Pediatric Academic Societies meeting, May 2014, Vancouver, British Columbia, Canada. Most US children who seek care in EDs are treated in general EDs without specialized pediatric services. We aim the basics of emergency medicine a chief complaint guide pdf explore general ED providers’ experiences with screening and reporting of child abuse and neglect to identify barriers and facilitators to detection of child abuse and neglect in the ED setting. We conducted 29 semistructured interviews with medical providers at 3 general EDs, exploring experiences with child abuse and neglect.
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Consistent with grounded theory, researchers coded transcripts and then collectively refined codes and identified themes. Data collection and analysis continued until theoretical saturation was achieved. Barriers to recognizing child abuse and neglect included providers’ desire to believe the caregiver, failure to recognize that a child’s presentation could be due to child abuse and neglect, challenges innate to working in an ED such as lack of ongoing contact with a family and provider biases. Barriers to reporting child abuse and neglect included factors associated with the reporting process, lack of follow-up of reported cases, and negative consequences of reporting such as testifying in court. Reported facilitators included real-time case discussion with peers or supervisors and the belief that it was better for the patient to report in the setting of suspicion.
Finally, providers requested case-based education and child abuse and neglect consultation for unclear cases. Our interviews identified several approaches to improving detection of child abuse and neglect by general ED providers. These included providing education through case review, improving follow-up by Child Protective Services agencies, and increasing real-time assistance with patient care decisions. Check if you have access through your login credentials or your institution. Please see page 448 for the Editor’s Capsule Summary of this article. GT and KB conceptualized and designed the study and acquired the data. GT, MG, JRK, and KB analyzed and interpreted the data.
GT drafted the initial article. MG, JRK, AA, and KB reviewed and revised the article. AA critically reviewed the article. All authors approved the final version. GT takes responsibility for the paper as a whole.
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