Two page paper

Running head: CHILD ABUSE & NEAR MISSES ON ADMISSION

CHILD ABUSE & NEAR MISSES ON ADMISSION

Samantha Flores, Farah Elitani, Josephine Scott, Amanda Montgomery, and Thuy Nguyen

Child Abuse & Near misses on admission

Chamberlain University

NR452

Child Abuse & Near misses on admission

Child abuse, which is also known as child maltreatment, is considered as a physical, psychological, or sexual mistreatment or neglect of a child either by a parent, or caregiver, or any individual. The rate of child abuse is continuously increasing at a constant rate across the globe. Child abuse usually includes certain acts, committed by the parents or caregivers that result in potential harm to the kids. Such situations may occur anywhere either at home, or in society, or at schools. The government has developed serious legislation and jurisdictions against the maltreatment of the children because of various physical and psychological complications (Zeanah & Humphreys, 2018). The prevalence rate of childhood abuse is higher at the global level.

World Health Organization has identified that the rate of child abuse has varied rapidly in the United States of America. It has been estimated that around 14,000 children have reported some sort of abuse annually in the year 2014; out of which, 15 children committed suicide. Similarly, the National Research Council has also shown that 37% of the children have experienced several complications due to child abuse, which have affected their physical and psychological processes (Zeanah & Humphreys, 2018). Near misses have been identified as an inappropriate practice, in which child abuse is mainly neglected unintentionally by the healthcare professionals during the time of admission. The cases of such negligence have also been reported, which has resulted in the development of mild to severe complications. The emergency department professionals must report such cases immediately so that further processes can be followed. However, near misses cases during the time of admission have been witnessed and reported regarding child abuse (Afifi, et al. 2016). Therefore, the project has aimed to focus on the health issue of child abuse along with the near misses cases of such children.

Importance

There is a need to understand the impact of child abuse over children to know about the significance of this issue. Child abuse is a severe condition, which needs to be diagnosed as early as possible to reduce the risk of various complications. At the time of admission, the diagnosis of child abuse is helpful for the child to recover from the underlined health issue along with future complications. Therefore, it is said that there is a need to know about future complications associated with child abuse. It has been evaluated that child abuse has an immediate impact physically because of its association with developmental issues (Afifi, et al. 2016). Similarly, chronic physical effects along with severe psychological impact can also be witnessed among the children.

Health behaviors and ill-health are common effects of child abuse. Emotionally, a child usually forms severe distress and anxiety because of child abuse. Mostly, the children, facing the issue of child abuse, usually suffer from ignorance, being terrorized by society, or humiliated by the social circle. Shaken body syndrome and impaired brain development are two common physical issues associated with child abuse. Similarly, poor physical health and exposure to violence are also common effects of child abuse (Badoe, 2017). Therefore, it can be said that such healthcare issues have a direct impact on the quality of life among children.

As mentioned above, there are mild to severe complications associated with child abuse. There is a need to understand such complications and their relative aspects related to the physical and psychological health of children. Therefore, the cases of near misses of child abuse during the time of admission must be reduced through an effective approach. In such a way, this topic is extremely important to discuss and develop a thorough strategy for researching the causes of near misses. Similarly, there is a need to develop different recommendations for better addressing the highlighted issue.

Patient Population

According to Greene & Bennett (2019), an estimated 7.5 million children per year are reported to the Child Protective Services (CPS) for maltreatment. The maltreatments were nonaccidental trauma (NAT) pertaining to cutaneous trauma such as burns and bruises, oral trauma, eye injuries, intra abdominal and intrathoracic injuries, fractures, and abusive head trauma. Estimated child abuse was from 4% to 16% of all children and many go unreported (Greene & Bennett, 2019). The number of children fatalities in 2017 were 1688, which is more than the number of children who died from cancer (Greene & Bennett, 2019). The leading causes of death were abusive head trauma among children younger than the age of 3, which represents 70% of fatal cases from child abuse (Greene & Bennett, 2019).

There are different risk factors related to the child, parent, or environment that could contribute to child abuse. If these risk factors could be addressed then child abuse could possibily be prevented. Some of the child risk factors were challenging developmental stages, chronic medical illness, behavioral issues, unplanned pregnancy, prematurity, or physical disabilities (Greene & Bennett, 2019). Risk factors that were parent-related were substance or alcohol abuse, mental illness, poor self-esteem, being a single parent, impulsivity, young age, or history of child abuse as a child (Greene & Bennett, 2019). Environmental risk factors included non-male relatives residing in the home, poverty, low education level, social isolation, unemployment, or intimate partner violence.

As stated by Greene & Bennett (2019), mandate reporting to CPS if there is reasonable suspicion or reason to believe abuse or neglect has occurred, even if there is no definitive proof. Prompt reporting to CPS is important, as the safety of other children may be a concern (Greene & Bennett, 2019). Mandate reporting is one way of acting in a beneficence way for this patient population. By reporting this to the right authorities, justice can be served and brought to the situation. This patient population relies on adults to act in a non-maleficence manner and advocate for their well-being.

Proposed Solution

Too many cases of unreported cases of child abuse go missed when these children are admitted into the hospital. Many times the health care system is the first point of contact for children who have experienced abuse or is currently experiencing abuse. One of the main reasons health professionals do not report child abuse is missing the possible warning signs and not having the proper training in their career to know what signs to look out for in children. Screening protocols and improved specialized training for hospital staff can help reduce the amount of child abuse cases missed on admission. Educational sessions, a screening protocol and increased knowledge of health care professionals in the emergency department can create confidence in being able to recognize the warning signs of of child abuse on admission (Carson, 2018). (Berger et al., 2017)

Goals

One short term goal would be for nurses to understand and be knowledgeable of the risk factors associated with child abuse and near misses. By so doing, they will have a ground to help these children. Some of the risk factors that contribute to child abuse include irresponsible parents, challenges in nurturing the children, criminal behavior, similar experiences when young, and financial difficulties. In the short term, nurses should evaluate each of these issues and how it results in child abuse. Therefore, it helps nurses know how to approach different cases regarding child abuse (Raman & Jones, 2017). The goal can be measured by assessing nurses’ knowledge of these risk factors and applying them in child abuse cases.

The long term goal for nurses would be to ensure they support prevention programs that will integrate risk factors and parents to these children. The program will aim to help society understand why these children are neglected and how their parents can accommodate their children (Raman & Jones, 2017). The effectiveness of this goal will be measured by the program's success rate, including parents' participation. Therefore, it will ensure that nurses are integrated into helping families take better care of their children.

Barriers

· Identifies a minimum of two anticipated barriers to the success of preventing or resolving the clinical issue.

· Describes at least one strategy for addressing each anticipated barrier.

Benefits

· Describes a minimum of one benefit to the patient population and one benefit to the nursing profession that will result from preventing or resolving the clinical issue.

· Provides a minimum of one scholarly, peer-reviewed source in support of the benefit of the plan to the patient population.

Participants & Interdisciplinary approach

Screening for child abuse in the hospital should be done in a multidisciplinary approach. Just some of the members of the multidisciplinary team includes the Pediatrician, Registered nurse, Social worker, Pediatric Surgeon and even administrative support staff. It is important to involve the entire staff in a mandatory training on screening protocols for child abuse on admission. It is important to recognize that administrative staff is a very important piece to the puzzle due to the fact that when a child is checked into the hospital this is the first person they will possibly come into contact with. If the administrative staff receives specialized training necessary for recognizing the warning signs of child abuse then they are able to become the first line of defense for these children admitted into the hospital reducing the amount of near misses on admission. The American Pediatric Surgical Assoiciation recognizes that a screening tool is important for Pediatric surgeons to properly recognize suspected child abuse in chidrens surgery (Escobar, Wallenstein, Christison-Lagay, Naiditch, & Petty, 2019).

Conclusion

· Provides a thorough recap of the purpose of the plan to prevent or help to resolve the clinical issue.

· Includes a complete statement describing why addressing the clinical problem matters and to whom

References

Afifi, T. O., MacMillan, H. L., Boyle, M., Cheung, K., Taillieu, T., Turner, S., & Sareen, J. (2016). Child abuse and physical health in adulthood. Health reports, 27(3), 10.

AHC MEDIA. (2020). Nonaccidental Trauma. Trauma Reports, 21(1), N.PAG.

Badoe, E. (2017). A critical review of child abuse and its management in Africa. African journal of emergency medicine, 7, S32-S35.

Berger, R. P., Saladino, R. A., Fromkin, J., Heineman, E., Suresh, S., & Mcginn, T. (2017). Development of an electronic medical record–based child physical abuse alert system. Journal of the American Medical Informatics Association,25(2), 142-149. doi:10.1093/jamia/ocx063

Carson, S. M. (2018, November) Implementation of a Comprehensive Program to Improve Child Physical Abuse Screening and Detection in the Emergency Department. Journal of Emergency Nursing, 44(6), 576-581. https://doi.org/10.1016/j.jen.2018.04.003

Escobar, M. A., Wallenstein, K. G., Christison-Lagay, E. R., Naiditch, J. A., & Petty, J. K. (2019). Child abuse and the pediatric surgeon: A position statement from the Trauma Committee, the Board of Governors and the Membership of the American Pediatric Surgical Association. Journal of Pediatric Surgery, 54(7), 1277-1285. doi:10.1016/j.jpedsurg.2019.03.009

Greene, M., & Bennett, B. L. (2019). Nonaccidental Trauma. Retrieved August 12, 2020, from http://www.reliasmedia.com/articles/145439-nonaccidental-trauma

Raman, S., Maiese, M., Vasquez, V., Gordon, P., & Jones, J. M. (2017). Review of serious events in cases of (suspected) child abuse and neglect: A RoSE by any other name?. Child Abuse & Neglect, 70, 283-291.

Zeanah, C. H., & Humphreys, K. L. (2018). Child abuse and neglect. Journal of the American Academy of Child & Adolescent Psychiatry, 57(9), 637-644.