Development of a screening tool for child maltreatment targeting pediatric trauma patients at emergency departments

Objectives: To develop a screening tool for child maltreatment to be used by first-line healthcare providers (nurses and resident physicians) for pediatric trauma patients in Korean emergency departments (ED). Methods:... [ view full abstract ]

Objectives: To develop a screening tool for child maltreatment to be used by first-line healthcare providers (nurses and resident physicians) for pediatric trauma patients in Korean emergency departments (ED).
Methods: Eighteen specialists reviewed 12 candidate questions taken from eight relevant articles in two rounds of consultation using the Delphi method. The validity of the screening tool was tested in a 10-week pilot study in six EDs.
Results: The screening tool consisted of eight questions: 1) Was there unnecessary delay in seeking help? 2) Is the trauma history confused or inconsistent among caregivers? 3) Is the mechanism of injury incompatible with the age of the child? 4) Are the mechanism and type of injury incompatible/conflicting? 5) Does the child have suspected sign(s) of physical abuse? 6) Is the injury clinically significant for an infant (<2 years old)? 7) Is the relationship between the child and caregiver(s) inappropriate? 8) Are the clothes and/or hygiene of the child inappropriate? In instances of one or more “yes” responses to these questions, first-line healthcare providers were advised to report the case to a specialist. During the pilot validation study, 3,855 pediatric trauma patients visited the EDs and 2,791 (72.4%) patients were screened. A total of 36 cases had one or more “yes” responses; of those, 11 were suspected maltreatment, and two cases were submitted to Child Protection Services for investigation.
Conclusion: We developed local version of child maltreatment screening tool in the Korean ED. Future studies are needed to further validate our local child maltreatment-screening tool for use in Korean EDs.