Details

Autor(en) / Beteiligte

• Martin, Nolan
• Claypool, Anneke L.
• Diyaolu, Dupe
• Chan, Katy
• A’Neals, Elizabeth
• Iyer, Karan
• Stewart, Christopher C.
• Egge, Melissa
• Bernacki, Krysta
• Hallinan, Michelle
• Zuo, Linda
• Gupta, Urvi
• Naru, Navleen
• Scheinker, David
• Morris, Arden M.
• Brandeau, Margaret L.
• Chao, Stephanie

Titel

SCAN for abuse: Electronic health record-based universal child abuse screening

Ist Teil von

• Journal of pediatric surgery, 2024-02, Vol.59 (2), p.337-341

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• Identification of physical abuse at the point of care without a systematic approach remains inherently subjective and prone to judgement error. This study examines the implementation of an electronic health record (EHR)-based universal child injury screen (CIS) to improve detection rates of child abuse. CIS was implemented in the EHR admission documentation for all patients age 5 or younger at a single medical center, with the following questions. 1) “Is this patient an injured/trauma patient?” 2) “If this is a trauma/injured patient, where did the injury occur?” A “Yes” response to Question 1 would alert a team of child abuse pediatricians and social workers to determine if a patient required formal child abuse clinical evaluation. Patients who received positive CIS responses, formal child abuse work-up, and/or reports to Child Protective Services (CPS) were reviewed for analysis. CPS rates from historical controls (2017-2018) were compared to post-implementation rates (2019-2021). Between 2019-2021, 14,150 patients were screened with CIS. 286 (2.0%) patients screened received positive CIS responses. 166 (58.0%) of these patients with positive CIS responses would not have otherwise been identified for child abuse evaluation by their treating teams. 18 (10.8%) of the patients identified by the CIS and not by the treating team were later reported to CPS. Facility CPS reporting rates for physical abuse were 1.2 per 1000 admitted children age 5 or younger (pre-intervention) versus 4.2 per 1000 (post-intervention). Conclusions: Introduction of CIS led to increased detection suspected child abuse among children age 5 or younger. Study of Diagnostic Test, Level II. •Although the adverse effects of child maltreatment are well known, guidelines for maltreatment screening remain scarce.•Application of a standardized framework for physical child abuse screening allowed for improved detection of physical abuse. A lack of standardized metrics for abuse reporting prevents effective comparisons of screening performance between institutions.