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Screening methods to detect child maltreatment: high variability in Dutch emergency departments
Eva M M Hoytema van Konijnenburg1, Arianne H Teeuw, Sophie A Zwaard
1Department of Social Paediatrics, Emma Children's Hospital, Academic Medical Center Amsterdam, , Amsterdam, The Netherlands.
Insights
Child maltreatment screening varies widely across Dutch emergency departments. Most methods lack empirical evidence, highlighting a need for standardized, evidence-based approaches in child protection.
Area of Science:
- Pediatrics
- Public Health
- Emergency Medicine
Background:
- Mandatory child maltreatment screening is in place in all Dutch emergency departments.
- Current screening methods employed are not well-defined.
- This study aims to identify and evaluate existing screening practices.
Purpose of the Study:
- To overview child maltreatment screening methods used in Dutch emergency departments.
- To assess the empirical substantiation of these screening methods.
Main Methods:
- A nationwide survey of all emergency departments in the Netherlands was conducted.
- Screening checklists were collected and compared against existing literature.
- Data on screening practices, including checklists, physical exams, and parental risk factors, were analyzed.
Main Results:
- 80 out of 85 approached hospitals completed the survey, with 77 providing screening checklists.
- All hospitals utilize screening checklists, with variations in other methods: 41% use physical exams, 60% parental risk factors, and 3% chart reviews.
- Empirical evidence supporting most methods is lacking; 73% use un-reported checklists.
Conclusions:
- Significant heterogeneity exists in child maltreatment screening methods across Dutch emergency departments.
- The majority of screening practices lack a basis in empirical evidence.
- There is a critical need for evidence-based, standardized screening protocols.
Background:
In the Netherlands, screening for child maltreatment is mandatory in all emergency departments but it is unclear which screening methods are being used. As a first step towards implementation of a universal screening method across all emergency departments, we assessed the currently used screening methods.
Objective:
To provide an overview of the screening methods for child maltreatment across all emergency departments in the Netherlands and to assess their empirical substantiation.
Methods:
We surveyed all emergency departments in the Netherlands using a questionnaire on screening methods. All screening checklists used in emergency departments were assembled and compared with the literature.
Results:
85 hospitals with an emergency department were approached, 80 of which completed the questionnaire and 77 provided copies of their screening checklists. All participating hospitals use a screening checklist, 41% a screening physical examination, 60% a screening based on parental risk factors and 3% a retrospective review of all charts. The empirical substantiation for these screening methods is largely lacking, and at least 73% of the hospitals use a checklist that has not been reported in the literature.
Conclusions:
Large variations in screening methods exist across emergency departments in the Netherlands, most of which are not based on empirical evidence.
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