Promoting safe environments and parenting practices with home visitation programs

Background: Unintentional injuries are the leading cause of morbidity and mortality in children. Interventions reducing injury risks by educating parents and providing safety supplies can be effective, but such interventions have not yet been offered by home visitation programs serving high-risk populations. This research reports on the process of integrating an evidence-based injury prevention model, Safe N' Sound (SNS), into a nurse home visitation program. Methods: Fifteen semi-structured interviews were conducted with a sample of nurses from each of three study groups (SNS and safety products provided, injury risk assessment only, or routine care). Interviews were recorded, transcribed, and coded using a consensus coding process. Codes were entered into Atlas Ti and relevant information grouped. Themes were generated through a second consensus analysis process. Results: Nurses welcomed using a standardized injury prevention model, noting that this systematic approach allowed for more efficient client education. Nurses expressed that using this model broadened their own awareness of injury risks, bringing to the forefront specific risks not typically addressed. Providing safety supplies to clients was a critical feature of the program, helping nurses not only identify problems but to also provide solutions for high-risk families. Nurses articulated the need for seamless integration of SNS into current case management software to alleviate technical problems and streamline the risk assessment and program process. Conclusions: The process evaluation demonstrates that it is feasible to integrate injury prevention assessment and programming into home visitation programs as well as utilize a consistent, standardized injury prevention clinical guideline.