Type of publication:
Conference abstract

Author(s):
*Saran S.; Ganesh M.; Yousif E.

Citation:
Archives of Disease in Childhood; Jun 2019; vol. 104

Abstract:
Background: Child protection medical examinations should be undertaken in the presence of a chaperone. This as a good practice recommendation is clearly stated in the Child Protection companion. Aim(s): We undertook an audit of Child Protection medical examination reports to see if our practice meets the standards set by RCPCH in Child Protection companion. Method Child protection companion's model report was chosen as the standard to compare our practices. Hospital-based electronic patient records system (clinical portal) was used to review the reports by a single auditor. Twenty-eight reports were randomly selected. These children undertook Child Protection medical examination at a District General Hospital over a period of 14 months from January'2017 to February'2018. Demographics Three-fourth were boys & one-fourth were girls. Fifteen percent were under 1 year old, sixty percent were between 1 & 5 years old and twenty-five percent were over 5 years old. Timeliness Three-fourth of the reports were typed within 72 hours of CP medical examination. Quality All (100%) the reports stated the source of information and recommendations made after assessment. Over three-fourth reports stated informed consent was taken; included a brief introduction of the author and information about the growth centiles. Two-third reports established that child's concerns were recorded. Reference to the evidence-based literature was made in fifteen percent of the reports. Only seven percent of the reports stated use of Chaperones and amendments in the report after peer review meeting. Three percent of the reports stated both the time and date of referral. Recommendations Our audit highlighted that Chaperons is an underused entity in child protection medical examinations. Chaperons are not only supposed to provide assurance to the child and family but also offers clinicians with an extra layer of protection in case of a complaint. Thus we strongly advocate using Chaperon's in all cases of Child Protection Medicals unless declined by the child/family. In that case, this should be clearly documented. There is also a pressing need to improve the quality of overall documentation.

Link to full-text [NHS OpenAthens account required]

Type of publication:
Conference abstract

Author(s):
*Saran S., *Brough R., *Ganesh M., *Vadali Y.

Citation:
Archives of Disease in Childhood, April 2014, vol./is. 99/(A64), 0003-9888 (April 2014)

Abstract:
Background Child protection medical examination is an essential competency for any trainee to progress through CCT. Often trainees are apprehensive when asked to perform Child Protection medicals. Inadequate training may lead to poor quality assessments resulting in potential risk to the child, family and possible litigations. Aim To elucidate the learning opportunities which Paediatric trainees get in an average sized district general hospital in England. Methods We have audited notes of children who were referred for the ”Child Protection Medical Examination” to our hospital between 01/05/2012 to 30/09/2013. Results There were 24 ”Child Protection Medical Assessments” performed during 16 months. Both boys and girls were equal in number (12 each). 3 (12%) children were under the age of 12 months, 11 (46%) were between 1 and 5 years and 10 (42%) were older than 5 years. 20 (84%) of these assessments were performed during the weekday and 4 (16%) were done during the weekends. 9 (38%) of the assessments were performed by the ’Community Paediatric Registrars’ who are on call to perform this task in the weekdays during the normal working hours. Equal number 9 (38%) of assessments was performed by the ’Ward Registrars’. On call general paediatric consultants did remaining 6 (24%) assessments. Conclusion Child safeguarding attracts media attention often due to medical inadequacies. We are aware about various serious case reviews in the past and a common recommendation in all of them was to ensure proper training of the front line staff. 24 child protection examinations in 16 months imply an average of 1.5 per month. Just to add to our worry is that on call registrars for child safeguarding have only performed 9 assessments in 16 months, i.e. approximately one assessment every other month. We are seriously concerned about lack of exposure which trainees are getting in this very important component of Paediatric training. We strongly feel to consider other training modalities including introducing simulation technique for ”Child Safeguarding” in the Paediatric curriculum.

Link to more details or full-text: http://adc.bmj.com/content/99/Suppl_1/A64.1