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The British Journal of General Practice... Dec 2014
Topics: Child Abuse; General Practice; Humans; Mandatory Reporting
PubMed: 25452520
DOI: 10.3399/bjgp14X682705 -
Swiss Medical Weekly Jun 2023Under-detection and under-reporting of child abuse remains a considerable challenge in paediatric care, with a high number of cases missed each year in Switzerland and... (Observational Study)
Observational Study
Nurses' and physicians' reported difficulties and enablers to recognising and reporting child abuse in Swiss paediatric emergency and paediatric surgery departments - an observational study.
BACKGROUND
Under-detection and under-reporting of child abuse remains a considerable challenge in paediatric care, with a high number of cases missed each year in Switzerland and abroad. Published data regarding the obstacles and facilitators of detecting and reporting child maltreatment among paediatric nursing and medical staff in the paediatric emergency department (PED) are scarce. Despite the existence of international guidelines, the measures taken to counteract the incomplete detection of harm done to children in paediatric care are insufficient.
AIM
We sought to examine up-to-date obstacles and enablers for detecting and reporting child abuse among nursing and medical staff in PED and paediatric surgery departments in Switzerland.
METHODS
We surveyed 421 nurses and physicians working in PEDs and on paediatric surgical wards in six large Swiss paediatric hospitals using an online questionnaire between February 1, 2017, and August 31, 2017.
RESULTS
The survey was returned by 261/421 (62.0%) respondents (complete n = 200, 76.6%; incomplete n = 61, 23.3%) with a preponderance of nurses (n = 150/261; 57.5%), 106/261 (40.6%) physicians, and 1/261 (0.4%) psychologists (n = 4/261; 1.5% missing profession). The stated obstacles to reporting child abuse were uncertainty about the diagnosis (n = 58/80; 72.5%), feeling unaccountable for notification (n = 28/80; 35%), uncertainty of whether reporting has any consequences (n = 5/80; 6.25%), lack of time (n = 4/80; 5%), forgetting to report (n = 2/80; 2.5%), and parental protection (n = 2/80; 2.5%) (unspecific answer, n = 4/80; 5%, multiple answers were possible, therefore items don not sum up to 100%). Even though most (n = 249/261 95.4%) respondents had previously been confronted with child abuse at/outside work, only 185/245 (75.5%) reported cases; significantly fewer nursing (n = 100/143, 69.9%) than medical staff (n = 83/99, 83.8%) (p = 0.013). Furthermore, significantly more nursing (n = 27/33; 81.8%) than medical staff (n = 6/33; 18.2%) (p = 0.005) reported a discrepancy between the number of suspected and reported cases (total 33/245 (13.5%). An overwhelming amount of participants were strongly interested in mandatory child abuse training (n= 226/242, 93.4%) and in the availability of standardised patient questionnaires and documentation forms (n = 185/243, 76.1%).
CONCLUSION
In line with previous studies, insufficient knowledge about and lack of confidence in detecting the signs and symptoms of child abuse were the principal obstacles to reporting maltreatment. To finally address this unacceptable gap in child abuse detection, we recommend the implementation of mandatory child protection education in all countries where no such education has been implemented in addition to the introduction of cognitive aid tools and validated screening tools to increase child abuse detection rates and ultimately prevent further harm to children.
Topics: Humans; Child; Switzerland; Physicians; Emergency Service, Hospital; Mandatory Reporting; Child Abuse; Surveys and Questionnaires; Nurses
PubMed: 37410935
DOI: 10.57187/smw.2023.40017 -
Journal of Elder Abuse & Neglect 2016This article provides an overview of elder abuse screening and detection methods for community-dwelling and institutionalized older adults, including general issues and... (Review)
Review
This article provides an overview of elder abuse screening and detection methods for community-dwelling and institutionalized older adults, including general issues and challenges for the field. Then, discussions of applications in emergency geriatric care, intimate partner violence (IPV), and child abuse are presented to inform research opportunities in elder abuse screening. The article provides descriptions of emerging screening and detection methods and technologies from the emergency geriatric care and IPV fields. We also discuss the variety of potential barriers to effective screening and detection from the viewpoint of the older adult, caregivers, providers, and the health care system, and we highlight the potential harms and unintended negative consequences of increased screening and mandatory reporting. We argue that research should continue on the development of valid screening methods and tools, but that studies of perceived barriers and potential harms of elder abuse screening among key stakeholders should also be conducted.
Topics: Aged; Child; Child Abuse; Elder Abuse; Emergency Service, Hospital; Geriatrics; Health Knowledge, Attitudes, Practice; Humans; Intimate Partner Violence; Long-Term Care; Mandatory Reporting; Mass Screening; Spouse Abuse
PubMed: 27593945
DOI: 10.1080/08946566.2016.1229241 -
BMC Oral Health Dec 2015On July 1(st) 2013 the Mandatory Reporting Code Act came into force in the Netherlands, making it compulsory for health professionals to adhere to a reporting code when...
BACKGROUND
On July 1(st) 2013 the Mandatory Reporting Code Act came into force in the Netherlands, making it compulsory for health professionals to adhere to a reporting code when they suspect patients to be victims of domestic violence (DV) or child abuse (CA). The Royal Dutch Dental Association (KNMT) developed a reporting code for dental professionals (RCD). Moreover, an e-learning module about DV has been developed. A web-survey was conducted to investigate how general dental practitioners (GDPs) deal with the RCD and what their experiences are with (signs of) DV and CA.
METHODS
In April 2014 1038 GDPs were invited by e-mail to participate in a web-survey consisting of 24 items, through the KNMT Data Stations Project. The data was analyzed using SPSS (RELIABILITY, CHISQ and ANOVA).
RESULTS
Of all GDPs invited to participate 264 (25 %) responded. 82 % of these GDPs are aware of their obligation to use the reporting code. 54 % of the GDPs are in favor of this obligation. 76 % of the GDPs have taken notice of the KNMT's RCD and 51 % of the GDPs have implemented the reporting code in one form or another in their practice. 24 % of the GDPs stated having suspected DV during the last twelve months in the case of 2.4 patients on average. 81 % took note of this in the patient's record and 58 % also took action in different ways. 54 % wants to complete the e-learning module.
CONCLUSIONS
Most GDPs are aware of the new legislation and have taken cognizance of the RCD. Even though the majority of GDPs are not opposed to using a reporting code, over half of them have not yet implemented the code in practice. An important factor in this regard seems to be that a substantial minority of the GDPs says they are not sufficiently informed about aspects of reporting a case and about the steps they have to take.
Topics: Attitude of Health Personnel; Dentists; Domestic Violence; Humans; Mandatory Reporting; Netherlands; Reproducibility of Results; Surveys and Questionnaires
PubMed: 26667115
DOI: 10.1186/s12903-015-0141-4 -
Child Abuse & Neglect Mar 2012This article reviews research, policy and programming in Australia, Canada and the US on the child welfare response to EDV. (Review)
Review
OBJECTIVES
This article reviews research, policy and programming in Australia, Canada and the US on the child welfare response to EDV.
METHOD
The review draws on searches of standard research databases, interviews with researchers and practitioners, and the authors' own research.
RESULTS
Although EDV is underreported, across studies 7% to 23% of youths in general population surveys experienced EDV, 36-39% of youth in DV cases have witnessed the violence, and 45-46% of primary caregivers in child maltreatment investigations have experienced DV. Mandatory reporting can increase the number of cases that come to the attention of child welfare, but without resources for training and programming can lead to inappropriate reports, lack of referral for further assessment, and strains on the child welfare system. Improving the child welfare response to EDV can include collaboration between child welfare workers and DV advocates; increased training on screening for DV; new protocols on DV; and dedicated DV staffing within child welfare agencies. In recent years, policy and program attention to EDV has also been embedded within broader national efforts to protect children from violence and maltreatment. Differential response models that eschew investigation in favor of assessment and service delivery hold promise for families with DV.
CONCLUSIONS
Empirical data are limited, but current research and practice experience suggest that child welfare agencies seeking to improve the response to EDV should collaborate with other disciplines involved with preventing and responding to DV, seek resources to support training and programming, consider methods that avoid stigmatizing parents, and build in a program evaluation component to increase knowledge about effective practice.
Topics: Adolescent; Australia; Canada; Child; Child Abuse; Child Welfare; Child, Preschool; Domestic Violence; Health Policy; Humans; Infant; Mandatory Reporting; Prevalence; United States
PubMed: 22425164
DOI: 10.1016/j.chiabu.2011.11.004 -
Journal of Rehabilitation Medicine May 2014
Topics: Biomedical Research; Disabled Persons; Guideline Adherence; Guidelines as Topic; Humans; Mandatory Reporting; Publishing; Quality of Health Care
PubMed: 24733355
DOI: 10.2340/16501977-1829 -
Medicare & Medicaid Research Review 2014Serious adverse events that occur in hospitals rank as a leading cause of preventable death in the United States. Many states operate reporting systems to monitor and...
BACKGROUND
Serious adverse events that occur in hospitals rank as a leading cause of preventable death in the United States. Many states operate reporting systems to monitor and publicly report serious adverse events, a subset that falls under Medicare's Hospital-Acquired Conditions (HACs).
PURPOSES
Identify and describe state efforts, and the supporting role of federal initiatives, to track and report HACs and other serious adverse events.
DATA SOURCES
Document review of state and federal reports, databases, and policies for HACs and other serious adverse events; conduct semi-structured telephone interviews with state health department officials and directors of patient safety organizations.
RESULTS
Thirty-two states and the District of Columbia (D.C.) track at least one Medicare HAC. Five states collect nearly all ten Medicare HACs (9-10). Eighteen states and D.C. track events through both a state-based reporting system and the Centers for Disease Control National Healthcare Safety Network (NHSN) for health-care associated infections (HAI). For serious adverse events, most states either partially or fully adopted the National Quality Forum's Serious Reportable Events. For HAIs, thirty states and D.C. mandate reporting through NHSN. States interviewed reported that Medicare's choice of HACs for nonpayment had at least a partial influence on which serious adverse events required reporting.
CONCLUSIONS
Many states use the collected data on HACs and other events for quality improvement initiatives and to provide greater transparency through public reporting. More work and research is needed to develop a national reporting system template that has standard definitions, methodology, and reporting.
Topics: Cross Infection; Federal Government; Humans; Interviews as Topic; Mandatory Reporting; Medicare; Population Surveillance; State Government; United States
PubMed: 25584196
DOI: 10.5600/mmrr.004.04.a04 -
Australian Dental Journal Jun 2021Up to 50% of child abuse (CA) victims exhibit evidence of traumatic facial or intraoral injuries. Dental health professionals (DHPs) are therefore well-positioned to...
BACKGROUND
Up to 50% of child abuse (CA) victims exhibit evidence of traumatic facial or intraoral injuries. Dental health professionals (DHPs) are therefore well-positioned to detect and report incidences of CA. This study aimed to assess the knowledge and attitudes of Western Australian DHPs towards identifying and reporting CA.
METHODS
General dentists, specialists, hygienists and oral health therapists completed an online questionnaire which assessed their knowledge and experience in identifying and reporting CA.
RESULTS
A total of 228 participants completed the questionnaire (representing 7% of DHPs, 60% of paediatric dentists and 11% of all dental hygienists and therapists in Western Australia). The majority of participants (66.2%, P < 0.05) felt that they were unlikely to recognize a patient with physical abuse, or detect signs of sexual abuse (90.8%, P < 0.001). Uncertainty around diagnosing abuse was a barrier towards reporting cases (86.4%, P < 0.05) and most participants (78.0%, P < 0.05) felt that they did not have adequate safeguarding training to report CA.
CONCLUSIONS
Self-reported confidence in identifying and reporting CA cases was low; with the majority of the dental professionals participating in this study unlikely to recognize signs of CA. Inadequate training and knowledge around correct reporting protocols were identified as barriers, which warrants an appropriate change to improve child safeguarding.
Topics: Attitude of Health Personnel; Australia; Child; Child Abuse; Dentists; Humans; Mandatory Reporting; Surveys and Questionnaires; Western Australia
PubMed: 33450084
DOI: 10.1111/adj.12823 -
Australian Journal of General Practice Oct 2018General practitioners (GPs) and practice nurses (PNs) are mandated to report child abuse; however, only 2–4% of reports are made by Victorian health professionals....
BACKGROUND AND OBJECTIVE
General practitioners (GPs) and practice nurses (PNs) are mandated to report child abuse; however, only 2–4% of reports are made by Victorian health professionals. This is concerning, given that the estimated prevalence of physical child abuse alone in Australia is 5–18%. The aim of this study was to explore GPs’ and PNs’ experiences and perceptions of mandatory reporting of child abuse in Victoria.
METHODS
Semi-structured interviews with 17 Victorian GPs and PNs were undertaken and thematically analysed.
RESULTS
Participants had limited understanding of mandatory reporting in Victoria, struggled with negotiating the risks of reporting child abuse and felt unsupported by their practice and Child Protection Services.
DISCUSSION
GPs and PNs must negotiate their legal obligation, with the emotional burden associated with the decision to report. Updated education on reporting processes and more support for GPs and PNs are recommended.
Topics: Adult; Aged; Child; Child Abuse; Child Protective Services; Child, Preschool; Female; General Practitioners; Humans; Interviews as Topic; Male; Mandatory Reporting; Middle Aged; Qualitative Research; Victoria
PubMed: 31195787
DOI: 10.31128/AJGP-04-18-4563 -
Drug Safety Jan 2022European Union legislation has mandated the submission of European Economic Area non-serious reports to the EudraVigilance database since November 2017. As spontaneous...
INTRODUCTION AND OBJECTIVE
European Union legislation has mandated the submission of European Economic Area non-serious reports to the EudraVigilance database since November 2017. As spontaneous reports of suspected adverse reactions to medicines represent a key source of safety signals, the European Medicines Agency has undertaken this work to assess the effects of this requirement on the characteristics of the reports submitted to EudraVigilance and on the detection of adverse drug reactions through routine analyses of the database.
METHODS
Changes in the numbers of serious and non-serious reports transmitted to EudraVigilance were examined over the period during which the legislation was implemented. The numbers and nature of potential safety signals emerging from established statistical algorithms used at the European Medicines Agency applied either to only the serious reports or to all reports in EudraVigilance were compared.
RESULTS
Up to November 2017, less than 25% of European Economic Area reports in EudraVigilance were classified as non-serious, since than this figure was slightly above 60%. This change accompanied an increase in the total number of reports received. Addition of non-serious reports to the signal detection process resulted in a small overall increase in signals of disproportionate reporting with some new signals of disproportionate reporting appearing and some existing signals of disproportionate reporting disappearing; the sensitivity of the signal detection system was slightly increased and the proportion of signals of disproportionate reporting that corresponded to known adverse drug reactions (a measure of efficiency) was unchanged.
CONCLUSIONS
The change in legislation has led to a small increase in sensitivity, without affecting the efficiency of the routine statistical measures used. The number of non-serious reports as a proportion of reports in EudraVigilance is likely to increase over time and further monitoring of the impact on signal detection is required. Further work is also required on the qualitative impact of non-serious reports on the nature of signals detected and on their evaluation.
Topics: Adverse Drug Reaction Reporting Systems; Databases, Factual; Drug-Related Side Effects and Adverse Reactions; European Union; Humans; Mandatory Reporting; Pharmacovigilance
PubMed: 34881404
DOI: 10.1007/s40264-021-01137-0