"The home, the bathroom, the taps, and hot water": The contextual characteristics of tap water scalds in Australia and New Zealand.

INTRODUCTION: Scalds from hot tap water can have devastating consequences and lifelong impact on survivors. The aims of this study were to (i) describe the frequency, demographic profile, injury event characteristics, and in-hospital outcomes for people with tap water scalds admitted to Australian and New Zealand burn centres; and (ii) determine whether variation was present in the frequency and epidemiological characteristics of tap water scalds between jurisdictions. METHODS: Data were extracted from the Burns Registry of Australia and New Zealand for people with tap water scalds admitted to Australian or New Zealand burn centres between January 1, 2010 and December 31, 2018. Demographic, injury severity and event characteristics, surgical intervention, and in-hospital outcomes were investigated. RESULTS: We included 650 people with tap water scalds admitted to Australian and New Zealand burn centres during the study period. Australians with tap water scalds (median [IQR] 29 [1-69] years) were older than New Zealanders (2 [1-36] years). Most tap water scalds occurred in the home, and 92% of these occurred in the bathroom. More than 55% of injuries occurred due to the accidental alteration of water temperature at the tap fixture. Two thirds of patients underwent a surgical wound procedure. The overall mortality rate was 3.7%, and the median hospital length of stay was 8.8 days. CONCLUSION: Tap water scalds remain a public health problem in Australia and New Zealand. Our research highlights where gaps in current heated water regulations in residential homes perpetuate risks of tap water scalds, particularly in high-risk groups at the extremes of age. Extending current heated water regulations to include all Australia and New Zealand homes is urgently needed in conjunction with design safety improvements, and ongoing education of key stakeholders.

Epidemiology of work-related burn injuries presenting to burn centres in Australia and New Zealand.

BACKGROUND: Burn injuries to workers can have a devastating impact, however knowledge of the epidemiology of work-related burn injuries in Australia and New Zealand is limited. PURPOSE: To describe epidemiological characteristics of work-related burn injuries in Australia and New Zealand, and to compare these with non-work-related burns. METHODS: Adult burn injury data, 2009-2016, were extracted from the Burns Registry of Australia and New Zealand. Descriptive statistics were used to describe demographic, injury, management and outcome characteristics. Differences between work-related and non-work-related injuries were assessed using Chi-square and Wilcoxon rank-sum tests. RESULTS: Of 10,574 adult patients treated in burn centres in Australia and New Zealand, 2009-2016, 17% had work-related burns. Most work-related cases were male (85%), less than 35 years old (53%), and had sustained flame (33%), scald (30%) or chemicals (17%) burns. Proportions of chemical, scald and electrical burns were greater for work-related than for non-work-related burns, with this being most marked for chemical and electrical burns (17% vs. 3% and 7% vs. 1%, respectively). CONCLUSIONS: Almost one in five cases of working-aged people admitted to Australian and New Zealand burns centres was work-related. Through identification of vulnerable groups, this study informs policy and strategies to minimise occupational burn risk.

Developing clinical quality indicators for a Bi-National Burn Registry.

BACKGROUND: Clinical quality indicators are routinely used to benchmark and drive improvements in healthcare. There is a dearth of standardised clinical quality indicators established for management of burns that allow quality of care to be monitored and benchmarked across Australia and New Zealand. METHOD: Using published quality indicator development processes and clinician experience, the Bi-National Burn Registry (Bi-NBR) working party developed quality indicators for burn care to be included as routine data items in the Bi-NBR. RESULTS: Twenty indicators covering structure, process and outcome measures were identified. Preliminary testing resulted in further revision to the quality indicators to increase validity, reliability and improve data quality. The quality indicators are routinely collected in the Bi-NBR and reported quarterly. CONCLUSION: This is the first published account of the development and testing of standardised Bi-National clinical quality indicators for burns. The Bi-NBR quality indicators project remains a work in progress and it is hoped that further refinement of the indicators, in conjunction with international collaborators will assist in driving improvements in burn care.