(57) Are We Adequately Assessing and Recording Safeguarding Concerns for Pediatric Patients Seen in the Accident and Emergency Department (A&E) or Admitted by Oral and Maxillofacial Surgery (OMS)?

Abstract: Background/Introduction

Safeguarding children is a core duty of all healthcare professionals. The A&E department in Worcestershire Royal Hospital have history sheets available containing a safeguarding proforma in a tick-box form, which should be completed and signed.

Aims & Objectives

To assess if we are adequately screening for and documenting safeguarding concerns in children presenting at A&E or being admitted by OMFS.

Methodology

National and local guidelines were reviewed to establish standards for documentation. A retrospective audit of all paediatric patients seen in A&E in 2020 was completed using an Excel data collection tool.

Results

The audit covered 226 patients under the age of 18 seen in A&E by OMFS and 38 patients admitted under OMFS in 2020. The majority of the safeguarding checklist tick boxes were not completed. Data showed good compliance with recording the social situation of the child. There was low compliance with documentation of other signs indicating non-accidental injury e.g. history inconsistent with injury, unexplained injuries and the behaviour of the child.

Discussion/Conclusions

The safeguarding proforma is quick and easy to complete while covering the necessary screening questions. Clinicians should consider non-accidental injury for all paediatric facial injuries presenting at A&E. Completing the proforma ensures there is evidence that the child has been properly assessed for safeguarding concerns. Any concerns should be discussed immediately with the on-call OMFS/Paediatric consultant.

References:
National Institute for Health and Care Excellence, 2009. Child maltreatment: when to suspect maltreatment in under 18s.
Worcestershire Acute NHS Trust, 2015. Safeguarding Children and Young People Policy. Available at: https://www2.worcsacute.nhs.uk/search/?q=safeguarding