The Implementation of a Clinical Pathway to Improve Child Abuse Screening in Young Children With Fractures: A Quality Improvement Analysis

被引：0
|
作者：
Schaller, Stephanie L. [1 ]
Chappell, Kate K. [1 ]
Felder, Amanda M. [2 ]
Ribar, Alicia K. [1 ]
机构：
[1] Univ South Carolina, Coll Nursing, Columbia, SC 29208 USA
[2] Prisma Hlth Midlands, Pediat Trauma, Columbia, SC USA
来源：
JNP- THE JOURNAL FOR NURSE PRACTITIONERS | 2024年 / 20卷 / 03期
关键词：
child abuse; clinical pathways; pediatric fractures;
D O I：
10.1016/j.nurpra.2024.104935
中图分类号：
R47 [护理学];
学科分类号：
1011 ;
摘要：
The American Academy of Pediatrics recommends screening children under 2 years of age with a concerning fracture for physical abuse with a skeletal survey (SS). Nationally, 30% to 77% of children are not screened appropriately in emergency department settings. After implementation of an electronic clinical pathway for pediatric emergency department providers, guideline adherence improved from 61% to 81%. Among infants, SS performance increased from 79% to 81%. More non-White children received an SS, indicating potential implicit bias in screening practices. The results support clinical pathways to improve guideline adherence while promoting further examination of providers' determination of screening needs. (c) 2024 Elsevier Inc. All rights reserved.
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页数：5
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