Facilitators and barriers to screening for child abuse in the emergency department

BMC Pediatrics

Henriëtte A Moll¹  Harry J De Koning²  Marjo J Affourtit¹  Ida J Korfage²  Eveline CFM Louwers¹ 

[1]Department of Pediatrics, Erasmus MC-Sophia Children’s Hospital, Dr. Molewaterplein 60, 3015, GJ, Rotterdam, The Netherlands

[2]Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000, CA, Rotterdam, The Netherlands

关键词: Qualitative study;    Screening;    Emergency department;    Child abuse;   

Others  :  1170625
DOI  :  10.1186/1471-2431-12-167

 received in 2012-03-18, accepted in 2012-09-26,  发布年份 2012

【 摘 要 】

Background

To identify facilitators of, and barriers to, screening for child abuse in emergency departments (ED) through interviews with ED staff, members of the hospital Board, and related experts.

Methods

This qualitative study is based on semi-structured interviews with 27 professionals from seven Dutch hospitals (i.e. seven pediatricians, two surgeons, six ED nurses, six ED managers and six hospital Board members). The resulting list of facilitators/barriers was subsequently discussed with five experts in child abuse and one implementation expert. The results are ordered using the Child Abuse Framework of the Dutch Health Care Inspectorate that legally requires screening for child abuse.

Results

Lack of knowledge of child abuse, communication with parents in the case of suspected abuse, and lack of time for development of policy and cases are barriers for ED staff to screen for child abuse. For Board members, lack of means and time, and a high turnover of ED staff are impediments to improving their child abuse policy. Screening can be promoted by training ED staff to better recognize child abuse, improving communication skills, appointing an attendant specifically for child abuse, explicit support of the screening policy by management, and by national implementation of an approved protocol and validated screening instrument.

Conclusions

ED staff are motivated to work according to the Dutch Health Care Inspectorate requirements but experiences many barriers, particularly communication with parents of children suspected of being abused. Introduction of a national child abuse protocol can improve screening on child abuse at EDs.

【 授权许可】

   
2012 Louwers et al.; licensee BioMed Central Ltd.

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