Abstract
ObjectivesTo evaluate the different policies to recognize child maltreatment in emergency departments (EDs) in Europe in order to define areas of improvement.MethodsA survey was conducted on the recognition of child maltreatment in EDs in European countries with a focus on screening methods, parental risk factors, training and hospital policies. The survey was distributed through different key members from the EUSEM, REPEM and the EuSEN. A summary score based on the NICE guideline (4 questions on child characteristics, 4 questions on parental characteristics and 5 questions on hospital policy) was calculated.ResultsWe analysed 185 completed surveys, representing 148 hospitals from 29 European countries. Of the respondents, 28.6% used a screening tool, and 31.8% had guidelines on parental risk factors. A total of 42.2% did not follow training based on child characteristics, and 57.6% did not follow training on parental characteristics. A total of 71.9% indicated that there was a need for training. 50.8% of the respondents reported a standardized policy for the detection of child maltreatment. Translating the survey results to NICE summary scores of the EDs in Europe, we found that 25.6% (34/133) met most, 22.6% (30/133) met some and 51.9% (69/133) met few of the NICE guideline recommendations. More specifically, with respect to hospital policies, 33.8% (45/133) met most, 15.0% (20/133) met some and 51.1% (68/133) met few of the NICE guideline recommendations.ConclusionThere is high variability regarding policies for child maltreatment detection and only a quarter of the EDs met most of the NICE guideline recommendations for child maltreatment. There is a need for the use of screening tools, training of ED staff and implementation of local hospital policies.
Highlights
Child maltreatment is a major public health problem and responsible for a huge socio-economic burden [1,2]
A total of 42.2% did not follow training based on child characteristics, and 57.6% did not follow training on parental characteristics
A total of 71.9% indicated that there was a need for training. 50.8% of the respondents reported a standardized policy for the detection of child maltreatment
Summary
Child maltreatment is a major public health problem and responsible for a huge socio-economic burden [1,2]. The World Health Organization (WHO) defines child maltreatment as the abuse and neglect that occurs to children under 18 years of age; it includes all types of physical and/or emotional ill-treatment, sexual abuse, neglect, negligence and commercial or other exploitation, which results in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power [3]. The negative impact of child maltreatment on individual health is well known and the long lasting effects persist into adulthood varying from mental health problems, like substance abuse, depression, psychological distress and suicide to physical health problems, like respiratory disease, chronic pain, obesity, memory impairment and even ischemic heart disease [6,7,8,9,10]. In emergency departments (EDs) nonaccidental trauma is often falsely reported, sexual abuse is not mentioned and/or emotional abuse is not displayed or witnessed [14,15]
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