Developing a Bicycle Helmet Program for an Urban Pediatric Emergency Department

Abstract

Introduction and Rationale: Bicycle riding is popular among the pediatric population, but with popularity comes a significant increase in morbidity and mortality. Cycling injuries occur in one-fifth of children aged 15 years and younger. Most life-threatening injuries among bicycle riders occur when the head is involved in bodily injury. Traumatic brain injury (TBI) related to bicycle accidents accounts for three-fourths of deaths. Despite the risk, many bicycle riders go without wearing helmets, largely due to lack of ownership. Purpose and Objective: The purpose of this Doctor of Nursing Practice (DNP) project was to develop and implement a pilot bicycle helmet program for a pediatric population, ages 5-13, from a pediatric emergency department (PED) perspective. The project objective was to increase bicycle helmet use among participants' children by providing the child with a free bicycle helmet, and also providing the parent with education specifically related to the importance of bicycle helmet safety. The project was driven through the Health Belief Model, and utilized the Teachable Moment of a PED encounter to influence risk-reducing behavior. Methods: This DNP project utilized a quasi-experimental, one group, pre- and post-test design. Participants were recruited from an urban PED, and identified at triage as being involved in a bicycle accident. Eligible children were fitted for a free bicycle helmet, and the parent was provided with an educational session coupled with a handout for home. A one-month follow-up phone call was conducted to assess bicycle helmet use and education retainment following the intervention. Results: All participants reported an increase in bicycle helmet use by their children. This study was able to show statistical significance related to bicycle helmet use, thus the null hypothesis was fairly confidently rejected. However, there were only five participants in this study, which makes generalization of results to a larger population difficult. Conclusions: This study showed that a bicycle helmet program is feasible in a PED, and could increase bicycle helmet use in a pediatric population. A DNP is an excellent candidate to run such a program as it focuses on positively impacting injury-prevention and dissemination of good practice for a larger community.