SCAN for Abuse: Electronic Health Record-Based Universal Child Abuse Screening.

Autor: Martin NR; Eastern Virginia Medical School, Norfolk, VA, USA. Electronic address: martinnr@evms.edu., Claypool AL; Department of Management Science and Engineering, Stanford University, Stanford, CA, USA., Diyaolu M; Stanford University School of Medicine, Stanford, CA, USA., Chan KS; University of Washington School of Medicine, Seattle, WA, USA., A'Neals E; Lucile Packard Children's Hospital, Stanford, CA, USA., Iyer K; Lucile Packard Children's Hospital, Stanford, CA, USA., Stewart CC; Lucile Packard Children's Hospital, Stanford, CA, USA., Egge M; Lucile Packard Children's Hospital, Stanford, CA, USA., Bernacki K; Lucile Packard Children's Hospital, Stanford, CA, USA., Hallinan M; Lucile Packard Children's Hospital, Stanford, CA, USA., Zuo L; Department of Management Science and Engineering, Stanford University, Stanford, CA, USA., Gupta U; Department of Management Science and Engineering, Stanford University, Stanford, CA, USA., Naru N; Stanford University School of Medicine, Stanford, CA, USA., Scheinker D; Department of Management Science and Engineering, Stanford University, Stanford, CA, USA; Stanford University School of Medicine, Stanford, CA, USA., Morris AM; Stanford University School of Medicine, Stanford, CA, USA., Brandeau ML; Department of Management Science and Engineering, Stanford University, Stanford, CA, USA., Chao S; Stanford University School of Medicine, Stanford, CA, USA.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2024 Feb; Vol. 59 (2), pp. 337-341. Date of Electronic Publication: 2023 Oct 20.
DOI: 10.1016/j.jpedsurg.2023.10.025
Abstrakt: Background: 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.
Methods: 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).
Results: Between 2019 and 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.
Level of Evidence: Level II.
Type of Study: Study of Diagnostic Test.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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