Role of Nurse in Nursing Care of the Child and Family Order Instructions: Australian based nursing; nurse’s role in relation to nursing care of the child and family when there is a suspicion of child abuse
Evaluate the nurse’s role in relation to nursing care of the child and family when there is a suspicion of child abuse. Discuss how this information will guide evidence based Australian nursing practice.
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The essay is aimed at critically evaluating the content of the artefacts in the portfolio and the importance of using and evaluating evidence-based artefacts when caring for children, adolescents and their families in relation to current Australian nursing practice. This should include the following;
• Demonstration of what learning was achieved through the content of the artifacts selected for the portfolio relevant to the chosen essay topic.
• Evaluation of evidence and value of the information or message within the chosen artifacts. The essay will demonstrate the ability to critically evaluate the research contained in the artifact portfolio. This will be undertaken whilst discussing the importance/value of the evidence-base for future nursing practice.
FORMAT TO FOLLOW IS
1.into about child abuse
2.Child abuse data Australia stats.
3. Types of child abuse
4. Nursing process in DETAIL
5. Sign and symptoms (Recognise when suspicion)
6. Assessment (Diagnosed by assessment)
7. Intervention(nursing goal)- Nursing care plan
8. Evaluation (outcome)
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Role of Nurse in Nursing Care of the Child and Family Sample Answer
According to World Health organization, child abuse refers to all forms of ill-treatment (physical and emotional) including, neglect, sexual harassment, and exploitation, and results to potential harm to child’s development, dignity, and health. This broad definition identifies five main subtypes including a) sexual abuse, b) negligent treatment, c) physical abuse, d) exploitation, and e) emotional abuse (Biehal, 2014). Actions by the abuser or failing to act especially by the caregiver or parents will also result in child abuse. Child abuse can take place in different environments including the school, home, organizations, or the communities that the children interact with (Fraser et al, 2010).
Child abuse data Australia Statistics
Child abuse is a common social problem in Australia despite it been under-reported and underrated. Reports and statistics for the year 2013-2014 confirmed a high number of child abuse and neglect to about 40,844 children (Budiselik et al, 2010). The statistics indicate that for every 13 minutes, children suffer neglect or abuse in Australia. Emotional abuse accounts for most of the cases involving child abuse that is about 40 % as per statistics in 2013-2014(Reeve&Gool, 2013). Physical abuse and sexual abuse accounts for 19% and 14 % of the cases respectively. The statistics also indicate that there is a higher possibility of girl falling victims of child abuse as compared to the boys. The comparison of the 37,700 cases in 2011-2012 and the 40,844 cases in 2013-2014 indicates that there is some rise of the child abuse and neglect problems in Australia (Budiselik et al, 2010). The figures reported by the Australian Institute of Health and Welfare showing high cases of child abuse should prompt those responsible for addressing the issue with utmost seriousness.
Types of Child abuse
In Australia, there is a high prevalence of emotional abuse as compared to other types. Emotional abuse will refer to the social or psychological aspect of child abuse and includes, rude or coarse attitude, denigration of the child’s personality, harsh criticism and inattention are major ways that indicate the instance of emotional abuse (Budiselik et al, 2010).
Neglect occurs when the responsible people or parents fail to provide the required needs and support to the children. Physical abuse will entail the causing of harm of injury to children whereas Sexual abuse will entail the engagement of children in sexual acts or exposure to inappropriate sexual behavior or material (Paavilainen&Flinck, 2013).
Sign and Symptoms (Recognize when Suspicion)
Signs and symptoms of child abuse depend on the type of abuse the child is undergoing. Physical signs and symptoms include unexplained injuries and bruises, untreated dental or medical conditions. Sexual symptoms and signs include pregnancy; abuse of others sexually, sexually transmitted infections and the inappropriate sexual behavior at the child’s age Psychosocial disorders are the most common signs and symptoms of child abuse and include social withdrawal, loss of self-esteem and confidence, inappropriate emotional development and the avoidance of certain situations (Allwood&Widom, 2013).
Neglect type of child abuse will lead to signs and symptoms such as, poor hygiene, poor growth, emotional swings, and psychological problems, lack of basic needs; poor school attendance and indifference in the child Recognition and suspicion of these types of signs and symptoms of a child prompt the taking of necessary actions and interventions. Registered nurses should use these signs and symptoms to identify child abuse incidences and to take the appropriate actions (Allwood&Widom, 2013).
Other effects of child abuse include guilt, nightmares, self-blame, and insomnia and are common in child abuse victims. Subsequent ill health and high-risk health behaviors are among the effects of child abuse (Camilleri et al, 2013).
Nursing process refers to a series of well-organized steps that are designed for nurses aimed at delivering safe and quality care. The process involves five key steps namely assessment, diagnosis, planning, implementation, and evaluation.
During the assessment stage, the nurses need to identify the suspected child abuse cases properly (Francis et al, 2012). Identification is the first step in the nursing process when handling child abuse cases. The nurse will receive a disclosure or observe indicators. If the concerns relate to cases of child abuse, the nurse should assess and consult the issue (Oates, 2013).
Observations and concerns should be documented after the complete assessment. Assessment and diagnosis of the child are vital before interventions of the issue. Examples of assessment tools include the use of Estimate of Risk of Adolescence Sexual Offence Recidivism (ERASOR), Maltreatment and abuse chronology of exposure (MACE) scale used to assess child abuse due to neglect, other relevant psychological assessment scales. Various assessments of safety risk, family, and child functioning are vital when it comes to child protection strategies (Budiselik et al, 2010). The risk assessment scale will be used by nurses to diagnose the severity of the case. The history of the child will be useful to the nurses during the assessment of the child abuse issues during his/her lifetime. Contributing factors to the risk of child abuse and also the future risk will be assessed by the nurses through dependence on the risk assessment scale.
Diagnosis of child abuse victims will rely on symptoms of trauma, depression and the presence of unexplained injuries can be used to diagnose the case of child abuse (Babington, 2011). The nurses should thereafter refer the child urgently to those responsible for handling neglect issues. Legal action should be sought before referring the children to the relevant departments (Camilleri et al, 2013). Physical examinations of the child’s situation and circumstances are also crucial at this stage. This helps in planning and implementing of intervention strategies as described by evidence based nursing.
The nursing goal for Treatment
Nursing treatment goals will be guided by evidence-based practice. The nursing goal is to ensure improved physical state of children by treating those who might have experienced child abuse. Prevention is a key goal that would help avoid challenges that could be encountered during addressing the cases during severity levels. Most studies indicate that the effective treatment of child abuse is the use of a cognitive behavioral framework (Babington, 2011). However, this framework depends on the victim’s extent of abuse and other attributes such as age, gender, and ethnicity. In one randomized control study on 291 adults, it was identified that psychodynamic therapy resulted into the better outcome of victims than those who received CBT alone. This indicates that the nurse must reflect on the victim’s psychological status to select the best type of treatment (Camilleri et al, 2013). This is in accordance with nursing treatment goals of health restoration.
Evidence-based research also identities Trauma-focused cognitive behavioral therapy (TF-CBT) as a good treatment strategy. This therapy involves training sessions for both the offender and the caregiver. The key components of this treatment is an acronym as PRACTICE and entail, Psycho-education, Parenting techniques that are effective, Relaxation, Affective modulation, the ability for cognitive coping and trauma narrative. Six randomized studies have proved that the use of TF-CBT as best treatments within two years post-treatment (Fraser et al, 2010).
One follow up study on sexual child abuse associated with PTSD symptoms indicated that the use of TF- CBT therapy resulted to fewer PTSD symptoms as compared to use of Child-centered therapy (CCT). This involves implementing intervention strategies as supported by scientific research (Babington, 2011). The study concluded that effective treatment goals as evidenced by EBN entail the use of cognitive behavioral therapy (for both the victim and the offender), specifically those that are trauma-focused. Other treatment therapies such as multi-systemic therapy (MST) and Dynamic therapy are effective as they operate with concrete frameworks and are also more interpersonal, but they effectiveness is lower than TF-CBT (Oates, 2013).
Evidence-based research also indicates that the referral of the children to the relevant child protection agencies is a necessary intervention. This multi-factorial approaches and collaboration between the relevant stakeholders will facilitate effective coordination of intervention plans, maximum provision of support, and the quality provision of the care required by the abused children (Budiselik et al, 2010). It is the objective of nurses to monitor the children for as long as possible to avoid recurrence of cases and for the provision of vital physical and psychological medications.
Evidence-based research indicates that management and intervention are also vital in this process. The nurses can adopt the nurse-family partnership, which is an effective intervention method. The nurses will have the program for teaching appropriate parenting skills and healthy behaviors by those in the community (Fraser et al, 2010). The intervention will help the development of the child abuse cases to severity levels. The nurse will compare the It will ensure the follow up of assessed cases is effective to prevent issues related to abuse. The nurse can support the child-parent centers as an intervention measure. They will encourage the individualized approach to cognitive and social development. The nurse should provide support and ongoing treatment. Media based public awareness is a proper intervention where nurses will create awareness on the effects and ills of child abuse to the community (Babington, 2010).
The intervention is taken as a measure for prevention of the child maltreatment by encouraging responsibility among people. The nurses can also support the mutual aid groups that seek to address the child abuse cases. Further assessment, to identify exposure to other child abuse cases is vital for necessary interventions to be taken (Fraser et al, 2010). The nurses should respond to the child by providing moral support. In case of any physical injuries, first aid treatment should be provided The nurse should consider issues relating to sharing of information and consent to treatment. It will also involve having consultations with health workers or other child abuse managers.
To carry out the effective evaluation, the close monitoring of intervention plans is important. The outcomes of the interventions include reduction of risks of child maltreatment. Overall performance at the family and school level is another outcome to be evaluated by the nurses after implementation of the interventions. The improvement of the performance will indicate success of the intervention plans. The outcome of the intervention plan will also be done using the improvement of physical health, which is expected after implementation of efforts by the nurse. The success of intervention plans by the nurses is determined by the effectiveness of treatment administered as well as the child protection strategies (Oates, 2013). The child protection reports will be evaluated to identify the major issues that need better intervention methods. The family satisfaction in the achievement of the set goals will also be used to evaluate outcomes. The outcomes will be based on the risk factor consideration of the prevalence of signs and symptoms (Fraser et al, 2010). Improvements and the end of signs and symptoms assessed through various diagnoses is a positive outcome indicating the success of the process of child abuse management by the nurses (Fraser et al, 2010).
Role of Nurse in Nursing Care of the Child and Family Conclusion
Concisely, the nurses have the role of ensuring the cases of child abuse in Australia are properly addressed to reduce the prevalence. The identification, assessment, intervention, and evaluation of the issues affecting the children will be vital during the performance of their roles in accordance with the Australian nursing practice (Oates, 2013). The early identification of signs and symptoms will make the process for the nurses easier. Collaboration between all people in the society will smoothen and ensure child abuse management is efficient.
Role of Nurse in Nursing Care of the Child and Family References
Allwood, M. A., &Widom, C. S. (2013). Child abuse and neglect, developmental role sattainment, and adult arrests. Journal of research in crime and delinquency, 0022427812471177.
Babington, B. (2011). National Framework for Protecting Australia’s Children: Perspectives on progress and challenges. Family Matters, (89), 11-20.
Biehal, N. (2014). Maltreatment in Foster Care: A review of the evidence. Child Abuse Review, 23(1), 48-60. doi:10.1002/car.2249
Budiselik, W., Crawford, F., & Squelch, J. (2010). Acting in the best interests of the child: a case study on the consequences of competing child protection legislation in Western Australia. Journal Of Social Welfare & Family Law, 32(4), 369-379. doi:10.1080/09649069.2010.539356
Camilleri, P., Thomson, L., & McArthur, M. (2013). Needs or deeds? Child protection and youth justice in the Australian Capital Territory. Journal Of Social Welfare & Family Law, 35(2), 193-206. doi:10.1080/09649069.2013.800285
Francis, K., Chapman, Y., Sellick, K., James, A., Miles, M., Jones, J., & Grant, J. (2012). The decision-making processes adopted by rurally located mandated professionals when child abuse or neglect is suspected. Contemporary Nurse: A Journal For The Australian Nursing Profession, 41(1), 58-69.
Fraser, J. A., Mathews, B., Walsh, K., Chen, L., & Dunne, M. (2010). Factors influencing child abuse and neglect recognition and reporting by nurses: A multivariate analysis. International Journal of Nursing Studies , 146(153).
Oates, R. K. (2013). The spectrum of child abuse: Assessment, treatment and prevention. Routledge.
Paavilainen, E., &Flinck, A. (2013). National Clinical Nursing Guideline for Identifying and Intervening in Child Maltreatment within the Family in Finland. Child Abuse Review, 22(3), 209-220. doi:10.1002/car.2207
Reeve, R., &Gool, K. (2013). Modelling the Relationship between Child Abuse and Long-Term Health Care Costs and Wellbeing: Results from an Australian Community-Based Survey. Economic Record, 89(286), 300-318. doi:10.1111/1475-4932.12044