Improving Newborn Car Seat Safety Before Hospital Discharge [paper]




Mowry, Shelby

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Background: A significant cause of infant and childhood injuries and mortality is motor vehicle accidents. Assessment and remediation studies have determined there are many common errors parents make regarding positioning of a newborn in a car safety seat (CSS). A multi-phased project was undertaken to determined CSS misuse rates at baseline and after implementing newborn CSS positioning educational strategies among parent/newborn dyads at a large urban 60-bed postpartum unit. Method: A 12 registered nurse trained quality improvement team using a 7-point checklist, based on positioning recommendations from the American Academy of Pediatrics, conducted dyad assessments at baseline and phase I (N=192). In phase I, a step-by-step CSS positioning educational pamphlet was added to mothers’ discharge teaching. In phase II, a CSS positioning YouTube demonstration video was designed, developed and evaluated by registered nurses working in the field of maternal-child health. Phase II data collection metrics included website viewing and educational tool evaluation of the CSS parental video in continuation of the Plan-Do-Study-Act process. Results: At baseline CSS 7-point criteria was met by few (n=20; 20.8%) dyads with most dyads (n=76) demonstrating one or more positioning errors. Shoulder-strap misalignment was the highest criteria missed. After education, CSS criteria was met by 67 (69.8%) dyads. For phase II, the video was evaluated by 14 registered nurses, the rubric scores ranged from 92 to 100, with a mean score of 96.79%. Nurses determined the CSS educational pamphlet and video to be useful tools in parental education. Conclusion: CSS positioning education at the point of care supports parent safety behaviors. At this facility, nursing staff are poised to implement video applications in their patient education. However, further study would be necessary to measure pamphlet versus video education effectiveness.


A capstone project submitted to the St. David's School of Nursing at Texas State University in partial fulfillment of the requirements for the degree of Master of Science in Nursing, May 2019.


newborns, child passenger safety, injury prevention, safety policies, Nursing


Mowry, S. (2019). Improving newborn car seat safety before hospital discharge. St. David's School of Nursing, Texas State University.


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