency, (2) contract enforcement and deterrent rights, and (3) accountability for safety net officials. The analysis portrays deposit insurance as a part of a country's larger safety net and contracting environment. This means that there is no universal method for preventing and resolving banking problems and that the structure of a country's safety net should evolve over time with changes in private and government regulators' capacity for valuing financial institutions, disciplining risk taking and resolving insolvency promptly, and for being held accountable for how well they perform these tasks.

Problems experienced by students on field placement: using research findings to inform curriculum design and content

Recent recognition of workplace learning from within the University sector has resulted in more emphasis being placed on including field experiences in course curriculum across a range of disciplines. This article begins with a short review of the literature relating to the current context in which work-based learning occurs. Next, selected findings from a survey of 39 Victorian social work students on their experiences of placement learning are reported. The survey focused on problems encountered by students on placement. A number of the problems students faced suggested the need for additional opportunities both before and during the placements to engage with material on safety in the field, and ways to deal with workplace stress and conflict. In response to these issues the article summarises some pedagogical strategies that may be used to enhance student learning in these areas both leading up to and during their field placements. In addition to matters relating to safety and stress, financial pressures were evident for students endeavouring to complete field placements. The recent moves from universities to embrace industry based learning, clearly has implications for funding support made available to students undertaking this type of education.

Understanding parental motivators and barriers to uptake of child poison safety strategies: a qualitative study

Objectives: To develop an understanding of factors acting as barriers and motivators to parental uptake of child poison safety strategies.

Design: A qualitative study involving semistructured interviews and focus groups. A grounded theory approach was used for the collection and analysis of data.

Participants: Sixty five parents of children under 5 years of age, some of whom had experienced an unintentional child poisoning incident.

Results: A range of knowledge based, environmental, and behavioral barriers to comprehensive parental uptake of poison safety practices were identified. As a result there tended to be only partial implementation of safety initiatives in the home. Selection of safety practices was often guided by the interests and behaviors of the child. This made the child vulnerable to changes in the home environment, inadequate supervision, and/or shifts in their own behavior and developmental ability. Personal or vicarious exposure of a parent to a child poisoning incident was a significant motivator for parental review of safety practices.

Conclusion: Environmental measures targeting child resistant containers, warning labels, and lockable poisons cupboards will support parents’ efforts to maintain poison safety. Additional education campaigns using stories of actual poisoning incidents may help to increase awareness of risk and encourage increased uptake.

The role of the print media in informing the community about safety in public hospitals in Victoria, Australia: the case of `golden staph`

Objective. In this article the authors explore how the print media contribute to information and education of the community on issues of safety and quality in the health services, since this is an important avenue of such information and education for many members of the community. Study design. The authors undertook a qualitative study of a random sample of articles in the Australian print press between 1996 and 2004 where ‘golden staph’ was presented as a major issue of risk to the safety of consumers of health services. The content of each article was examined with reference to several criteria including title, the source of the article, and the metaphorical language employed by the journalist.
Results. Results show that while the articles are substantially accurate as sources of information on concrete events, they do not serve as sources of education on issues of safety, typically apportioning blame and serving to maintain the status quo.
Conclusion. The authors conclude that print media are not a good source of community education in areas of safety and quality and do not assist members of the community to participate in addressing issues of safety in health services.

Safety and efficacy of routine postoperative ibuprofen for pain and disability related to ectopic bone formation after hip replacement surgery (HIPAID): a randomised control trial

Objectives To determine the benefits and risks of a non-steroidal anti-inflammatory drug (NSAID) as prophylaxis for ectopic bone formation in patients undergoing total hip replacement (or revision) surgery.
Design Double blind randomised placebo controlled clinical trial, stratified by treatment site and surgery (primary or revision).
Setting 20 orthopaedic surgery centres in Australia and New Zealand.
Participants 902 patients undergoing elective primary or revision total hip replacement surgery.
Intervention 14 days' treatment with ibuprofen (1200 mg daily) or matching placebo started within 24 hours of surgery.
Main outcome measures Changes in self reported hip pain and physical function 6 to 12 months after surgery (Western Ontario and McMaster University Arthritis index).
Results There were no significant differences between the groups for improvements in hip pain (mean difference -0.1, 95% confidence interval -0.4 to 0.2, P = 0.6) or physical function (-0.1, -0.4 to 0.2, P = 0.5), despite a decreased risk of ectopic bone formation (relative risk 0.69, 0.56 to 0.83) associated with ibuprofen. There was a significantly increased risk of major bleeding complications in the ibuprofen group during the admission period (2.09, 1.00 to 4.39).
Conclusions These data do not support the use of routine prophylaxis with NSAIDs in patients undergoing total hip replacement surgery.
Trial registration NCT00145730.

Efficacy and safety of vertebroplasty for treatment of painful osteoporotic vertebral fractures: a randomised controlled trial [ACTRN012605000079640]

Background: Vertebroplasty is a promising but as yet unproven treatment for painful osteoporotic vertebral fractures. It involves radiographic-guided injection of various types of bone cement directly into the vertebral fracture site. Uncontrolled studies and two controlled quasi-experimental before-after studies comparing volunteers who were offered treatment to those who refused it, have suggested an early benefit including rapid pain relief and improved function. Conversely, several uncontrolled studies and one of the controlled before-after studies have also suggested that vertebroplasty may increase the risk of subsequent vertebral fractures, particularly in vertebrae adjacent to treated levels or if cement leakage into the adjacent disc has occurred. As yet, there are no completed randomised controlled trials of vertebroplasty for osteoporotic vertebral fractures. The aims of this participant and outcome assessor-blinded randomised placebo-controlled trial are to i) determine the short-term efficacy and safety (3 months) of vertebroplasty for alleviating pain and improving function for painful osteoporotic vertebral fractures; and ii) determine its medium to longer-term efficacy and safety, particularly the risk of further fracture over 2 years.

Design: A double-blind randomised controlled trial of 200 participants with one or two recent painful osteoporotic vertebral fractures. Participants will be stratified by duration of symptoms (< and ≥ 6 weeks), gender and treating radiologist and randomly allocated to either the treatment or placebo. Outcomes will be assessed at baseline, 1 week, 1, 3, 6, 12 and 24 months. Outcome measures include overall, night and rest pain on 10 cm visual analogue scales, quality of life measured by the Assessment of Quality of Life, Osteoporosis Quality of Life and EQ-5D questionnaires; participant perceived recovery on a 7-point ordinal scale ranging from 'a great deal worse' to 'a great deal better'; disability measured by the Roland-Morris Disability Questionnaire; timed 'Up and Go' test; and adverse effects. The presence of new fractures will be assessed by radiographs of the thoracic and lumbar spine performed at 12 and 24 months.

Discussion: The results of this trial will be of major international importance and findings will be immediately translatable into clinical practice.

Trial registration: Australian Clinical Trial Register # [ACTRN012605000079640]

Implementation of a medication guideline to improve medication safety for patients

Although the incidence of medication error remains unknown, in Australian hospitals, they are thought to occur in 5-20 % of drug administrations 1. Not surprisingly, international debate has focused on the mechanisms to improve the safety of patients. Thus a new National Inpatient Medication Chart (NIMC) was endorsed to improve communication and reduce medication errors 2. This study aimed to investigate the documentation practices of clinicians following the implementation of a medication guideline and NIMC.
A pre and post-test design was used to evaluate the adoption of and adherence to the medication guideline at Western Health, an 850 bed healthcare network in Australia. Audits of inpatient medication charts (N=265) were conducted at 3 months prior to and repeated 4 months (N=290) after implementation. The pre-test data was used to formulate an interdisciplinary organizational strategy that included mandatory education for all clinical staff, practice reminders, decision prompts, a telephone hotline for support, an intranet information website and electronically distributed Frequently Asked Questions.
Pre and post implementation audits highlighted areas of potential medication error. The post-test showed an overall trend towards improvement in documentation. There were significant improvements in 4 critical practices: Drug name clear (p=0.0003); Drug dose clear (p=0.0002); Prescribed frequency equals documented frequency (p=0) and; No signature by administrator (p=0).
The majority of documentation errors showed poor attention to detail and would be considered a slip or lapse in skill based judgment 3. Although this study was designed to evaluate documentation practices, future research should include observation methods to increase our understanding of the context behind the judgments such as work place interruptions, skill mix and knowledge levels. While evidence based guidelines enable work, they are not the actual work or substance of patient care. Organisational systems can assist in preventing unconscious aberrations that lead to error.

Vehicle design for minimum societal harm

A design technique was developed to provide the best protection to all occupants in the real-world crashes that occur on Australian roads. A team of experts from around the world was marshalled to analyse crash data, develop new information on impact injury and a new computer optimising technique for simulation of side impact crashes.

Nurses' role in medication safety

Aim To explore the nurses role in the process of medication management and identify the challenges associated with safe medication management in contemporary clinical practice.
Background Medication errors have been a long-standing factor affecting consumer safety. The nursing profession has been identified as essential to the promotion of patient safety.
Evaluation A review of literature on medication errors and the use of electronic prescribing in medication errors.
Key issues Medication management requires a multidisciplinary approach and interdisciplinary communication is essential to reduce medication errors. Information technologies can help to reduce some medication errors through eradication of transcription and dosing errors. Nurses must play a major role in the design of computerized medication systems to ensure a smooth transition to such as system.
Conclusion The nurses roles in medication management cannot be over-emphasized. This is particularly true when designing a computerized medication system.
Implication for nursing management The adoption of safety measures during decision making that parallel those of the aviation industry safety procedures can provide some strategies to prevent medication error. Innovations in information technology offer potential mechanisms to avert adverse events in medication management for nurses.