Denise Kendrick Professor of Primary Care Research University of Nottingham Jane Stewart
19
An evaluation of thermostatic mixer valves to reduce bath water temperature in homes of families with young children living in social housing Denise Kendrick Professor of Primary Care Research University of Nottingham Jane Stewart Senior Research Fellow Nottinghamshire Healthcare Trust (NHS Nottinghamshire County) And co- authors
description
An evaluation of thermostatic mixer valves to reduce bath water temperature in homes of families with young children living in social housing. Denise Kendrick Professor of Primary Care Research University of Nottingham Jane Stewart Senior Research Fellow Nottinghamshire Healthcare Trust - PowerPoint PPT Presentation
Transcript of Denise Kendrick Professor of Primary Care Research University of Nottingham Jane Stewart
An evaluation of thermostatic mixer valves to reduce bath water
temperature in homes of families with young children living in social
housing
Denise Kendrick
Professor of Primary Care Research
University of Nottingham
Jane Stewart Senior Research Fellow
Nottinghamshire Healthcare Trust (NHS Nottinghamshire County)
And co- authors
The problem – bath hot tap water scalds in young children
• Each year 2,000 ED attendances, 500 admissions
• Most admissions children < 5years
• Steep social gradient– most deprived most vulnerable
• Domestic hot water temperatures can scald in about a second
• Cost of severe scald ~ £250 000
What is a Thermostatic Mixer Valve (TMV)?
• Engineering solution to reduce the temperature of hot bath tap water temperature
• No active participation by parents required• Mixes hot and cold bath tap water to pre-set
temperature - 46 ºC • Takes 6 hours for a scald at this temperature
Aims of the study
• To assess TMVs for their:
• Effectiveness and cost effectiveness in reducing bath hot water temperature
• Acceptability to families
• Impact on bath time safety practices
– In families with children under the age of 5 years living in social housing
Methods• Randomised controlled trial
– Questionnaire at baseline
• Delivered the intervention – TMV– Educational leaflet– Laminated leaflet on how to use TMV
– Water temperature checks at baseline, 3 and 12 months
– Questionnaire at 12 months follow up
• Fieldwork in Glasgow
Participants124 families completed baseline questionnaire
Intervention arm62
(46 TMVs fitted)
Control arm62
Water temps: baseline n=233 months n=1512 months n=16
Water temps: baseline n=273 months n=1512 months n=15
12 month questionnaire49 still tenants/participating
12 month questionnaire44 still tenants/participating
40 returned (91.9%)
40 returned(81.6%)
Characteristics of participantsCharacteristics Intervention arm
n=62 Control arm
n=62
Mother completed questionnaire 57 (91.9) 58 (93.6)
Single adult household 40 (64.5) 47 (75.8)
Number of children in the home 12
29 (46.8)21 (33.9)
25 (40.3)26 (41.9)
Age respondent left full time education ≤16 38 (73.1) [10] 43 (72.9) [3]
Number of adults in paid employment 01
39 (65.0) [2]16 (26.7)
40 (65.6) [1]17 (27.9)
Family receives state benefits 50 (82.0) [1] 56 (90.3)
Ethnic group of respondent White ScottishBlack African
54 (88.5) [1]6 (9.8)
54 (88.5) [1]3 (4.9)
[ ] missing values
Acceptability of bath hot tap water(baseline)
[ ] missing values
Intervention arm
Control arm
Satisfaction (number (%)) n=62 n=62
Very happy or happy with bath hot tap water temperature 39 (62.9) 37 (59.7)
Bath water is:Very hot – need to add a lot of
cold water to the bathHot – need to add some cold
water to the bath
41 (67.2) [1]
19 (31.2)
38 (61.3)
24 (38.7)
Bath time safety practices
(baseline)
[ ] missing values
Safety practices Intervention arm n=62
Control arm N=62
Runs bath using cold water first 2 (3.2) 9 (14.8) [1]
Bath water temperature checked for every bath
54 (88.5) [1] 54 (88.5) [1]
Child has been left alone in the bath
27 (43.6) 13 (21.0)
Child has been left alone in bathroom whilst bath is running
19 (30.7) 12 (19.4)
Hot bath tap water temperatures at baseline, 3 and 12 months
4050
6070
8090
100
Bas
elin
e w
ater
tem
pera
ture
(de
gre
es C
elsi
us)
Control arm Intervention arm
4050
6070
8090
100
3 m
onth
wat
er t
empe
ratu
re (
degr
ees
Cel
sius
)
Control arm Intervention arm
4050
6070
8090
100
12 m
onth
wat
er t
empe
ratu
re (
deg
rees
Cel
sius
)
Control arm Intervention arm
Were parents satisfied with the TMV?
Intervention arm responders with TMV fitted (n=34)
Very happy or happy with TMV 30 (88.2)
Would recommend TMV to a friend 28 (87.5) [2]
Would not be happy if kitchen and bath hot tap water were same temperature
23 (69.7) [1]
Since having TMV…
Child less likely to be scalded 32 (94.1)
Doesn’t take longer to run bath 22 (68.8) [2]
Easier to control bath water temperature
29 (90.6) [2]
Bath water isn’t hot enough 12 (36.4) [1]
Can no longer top up bath with hot water whilst in the bath
9 (27.3) [1]
Acceptability of bath hot tap water (follow up)
Intervention arm
Responders n=40 (%)
Control arm
Responders n=40 (%)
Relative Risk (95% CI)
Very happy or happy with bath hot tap water temperature
32 (82.1) [1]
23 (57.5)1.43 (1.05, 1.93)
Bath water is:Very hot – need to add a lot
of cold water to the bathHot – need to add some cold
water to the bathWarm enough - don’t need to
add any cold water to the bath
7 (18.0) [1]
16 (41.0)
14 (35.9)
22 (55.0)
18 (45.0)
0 (0.0)
0.33 (0.16, 0.68)†
Bath time safety practices (follow up)
Intervention arm responders n=40(%)
Control arm responde
rs n=40(%)
Relative Risk (95% CI)
Runs bath using cold water first*5 (12.5) 11 (27.5) 0.55 (0.22, 1.39)
Bath water temperature checked for every bath
32 (84.2) [2] 40 (100.0) 0.84 (0.73, 0.97)
Child has been left alone in the bath* 13 (32.5) 8 (20.5) [1] 1.11 (0.51, 2.41)
Child has been left alone in bathroom whilst bath is running*
12 (30.8) [1] 9 (22.5) 1.28 (0.62, 2.68)
Health economic analysisProfessor Ceri Phillips - Swansea University
•NHS costs to treat a scald – •range from £25, 226 - £71, 902
• Cost-effectiveness analysis indicated a potential saving to the NHS of
£3, 229, 008
• £1.41 saved for every £1 spent
Summary
• TMVs are effective in reducing bath hot tap water temperature
• Majority of parents satisfied with the TMV and the temperature
• Would recommend a TMV to a friend
• Feel child less likely to be scalded
• However, parents checking temperature of bath water less often
• A third of people reported bath water not hot enough
Implications• Suggests that parents are willing to
trade some inconvenience for increased safety
• TMVs should be considered as a scald prevention intervention for families with children
• Important to reinforce bath time safety messages about checking the water temperature and leaving children alone in the bath
• Cost effective solution – requires interagency working – spend money in one sector to save money in another
Funding
• Policy Research Programme (PRP) at the Department of Health -Accidental Injury Prevention Research Initiative (001/0009)
• The final study design, data collection, analysis, interpretation of results, and paper writing was the sole responsibility of the authors. The views and opinions expressed in this paper do not necessarily reflect those of the funding body. This is an independent report commissioned and funded by the Policy Research Program in the Department of Health. The views expressed are not necessarily those of the Department.
Thank you for
listening!
Any questions?
