Abstract
Objective: An evidence based Clinical Decision Rule (CDR) was developed from a systematic review and epidemiological study to identify burns due to child maltreatment (abuse or neglect). Prior to an implementation evaluation, we aim to explore clinicians’ views of the CDR, the likelihood that it would influence their management, and factors regarding its acceptability.
Methods: A semi-structured questionnaire exploring demographics, views of the CDR and data collection proforma, ability to recognize maltreatment, and likelihood of following CDR recommended child protection (CP) action, was administered to 55 doctors and nurses in 8 Emergency Departments and 2 burns units. Recognition of maltreatment was assessed via four fictitious case vignettes.
Analysis: Fisher’s exact test and variability measured by coefficient of unalikeability.
Results: The majority of participants found the CDR and data collection proforma useful (45/55 = 81.8%). Only 5 clinicians said that they would not take the action recommended by the CDR (5/54, 9.3%). Lower grade doctors were more likely to follow the CDR recommendations (P=0.04) than any other grade, while senior doctors would consider it within their decision making. Factors influencing uptake include: brief training, background to CDR development and details of appropriate actions.
Conclusions: It is apparent that clinicians are willing to use a CDR to assist in identifying burns due to child maltreatment. However, it is clear that an implementation evaluation must encompass the influential variables identified to maximize uptake.
Methods: A semi-structured questionnaire exploring demographics, views of the CDR and data collection proforma, ability to recognize maltreatment, and likelihood of following CDR recommended child protection (CP) action, was administered to 55 doctors and nurses in 8 Emergency Departments and 2 burns units. Recognition of maltreatment was assessed via four fictitious case vignettes.
Analysis: Fisher’s exact test and variability measured by coefficient of unalikeability.
Results: The majority of participants found the CDR and data collection proforma useful (45/55 = 81.8%). Only 5 clinicians said that they would not take the action recommended by the CDR (5/54, 9.3%). Lower grade doctors were more likely to follow the CDR recommendations (P=0.04) than any other grade, while senior doctors would consider it within their decision making. Factors influencing uptake include: brief training, background to CDR development and details of appropriate actions.
Conclusions: It is apparent that clinicians are willing to use a CDR to assist in identifying burns due to child maltreatment. However, it is clear that an implementation evaluation must encompass the influential variables identified to maximize uptake.
| Original language | English |
|---|---|
| Pages (from-to) | 465-470 |
| Number of pages | 6 |
| Journal | Emergency Medicine Journal |
| Volume | 33 |
| Issue number | 7 |
| Early online date | 11 Apr 2016 |
| DOIs | |
| Publication status | Published - Jul 2016 |
Keywords
- Paediatric non accidental injury
- burns
- clinical decision rule
Access to Document
- Full-text PDF (accepted author manuscript)
This is the author accepted manuscript (AAM). The final published version (version of record) is available online via BMJ at http://emj.bmj.com/content/33/7/465. Please refer to any applicable terms of use of the publisher.