Exploring the acceptability of a clinical decision rule to identify paediatric burns due to child abuse or neglect

Emma Louise Johnson, Linda Hollen, Alison Mary Kemp, Sabine Maguire

Research output: Contribution to journalArticle (Academic Journal)peer-review

8 Citations (Scopus)
348 Downloads (Pure)


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.
Original languageEnglish
Pages (from-to)465-470
Number of pages6
JournalEmergency Medicine Journal
Issue number7
Early online date11 Apr 2016
Publication statusPublished - Jul 2016


  • Paediatric non accidental injury
  • burns
  • clinical decision rule


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