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document
Randomized prospective study to evaluate child abuse documentation in the emergency department . OBJECTIVES The objective was to determine whether an educational intervention for health care providers would result in improved documentation of cases of possible physical child abuse in children < 36 months old treated in the emergency department ( ED ) setting . METHODS This study had a statewide group-randomized prospective trial design . Participating EDs were randomized to one of three intervention groups : no intervention , partial intervention , or full intervention . Medical records for children < 36 months of age were abstracted before , during , and after the intervention periods for specific documentation elements . The main outcome measure was the change in documentation from baseline . Generalized estimating equations ( GEEs ) were used to test for intervention effect . RESULTS A total of 1,575 charts from 14 hospitals EDs were abstracted . Hospital and demographic characteristics were similar across intervention groups . There were 922 ( 59 % ) injury visits and 653 ( 41 % ) noninjury visits . For each specific documentation element , a GEE model gave p-values of > 0.2 in independent tests , indicating no evidence of significant change in documentation after the intervention . Even among the 26 charts in which the possibility of physical abuse was noted , documentation remained variable . CONCLUSIONS The educational interventions studied did not improve ED documentation of cases of possible physical child abuse . The need for improved health care provider education in child abuse identification and documentation remains . Future innovative educational studies to improve recognition of abuse are warranted .
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Intervention_Educational
educational intervention for health care providers
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Intervention_Control
no intervention
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Intervention_Educational
partial intervention
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Intervention_Educational
full intervention
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Intervention_Educational
educational interventions
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Outcome_Other
abuse
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Outcome_Other
documentation
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Outcome_Other
ED documentation
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Outcome_Mental
recognition of abuse