Children often present to the emergency department (ED) for treatment of abuse-related injuries. ED healthcare providers (HCPs) do not consistently screen children for physical abuse, which may allow abuse to go undetected and increases the risk for re-injury and death. ED HCPs frequently cite lack of knowledge or confidence in screening for and detecting child physical abuse.

The purpose of this evidence-based quality improvement project was to implement a comprehensive screening program that included ED HCP education on child physical abuse, a systematic screening protocol, and use of the validated Escape Instrument. After a 20-minute educational session, there was a significant increase in ED HCP knowledge and confidence scores for child physical abuse screening and recognition (p < .001). There was no difference in diagnostic coding of child physical abuse by ED HCPs when evaluating a 30-day period before and after implementation of the screening protocol.

In a follow-up survey, the Escape Instrument and educational session were the most reported screening facilitators, while transition to a new electronic health system was the most reported barrier. The results of this project support comprehensive ED screening programs as a method of improving HCP knowledge and confidence in screening for and recognizing child physical abuse. Future research should focus on the impact of screening on the diagnosis and treatment of child physical abuse. Efforts should also be made to standardize child abuse screening programs throughout all EDs, with the potential for spread to other settings.

Hospitalized and chronically ill infants are at risk for motor, cognitive, and social developmental delays. Nurses have an important role in supporting infant and family development to mitigate these delays. A literature review was performed to identify nursing interventions that promote development in these three categories. After literature was selected, critical appraisals were performed to assess the quality of evidence. Breast feeding, early cognitive-motor intervention, and family centered care were found to be beneficial for promoting motor development. Maternal scaffolding, responsive-didactic caregiving, and skin-to-skin contact are recommended nursing interventions for cognitive development. Lastly, integration of music is the nursing intervention recommended to promote social development.