Implementation of a Comprehensive Program to Improve Child Physical Abuse Screening and Detection in the Emergency...

Area of Science:

• Pediatrics
• Emergency Medicine
• Public Health

Background:

• Children presenting to the emergency department (ED) with abuse-related injuries are often not consistently screened for abuse by ED providers.
• This lack of consistent screening can lead to undetected abuse, increasing risks of reinjury and death.
• Providers often lack the knowledge or confidence necessary for effective child abuse screening and detection.

Purpose of the Study:

• To implement and evaluate an evidence-based quality improvement project focused on child physical abuse screening in the ED.
• The project aimed to enhance provider knowledge and confidence through education, a systematic screening protocol, and the validated Escape Instrument.

Main Methods:

• A pre-test/post-test design was employed to assess changes in ED provider knowledge and confidence following a 20-minute educational session.
• Child physical abuse diagnostic codes were analyzed for a 30-day period before and after protocol implementation.
• A follow-up survey was conducted 4 months post-implementation to evaluate the screening program's impact.

Main Results:

• Significant improvements were observed in provider knowledge and confidence scores related to child physical abuse screening and recognition (P < .001).
• No significant difference was found in providers' diagnostic coding of child physical abuse.
• The educational session and the Escape Instrument were identified as key facilitators, while the transition to a new electronic health system posed a barrier.

Conclusions:

• Comprehensive screening programs effectively enhance ED provider knowledge and confidence in identifying child physical abuse.
• Further research is warranted to investigate the direct impact of such screening programs on the diagnosis and treatment of child physical abuse.