Guideline Title: Child Maltreatment: Care for the Child and Family
Effective Date: July 2014
Approved By: Nursing Practice Guidelines Committee; Nursing Practice Council
I. Guideline Overview
Pediatric patients and families
Nursing Practice Guideline Objectives
This guideline is intended to guide nursing assessment and interventions for the care of children who have
suspected or actual maltreatment.
Clinical Questions Considered
• What nursing considerations are needed to optimize care for the child and family where maltreatment is
• How do nurses report and document suspected or actual child maltreatment taking into account the
sensitive nature of this work?
• How do nurses differentiate cultural health practices versus behavior or actions that are considered
• How can nurses refer, educate and support families to prevent injury and escalation of child
For more information, please see the complete guideline.
II. Practice Recommendations
For more information about rating scheme used to describe strength of recommendations, see below.
1. Nurses should know clinical signs of child neglect to effectively promote early intervention and prevent
escalation to physical abuse.
2. Nurses should be knowledgeable about the physical signs of child maltreatment for early identification and
3. Nurses should report suspected or actual child maltreatment and neglect cases to appropriate
agencies or resources.
4. Nurses should provide clear and accurate documentation about all observations and physical findings
related to actual or suspected abuse.
5. Nurses should strive to better understand family roles and behaviors within specific cultures to
provide optimal care that is patient and family-centered and culturally congruent.
6. Nurses are in a key position to assume a leadership role involving key stakeholders toward the identification
and interventions on behalf of children at risk for maltreatment.
Benefits Balanced with Harm
University of Wisconsin Hospitals and Clinics
Nursing Practice Guideline At-a-Glance
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Last Revised: 07/2014EArsenaultknudsen@uwhealth.org
III. Pertinent Resources
A. UWHC Policies
• Policy 1.2.4 Suspected Child Abuse and Neglect
• Policy 8.01, Safe Place for Newborns
B. Patient Education Resources
• Periods of Purple Crying (DVD)
• Health Facts for You 7152, Protecting Your Baby
• Health Facts for You 7255, Sleeping with Your Baby – the Risks
• Health Facts for You 7419, Parenting a Child with a Chronic Medical Condition
See full guideline document for list of references.
V. Rating Scheme For The Strength Of The Recommendations
Interventions for which effectiveness has been demonstrated by strong evidence
from rigorously designed studies, meta-analysis, or systematic reviews, and for
which expectation of harm is small compared to the benefits.
Likely to be
Interventions for which effectiveness has been demonstrated from single rigorously
conducted controlled trial, consistent supportive evidence from well-designed
controlled trials using small samples, or guidelines developed from evidence and
supported by expert opinion.
Interventions for which clinicians and patients should weight the beneficial and
harmful effects according to individual circumstances and priorities.
Interventions for which insufficient or conflicting data or data of inadequate quality
currently exist, with no clear indication of harm.
Interventions for which lack of effectiveness has been demonstrated by negative
evidence from a single rigorously conducted controlled trial, consistent negative
evidence from well-designed controlled trials using small samples, or guidelines
developed from evidence and supported by expert opinion.
Interventions for which lack of effectiveness or harmfulness has been demonstrated
by strong evidence from rigorously conducted studies, meta-analyses, or systematic
reviews, or interventions where the costs, burden, or harm associated with the
intervention exceed anticipated benefit.