LeAnne Young
Memorial Healthcare System, USA
Title: When they can’t tell you why it hurts: The importance of implementing a nonaccidental trauma guideline
Biography
Biography: LeAnne Young
Abstract
Introduction: According to the Federal Child Abuse Prevention and Treatment Act of 2010, Child Maltreatment is defined as “any recent act or failure to act on the part of a parent or caregiver which results in any of the following: death, serious physical or emotional harm, sexual abuse and/or sexual exploitation” (CAPTA, 2010). Child Maltreatment remains a significant problem in the United States, accounting for over 700,000 reported victims in 2014; resulting in approximately 1580 deaths; an average of 4 deaths each day (Centres for Disease Control, 2014). Proper identification and assessment of victims of child maltreatment is essential for healthcare providers. However, many practitioners and healthcare systems do not have a standardized approach to the identification and assessment process, resulting in variations in management. This is especially true in cases of non-accidental trauma. By establishing a non-accidental trauma guideline, a trauma program can facilitate a standardized process, minimize practitioner bias, and minimize the risk of missing potential victims of abuse
Objectives:
1.Child Maltreatment remains a significant problem within the United States, resulting in approximately four paediatric deaths each day.
2.The identification and management of patient with suspected non-accidental traumatic injuries requires a systematic approach
3.A standardized non-accidental trauma guideline helps eliminate healthcare provider biases.
Case Presentation/Project Design: Over the course of a year the Paediatric Trauma Program identified several opportunities for improvement in the assessment and management of patents with suspected non-accidental trauma at a community based Paediatric Trauma Centre. During this time there was no established non-accidental trauma guideline. This necessitated the need for the development of a standardized non-accidental trauma guideline to be utilized for patients presenting to the Emergency Department and for direct admission inter-facility paediatric trauma transfers. The development and approval process for the standardized guideline involved a multi-disciplinary approach and took place over the course of eight months. Since the implementation of the guideline there have been no missed injuries in patients with suspected non-accidental trauma.
Discussion/Future Steps/Conclusion: A non-accidental trauma guideline provides a standardized approach to the identification, assessment, and management of patients with suspected non-accidental trauma, and is an essential component in any Paediatric Trauma Program. This type of guideline is equally important in combined programs or in Adult Trauma Programs that also manage paediatric trauma patients. While the development and implementation of a standardized guideline is an important first step, trauma programs must also conduct ongoing monitoring to ensure that the guideline is being followed as part of their performance improvement process.