Hospital Protocol Revision and Annotated Bibliography Within

Hospital Protocol Revision and Annotated Bibliography Within every hospital, clinic, private practice or similar health care facilitator, a strict set of institutional protocols and policies is used to govern the conduct of physicians, nurses, orderlies and any other employees responsible for the delivery of health care at the highest standard. The John Dempsey Hospital at the University of Connecticut Health Center currently maintains a protocol regarding identification and treatment of patients who are suspected of being child abuse victims.

Although this protocol is comprehensive in nature, providing health care professionals with clear guidelines to apply during interactions with young patients who are possibly being abused, the rate of reported child abuse cases deriving from the John Dempsey Hospital has fallen behind national and state averages. The purpose of this paper is to implement meaningful changes to the current child abuse policy in place at the John Dempsey Hospital, in order to increase the recent reduction in child abuse reporting.

Policy Overview Under the Patient Care section of the John Dempsey Hospital's Administrative Manual, Protocol #08-085 falls under the subject of Abuse: Child, and states unequivocally that patients under the age of 18 have the right to be free of exploitation and abuse, and that "the hospital will protect these patients from neglect, exploitation, and abuse that could occur while the patient is receiving care, treatment, and services & #8230; (by) evaluating and reporting allegations, observations, and suspected cases of neglect, exploitation, and abuse to appropriate authorities based on its evaluation of the suspected events, or as required by law." The policy mandates that hospital employees remain vigilant in monitoring for signs of potential child abuse, and that any legitimate suspicion of such criminal activity must be reported to the proper agencies per the provisions of the Child Welfare Act, Connecticut General Statutes 17-32 to 52b amended 1983, Connecticut Acts 43 amended 1988, which state that any case of suspected child abuse, neglect, or at-risk situation must be reported to the Department of Children and Families (DCF).

Policy Change Although the current protocol had been deemed sufficient for a number of years, a recent trend indicating that reporting of child abuse at John Dempsey Hospital has lagged behind established averages must be addressed through policy-wide revisions. Under the current protocol, the hospital itself is required to report cases of suspected child abuse, but the term "mandated reporter" is not sufficiently clarified, leaving nurses and physicians to assume that the other party may have already reported observable evidence.

In order to conform to "mandated reporter" statutes implemented in several other states, the John Dempsey Hospital should revise its child abuse protocol to specifically state that nurses are mandated reporters in addition to physicians, and that every hospital employee working with the child is mandated to report their own suspicions.

Research on the reporting role of nurses has shown that "nurses are specifically identified as mandatory reporters in a majority of state child protection statutes & #8230; (and) that the nurse's duty to report child abuse trumps the nurse's duty of confidentiality" (Kearney, 2007), which is why this change represents an important step towards ensuring that all child patients who are being abused have their cases reported, and that no case is overlooked simply because one party's assumption that another has already reported their suspicions.

With respect to the prevailing research indicating that nurses and physicians are often reluctant to make an official report for fear of being subjected to a defamation lawsuit, which holds "that medical and nursing staff avoid becoming involved and reporting child abuse for fear of misjudgment that might lead to legal charges" (Ben Natan, et al., 2012), hospital staff should also be apprised of the most current legislation regarding mandated reporting of child abuse.

The fact that "good faith laws usually protect citizens and mandated reporters from being sued & #8230; (as) evidence of abuse does not need to exist to file a SCAR if there is reasonable suspicion of abuse" (March, Pinto & Schub, 2013) must be instructed to every hospital employee who may encounter cases of suspected child abuse. Conclusion Protocol #08-085 of the Patient Care section of the John Dempsey Hospital's Administrative Manual should be revised to reflect the most current research on child abuse reporting.

By making nurses mandated reporters, as they are in the majority of states, the hospital can effectively reduce the rate of unreported suspected child abuse following interaction with young patients. Hospital staff must also be apprised of the current laws designed to protect them from malicious litigation, in an effort to make child abuse reporting a more palatable option.

By implementing these seemingly subtle revisions, the John Dempsey Hospital at the Connecticut University Health Center can once again stay ahead of the proverbial curve when it comes to reporting suspected cases of child abuse within its patient population. Annotated Bibliography Ben Natan, M., Faour, C., Naamhah, S., Grinberg, K., & Klein-Kremer, A. (2012). Factors affecting medical and nursing staff reporting of child abuse. International nursing review, 59(3), 331-337.

This research article describes a descriptive, correlational, cross-sectional study designed to assess the efficacy of the theory of planned behaviour (TPB) in predicting nursing and medical staff reporting of suspected child abuse. The research team administered a survey to 143 nurses and 42 doctors to.