P3.K215: Promoting Water Safety at the Nine Month Well Child Check: A Quality Improvement Project at the University of South Florida

Purpose/Objectives: Drowning is the leading cause of injury death in US children one to four years old. From 2018 to 2020, Florida had the highest rate of unintentional drowning death among children one to four years old. Parents need to be educated on how to properly prevent drowning with multiple layers of protection.
Our primary objective was to increase water safety anticipatory guidance provided by USF pediatric residents to caretakers at the nine-month well child check (WCC). Our secondary objective was to educate University of South Florida (USF) pediatric residents about AAP water safety recommendations and available community resources.

Design/Methods: Prior to starting our project, water safety was discussed in 15% of visits. Our aim was to increase water safety counseling at nine-month WCC at USF pediatric clinics by 20% from baseline (35% of visits) by 6/30/2024.
Intervention one was implementing a change to the nine-month WCC template. This template prompted providers to screen for water exposure. Intervention two was a resident lecture discussing AAP water safety recommendations and local resources. At this time, a “dot phrase” was introduced that included AAP water safety information, local swim lessons, and local CPR classes.

Results: Prior to any interventions, 58% of residents reported providing water safety education during less than 1/4 of visits. Additionally, 64% of residents reported that they screen for water exposure in less than 1/4 of visits. More than half of residents did not know where to find local swim lessons. 100% of residents felt it was important to discuss water safety.
After intervention one, 40% of residents screened for water exposure, however, only 6% of residents educated about water safety. 0% of the patients that positively screened for water exposure received water safety education. After intervention two, 83% of residents screened for water exposure and 25% of residents educated about water safety. 100% of the patients that positively screened for water exposure received water safety education. However, 0% of the patients that screened negatively for water exposure received water safety education.

Conclusion/Discussion: After intervention one, screening for water exposure increased by 40%, but only 6% of residents were providing water safety education. After intervention two, there was an increase in screening by 83% from baseline and an increase in education provided by 10% from baseline. However, after two interventions we are still below our goal to increase water safety counseling by 20%. Additionally, 0% of patients that screened negatively for water exposure received water safety education. Future interventions planned include further resident education to provide anticipatory guidance despite negative screening for water exposure as well as implementation of a visible reminder to discuss water safety at resident workstations.