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Sample: Four women self-identified as of Hispanic descent,who had at least 2 children with one younger than 5 years,were asked to participate in this pilot. The women wererecruited from various community settings. Because thepurpose of this pilot was to test the interview questions, only4 subjects were used in the pilot.

Methodology: The investigator conducted audiotaped, semi-structured interviews in the homes of the participants. Aninterview guide was used during the interview, yet theinterview process was iterative. Tapes where transcribedverbatim by a bilingual/bicultural trained transcriptionistand analyzed in the participant’s language of choice. Codesand themes extracted from the interview in Spanish wheretranslated into English. Because the purpose of this pilot wasto test the ethnographic questions, trustworthiness of the datawas limited to and established by the use of an audit trail byan expert qualitative nursing researcher.

Preliminary Results: The women in the study had clear viewsof how to prevent injuries in their children. Controlling achild’s environment by childproofing the home, using carseats, maternal watchfulness, and vigilance by bLa VirgenQ(religious beliefs) were the most common behaviors used bythe 4 participants.

Preliminary Conclusions: Hispanic mothers in this pilotstudy appeared to use injury prevention strategies recom-mended by experts. They also strongly believed that their ownwatchfulness and bLa VirgenQ vigilance was the main way ofprotecting their children. Abiding by the law and monetaryfines appeared were also motivators for car seat use. Thesepreliminary findings show the need to evaluate child injuryprevention practices currently used at home during ED visitsin order to establish what mothers are actually implementing.

Funding: NIH/NINR F31 NR 08174

doi: 10.1016/j.jen.2004.07.013

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RESEARCH POSTERS

8. Earthquakes in El Salvador: Mental Health and Psychoso-cial Effects. Audrey Snyder, RN, MSN, CEN, ACNP, Joanna

Woersching, RN, BSN, University of Virginia, School of Nursing/

Emergency Medicine, McLeod Hall, PO Box 800699, Charlottes-ville, VA 22908-0699

Purpose: In 2001, the mountain town of San Sebastian, ElSalvador, experienced a series of earthquakes affecting thelivelihood of the community. This geographically isolatedcommunity had to provide for its own needs without anyinternational support. The ability to recover is inf luenced by anumber of factors. The purpose of this study was to identifyvariables that affect an earthquake victim’s mental health, andto identify the commonly reported mental health complaints.The goal was to provide health officials with information todevelop a mental health-screening tool for their community.

Design/Setting/Sample: A convenience sample of 100 house-holds, identified by the local Red Cross or local governmentpublic health clinic, including 594 inhabitants of SanSebastian and the surrounding rural farming areas, were askedto complete a health assessment survey. The oral survey wasadministered 6 months after 2 devastating earthquakes.Inclusion criteria was residency in the town of San Sebastian(41%) or in the rural farming area (59%) surrounding thetown and age of 18 years when interviewed. Of therespondents, 30% were male and 70% female. The meanage was 45 years, with a range of 18 to 86 years.

Methodology: One study participant willing to complete thesurvey from each household was evaluated for mental healthand psychosocial changes after the earthquakes as a part of anoverall community health assessment. A questionnaire wasused to investigate the relationship between physical health,access to health care, housing, food and water, and the occur-rence of negative mental health markers. The mental healthsection consisted of 10 questions that were part of the larger32 question oral survey. The mental health survey questionsref lected the general symptoms of general depressive disordersand anxiety disorders of the Diagnostic Statistical Manual ofMental Health Disorders. Descriptive statistics were compiledwith SPSS. A chi-square test of independence identifiedstatistical significance between individual respondent variablesand the presence of 6 or more negative mental health markers.

Results: The findings indicated that the majority (67%) ofrespondents experienced 6 or more mental health complaintscontinuously for 2 or more weeks after the earthquakes. The2 most frequent complaints were having thoughts of deathand feeling sad or depressed. A change in household incomeand loss of job, a new illness or a new injury in the house-hold, the need to utilize health care services since the earth-quake, and management of chronic illness were risk factorsassociated with multiple negative mental health markers.Participants experienced emotional reactions 6 months fol-lowing the earthquakes. Age and sex were not independentlystatistically significant.

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Conclusions: The findings indicate a need for rapid, acutemental health screening with at-risk groups and the need toeducate the entire community regarding what medical andmental health treatments are available to reduce barriers totreatment and increase public awareness. The mental healthtool may be used by nurses to identify at risk groups forposttraumatic stress, anxiety, or depression following anearthquake and to provide rapid initial and intermediateassessment for mental health.

doi: 10.1016/j.jen.2004.07.014

9. Strategies Used by Nurses to Recover Medical Errors in anAcademic ED Setting. Fidela S.J. Blank, RN, MN, MBA,

Baystate Medical Center, 759 Chesnut St, Springfield, MA 01199

Purpose: The Institute of Medicine estimated that 98,000people die nationwide each year because of medical errors. Thepurpose of this study is to describe strategies that ED nursesuse to recover medical errors. The concept of humanbrecoveryQ as it relates to nursing is the process of interruptingan incident that has the potential to negatively affect thepatient. When the recovery process is effective, the resultis termed a bnear-miss,Q meaning that an adverse outcomewas averted.

Design/Setting: The investigators conducted focus groupsof ED nurses at a large, academic medical center located inan urban area of Western Massachusetts. This qualitativeresearch was approved by the Institutional Review Board ofthe hospital.

Sample: Posters describing the study, with sign-up sheets,were posted in the ED break room. Twenty staff nurses whohad at least 6 months of ED experience signed informedconsent forms to participate in the study. Each nurse whoparticipated received a stipend of $50.

Methodology: Eindhoven’s near-miss model serves as theframework for this study. A list of prepared questions wereasked during the focus groups to elicit discussion of the nurse’srole in the 3 phases of error recovery, namely identifying,interrupting, and correcting errors. Four focus groups wererun using Krueger and Casey’s methods. The sessions wereaudiotaped and investigators took field notes during the ses-sions. The audiotapes were transcribed; transcriptions werereviewed by the investigators, and later given to participantsfor any corrections. A comprehensive summary was generated.Summary transcripts were analyzed for patterns, trends, andthemes by the investigators (2 PhD nurses, 1 MN nurse, andone MD).

Results: Identified strategies include the following. One, iden-tifying errors: the strongest strategy is having a high level ofawareness for the potential for error in their everyday practice,expressed by constant monitoring and double-checking.Second, interrupting errors: assertiveness is an essential traitfor interrupting errors and mostly comes with experience.Third, correcting errors: a sense of team work and sharedresponsibility is important in correcting errors; if all else fails,a strategy mentioned by most is notifying either the super-vising physician or the nurse manager.

October 2004 30:5

Conclusions: ED nurses prevent many medical errors fromadversely affecting patients. Key factors in error recovery arecommunication and teamwork. Knowledge of strategies usedby emergency nurses to recover errors can be used in severalways to improve patient outcomes. Future research shouldlook at ways ED nurses can be supported by the system intheir role in error recovery.

doi: 10.1016/j.jen.2004.07.015

10. A Comparison of Injury Patterns in Women After Consen-sual Intercourse. Sarah L. Anderson, RN, MSN, Sandra L.

Annan, RN, MSN, Natalie McClain, RN, MSN, PNP, Barbara

Parker, PhD, FAAN, Cheryl M. Bourguignon, PhD, RN, Scott

Syverud, MD, University of Virginia Emergency Department &

School of Nursing, PO Box 801458, Charlottesville, VA 22908

Purpose: Because of the importance of documenting thepattern and extent of injuries in a sexual assault examination,there is ongoing interest in identifying types and patterns ofinjuries following consensual intercourse. Sexual assault nurseexaminers are often asked during testimony if the injuriesobserved were inconsistent with consensual intercourse. How-ever, until more is known about the injuries following con-sensual intercourse, comparisons are difficult to make. Thespecific aim of the study was to compare genital injury find-ings from 2 groups of study participants: women who hadconsensual intercourse knowing they would be examined fora study (group 1), and women who consented to participateafter they had intercourse (group 2). These studies wereundertaken to further document and understand genitalinjury patterns following consensual intercourse.

Design/Sample/Setting: A descriptive, comparative studydesign was used to study healthy females who were examinedwithin 72 hours of engaging in consensual intercourse. Thestudy was conducted at a university hospital emergencydepartment by sexual assault nurse examiners. The sampleconsisted of 15 healthy nonpregnant female volunteersbetween 18 Q 45 years of age who were recruited throughf lyers placed in designated areas in the community.

Methodology: The women underwent colposcopic examina-tion and photography of the external genitalia using standardsexual assault examination techniques. The number andlocation of the tears, abrasions, ecchymosis, redness, andswelling were documented. The documentation and photo-graphs of all of the cases was peer reviewed by experiencedsexual assault nurse examiners individually and as a group todetermine percent agreement.

Results: Approximately one third of the women in bothgroups were found to have some type of genital injuries (tears,ecchymosis, and abrasions) after consensual intercourse. Therewere no statistical differences between groups based on types,numbers, and location of injuries (m2 = .011, df = 1, P = .46).The nonscheduled examination group had a higher percentage(20%) of abrasions (m2 = 2.32, df = 1, P = .06). There weredifferences found in age (group 1: 29.3 + 6.0 to group 2: 22.1+ 3.8) (P b .05) using an independent t test. Condom use alsowas statistically different (group 1: 19.6% to group 2: 40%)(P = .05) using chi-square.

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