Child Abuse

Case Study Assignment 

This discussion provides an analysis regarding an assessment case of physical harm to a child brought to hospital by her neglecting mother. :

Risk Assessment

Concerning the report from the case study, the most likely cause of injury on the child could be blunt force trauma inconclusive. The risk assessment will thus entail the following actions:

  • The child is vulnerable to abuse. This is evident from the injuries and those identified by the X-Ray like the child could have been hit, kicked, or there was the use of objects like a bat.
  • The father seem to be stressed out and unleashes his anger on the child. This is evident by the circular scars which also could have been caused by burns from impressions of small objects of cigarettes. Also, the numerous bruises of the posterior and buttocks might have been caused by a blunt force trauma. The blunt traumatic force could have caused the bruising leading to a disruption of the superficial capillaries and fluid extravasation to the subcutaneous tissue. 
  • There is presence of warning signs and red flags because of the physical injuries point showing cases of abuse, especially with the issue of burn scars and folding of the arm.
  • There could be marital problems involved and possible domestic violence. It was openly evident that the mother also protected the husband, and she was quick to defend him when the nurses wanted to assess the child. Thus the safety the patient and the family is paramount.
  • The mother also is quick to defend the husband, it shows that it is possible the child is neglected and has been undergoing repeated cases of abuse.
  • Also the mother does not want the child to be undressed. It is also important to look at the possibility of sexual abuse on the child or the mother, or there could be a poor parent to child relationship (Rus, Parris, & Stativa, 2017). It is also important to find from the mother when the child acquired the bruises or knee injury to identify the danger areas.
  • There seen to be no social support system as the family members seem not to be aware of the situation. Find out the emotional need for the mother and the child and whether they have a support system to provide them.
  • According to the present data, it is evident that the child condition has been caused by repeated physical abuse for which the mother is trying to conceal. This is one of the warning signs to look in to. 

Documentation Requirement

Documentation and reporting of physical child abuse will also depend on the state.  For example, if the case happened in CA, it is essential that any case of domestic abuse is reported as per the state regulation, the procedure to be followed will be:

  • Ensure that all the information presented by the mother is well documented.
  • Take a graphical documented of the body where harm has been done. Ensure photographs have supporting description of the depth of the injury.
  • Inform the child’s mother that she is mandated to report.
  • Let the mother know that the social service and the investigating authority is going to look into the case and might summon her for more information.
  • Ensure that you are in contact with the law enforcement authorities, with the intent to protect the child. Provide details of the diagnosis, the parent contacts, address, and information regarding the husband.
  • The forms should be completed within two days (Snape, 2016).
  • Ensure that all recorded are done correctly in the system.

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Mandatory reporting requirements in this case

  • The case of child abuse should be reported as per the knowledge and observation of the child within the professional capacity or the scope of employment when there is evidence that the child is a victim of abuse or neglect according to Penal Code 111166 (Snape, 2016).
  • The State of California also required mandated reporting by healthcare professionals regarding suspected cases of child abuse or neglect. This should be done by contacting the child welfare agency or local law enforcement agency. The report should be made immediately via phone. There should also be a written report sent within two days of receiving the information on the incident.
  • The report should be submitted to the department of justice, that can also be requested by the local police or the county welfare department.
  • According to the California Penal Code, ““A person who fails to make a required report is guilty of a misdemeanour punishable by up to six months in jail and/or up to a $1,00 fine (California Penal Code Section 11166[s])” (Snape, 2016).

Community Resources for the Patients, family, and caregivers

Patient Education

Looking at the case analysis, it is evident that the mother is not ready to work things out with the husband and is on the defensive side. She blames the child for the physical injuries and is quick to protect the husband.  This means that it is possible she will continue staying with him.

  • It is essential to inform the mother regarding the prevalence of child and domestic abuse and the risk that she is putting herself and the child into.
  • The physical harm to the child is a sign and symptom of escalating violence, and she needs to rethink about defending her husband and take action to protect herself and her child. It is essential to introduce the mother to social support groups.
  • Try taking with the child alone and speak to the mother to acquire as much information as possible.
  • Ensure to use a light tone while talking to the mother as this is a sensitive subject. Try to help her see the bigger picture of child abuse and how this could escalate to something dangerous.
  • Educate the child on resources available and share with the mother emergency response contacts in the event that the case of abuse continues.
  • Educate the child and the mother about the care and management of the broken bone.

Follow-up Care Plan

  • The clinicians must conduct a follow up on the patient's physical and internal injuries to see improvement.
  • The assessment should also include psychological aspects of abuse, planning for an emergency, and prevention of any case of physical harm to the child or the mother (Rus, Parris, & Stativa, 2017).
  • It is also essential in the follow up to find out whether the mother is taking steps to ensure that the child is well protected and cases of abuse are do not recur.
  • The child should repeatedly come back for physical scanning to assess internal healing.
  • Make referrals to orthopaedics for the broken bone, ensure there is urgent care plan and repeated X-rays to assess the healing of the bone.

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