Detecting child abuse at the Emergency Department based on parental characteristics

2.50
Hdl Handle:
http://hdl.handle.net/10755/344150
Category:
Abstract
Type:
Poster
Title:
Detecting child abuse at the Emergency Department based on parental characteristics
Author(s):
Diderich, Hester
Lead Author STTI Affiliation:
Non-member
Author Details:
Hester Diderich, RN, CEN
Abstract:
Evidence-based Practice Abstract Purpose Identifying child abuse and neglect solely on the grounds of child characteristics leaves many children undetected. We developed a new approach (Hague protocol) for nurses and doctors, based on characteristics of parents who attend the Emergency Department (ED). The goal of this protocol is to enable the Reporting Center for Child abuse and neglect (RCCAN) to rapidly assess family problems and offer voluntary community based support to these parents. Aim of this study is to assess whether this protocol for screening adults presenting for care in the Emergency Department can identify children at high risk for maltreatment. Design We used a quasi-experimental pretest-posttest design with a non-randomized control group. Positive Predictive Value (PPV) was determined by calculating the proportion of true positives. This was done by calculating the number of referred cases where child abuse was confirmed, as a proportion of the total number of referred cases. Setting The study was carried out in three regions in the Netherlands, one intervention region where the new protocol was introduced and two control regions. The Hague protocol was introduced in the inner city of The Hague with two large inner city hospitals and three smaller local hospitals, all with EDs. The two control regions are rural areas; Flevoland and Zuid-Limburg with all together, five small hospitals with EDs and one University hospital. Participants All parents attending the adult ED because they have the following problems: 1) intimate partner violence, 2) substance abuse, or 3) suicide attempt or other serious psychiatric problems. Method A before and after study, conducted at 9 EDs in 3 regions in the Netherlands (one intervention region and 2 control regions). Results During the period January 2006 to November 2007, prior to the introduction of the Hague protocol, a total of 4 parents of 385,626 patients attending the ED in the intervention region (1 per 100,000) were referred to the RCCAN. In the period after introduction of the protocol (December 2007 to December 2011), the number rose to 565 parents of 885,301 patients at the ED (64 per 100,000). In the control region where the protocol was not implemented these figures were 2 per 163,628 (1 per 100,000) and 10 per 371,616 (3 per 100,000) respectively (OR = 28.0 (95 CI 4.6 – 170.7)). At assessment, child abuse was confirmed in 91% of referred cases. Implications Implementing guidelines for ED nurses and doctors to detect child abuse based on parental characteristics of parents attending the adult section of the ED can increase the detection rate of child abuse and neglect, allowing appropriate aid to be initiated for these families.
Keywords:
Child Abuse; Detecting Child Abuse; Parental Characteristics of child abusers
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Center
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleDetecting child abuse at the Emergency Department based on parental characteristicsen_GB
dc.contributor.authorDiderich, Hesteren_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsHester Diderich, RN, CENen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344150-
dc.description.abstractEvidence-based Practice Abstract Purpose Identifying child abuse and neglect solely on the grounds of child characteristics leaves many children undetected. We developed a new approach (Hague protocol) for nurses and doctors, based on characteristics of parents who attend the Emergency Department (ED). The goal of this protocol is to enable the Reporting Center for Child abuse and neglect (RCCAN) to rapidly assess family problems and offer voluntary community based support to these parents. Aim of this study is to assess whether this protocol for screening adults presenting for care in the Emergency Department can identify children at high risk for maltreatment. Design We used a quasi-experimental pretest-posttest design with a non-randomized control group. Positive Predictive Value (PPV) was determined by calculating the proportion of true positives. This was done by calculating the number of referred cases where child abuse was confirmed, as a proportion of the total number of referred cases. Setting The study was carried out in three regions in the Netherlands, one intervention region where the new protocol was introduced and two control regions. The Hague protocol was introduced in the inner city of The Hague with two large inner city hospitals and three smaller local hospitals, all with EDs. The two control regions are rural areas; Flevoland and Zuid-Limburg with all together, five small hospitals with EDs and one University hospital. Participants All parents attending the adult ED because they have the following problems: 1) intimate partner violence, 2) substance abuse, or 3) suicide attempt or other serious psychiatric problems. Method A before and after study, conducted at 9 EDs in 3 regions in the Netherlands (one intervention region and 2 control regions). Results During the period January 2006 to November 2007, prior to the introduction of the Hague protocol, a total of 4 parents of 385,626 patients attending the ED in the intervention region (1 per 100,000) were referred to the RCCAN. In the period after introduction of the protocol (December 2007 to December 2011), the number rose to 565 parents of 885,301 patients at the ED (64 per 100,000). In the control region where the protocol was not implemented these figures were 2 per 163,628 (1 per 100,000) and 10 per 371,616 (3 per 100,000) respectively (OR = 28.0 (95 CI 4.6 – 170.7)). At assessment, child abuse was confirmed in 91% of referred cases. Implications Implementing guidelines for ED nurses and doctors to detect child abuse based on parental characteristics of parents attending the adult section of the ED can increase the detection rate of child abuse and neglect, allowing appropriate aid to be initiated for these families.en_GB
dc.subjectChild Abuseen_GB
dc.subjectDetecting Child Abuseen_GB
dc.subjectParental Characteristics of child abusersen_GB
dc.date.available2015-02-04T11:27:24Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:24Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Centeren_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_GB
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