Madeline Sass

Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Galloway, Lynette

Committee Member

Robertson, Sara

Author's Keywords

car safety seats (CSS); self-efficacy; discharge teaching; electronic health record (EHR); education


Background: There is a lack of standardization for car safety seat education to caregivers before hospital discharge. Nationally, 59% of motor vehicle accident deaths occur because the car seat is misused (Greenwall, 2015). The American Academy of Pediatrics (1999) states this is a gap in care because all caregivers need to receive proper car safety seat instruction before discharge. Purpose: This quality improvement project aimed to increase nursing self-efficacy and compliance of registered nurses (RNs) by implementing a standardized CSS discharge intervention. Methods: RNs on the unit were educated with a 7-minute presentation video titled “Car Seat Safety: Discharge Teaching” about the new CSS education discharge process. Following education, the 2-month intervention period began. RN education was documented in the patient’s EHR. A pre-and post-test design was used to assess nursing self-efficacy. At the end of the trial period, EHR education documentation was analyzed. Results: Likert-scale statements number two, four, five, six, and seven all had significant change in self-efficacy mean scores, using a p-value of <0.05. Age and level of education were the most significant demographics that affected self-efficacy. 7% of patient charts had documentation about CSS teaching, Discussion: 60+ age range had lower self-efficacy scores than other age groups. CPSTs didn’t show a difference compared to RNs not certified. The Bachelor’s and Master’s degree groups showed a statistically significant difference for Likert-scale statement four. Further research needs to be conducted on ways to improve CSS documentation.

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Nursing Commons