At this busy inner-city hospital, staff are working within one of the most deprived areas of the country. With a long-established link between social deprivation and child maltreatment, 380 children from this area became subject to a child protection plan in one year alone. Furthermore, 30 out of 1000 children in the surrounding borough live under informal care arrangements. Therefore do we always know who has parental responsibility when we clerk our paediatric patients?
Aims To audit cross-specialty paediatric admissions to quantitatively assess the completion of a full social history, followed by the design and delivery of Trust-wide Paediatric Safeguarding teaching sessions. Impact of these sessions was measured using self-assessment feedback from all participants.
Methods The first 20 paediatric admissions from 1st February 2015 onwards were selected for each specialty of paediatrics, general surgery, urology, trauma and orthopaedics. Case notes were reviewed against a 9 point scoring system, designed to measure the completion of the Trust-wide clerking proforma. 1 mark was deducted for each incomplete sub-section (e.g. maternal details, any social concerns). This data was presented at the Trust’s adult and paediatric Grand Rounds, in conjunction with an educational session on key topics in safeguarding. Participants were asked to self-rate their knowledge of the topic before and after these sessions.
Results 67.5% of case-notes were located and accessible during the timeframe of the project. The results are shown in Figure 1 and Table 1. All specialities did not fully complete the proforma with basic information about who accompanied the child lacking.
44% of attendees at teaching sessions ‘agreed’ or ‘strongly agreed’ that they felt confident in their knowledge around safeguarding and consent in children; this increased to 94% following delivery of teaching sessions.
Conclusions A low rate of completion of a full social history across all specialties highlights the need for regular re-education and engagement of healthcare professionals in order to best serve the needs of our paediatric patients.
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