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Child protection procedures in emergency departments

By Peter Sidebotham, T. Biu and L. L. (Lisa L.) Goldsworthy

Abstract

Background: Emergency departments (EDs) may be the first point at which children who have been subject to abuse or neglect come into contact with professionals who are able to act for their protection. In order to ascertain current procedures for identifying and managing child abuse, we conducted a survey of EDs in England and Northern Ireland. \ud \ud Methods: Questionnaires were sent to the lead professionals in a random sample of 81 EDs in England and 20 in Northern Ireland. Departments were asked to provide copies of their procedures for child protection. These were analysed qualitatively using a structured template. \ud \ud Results: A total of 74 questionnaires were returned. 91.3% of departments had written protocols for child protection. Of these, 27 provided copies of their protocols for analysis. Factors judged to improve the practical usefulness of protocols included: those that were brief; were specific to the department; incorporated both medical and nursing management; included relevant contact details; included a single page flow chart which could be accessed separately. 25/71 (35.2%) departments reported that they used a checklist to highlight concerns. The most common factors on the checklists included an inconsistent history or one which did not match the examination; frequent attendances; delay in presentation; or concerns about the child’s appearance or behaviour, or the parent–child interaction. \ud \ud Conclusions: There is a lack of consistency in the approach to identifying and responding to child abuse in EDs. Drawing on the results of this survey, we are able to suggest good practice guidelines for the management of suspected child abuse in EDs. Minimum standards could improve management and facilitate clinical audit and relevant training. \ud \u

Topics: HV, RA
Publisher: BMJ Group
Year: 2007
OAI identifier: oai:wrap.warwick.ac.uk:3854

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Citations

  1. Audit of child protection procedures in accident and emergency department to identify children at risk of abuse. doi
  2. (2001). Burns and scalds in pre-school children attending accident and emergency: accident or abuse? Emerg Med J doi
  3. (2006). Child abuse fatalities: are we missing opportunities for intervention? Pediatr Emerg Care doi
  4. Documentation of child physical abuse: how far have we come? doi
  5. (2003). Early indicators of child abuse and neglect: a multiprofessional Delphi study. Child Abuse Review doi
  6. (2002). Early prediction and prevention of child abuse.
  7. (2006). Education and Skills. Working together to safeguard children.
  8. (1997). Effect of a screening profile on the diagnosis of nonaccidental burns in children. Pediatr Emerg Care doi
  9. (1993). Etiology of child maltreatment: a developmental-ecological analysis. doi
  10. (2005). Health. Safeguarding children. The second joint Chief Inspectors’ Report on Arrangements to Safeguard Children.
  11. (2003). Health. What to do if you’re worried a child is being abused. London: Department of Health,
  12. (1999). Health. Working together to safeguard children. London: The Stationery Office,
  13. (2003). Keeping children safe: the government’s response to the Victoria Climbie ´ inquiry report and joint chief inspectors’ report safeguarding children. London: Department for Education and Skills, Department of Health, Home Office,
  14. National audit of emergency department child protection procedures. doi
  15. (1984). Prediction of child abuse: a prospective study of feasibility. doi
  16. Red skies, risk factors and early indicators. Child Abuse Review doi
  17. (2004). Royal College of Paediatrics and Child Health. Responsibilities of doctors in child protection cases with regard to confidentiality. London: Royal College of Paediatrics and Child Health, doi
  18. (2007). Royal College of Paediatrics and Child Health. Services for children in emergency departments: report of the Intercollegiate Committee for Services for Children in Emergency Departments.
  19. Simple intervention to improve detection of child abuse in emergency departments. doi
  20. The Child Protection Register: a tool in the accident and emergency department? doi
  21. (2003). The Victoria Climbie inquiry. doi

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