2016 Annual Associate Safety Modules Section 11 Patient Safety

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1 2016 Annual Associate Safety Modules Section 11 Patient Safety Recognizing and Reporting Abuse

2 Abuse Abuse is not limited to a particular group. It is found among all racial, ethnic, and socioeconomic backgrounds.

3 Abuse of Children Four Types Physical Neglect Sexual Psychological or Emotional

4 Abuse of Children Physical Abuse Any mistreatment of a child that results in harm or injury Anyone under the age of 18 years whose physical or mental health and welfare is adversely affected by brutality, abuse or neglect Examples» Beating» Burning» Scalding» Kicking» Hitting with an object» Tying up» Locking in a small space

5 Abuse of Children Neglect Neglect is the failure to supply the child with adequate food, clothing, shelter, education, supervision, or healthcare, providing the parent or guardian is financially able to do so. Lack of Proper supervision Protection Adequate clothing A safe place to live Educational opportunity Adequate medical and dental care Proper hygiene Deprivation of sleep Leaving a child locked in a closet

6 Abuse of Children Sexual Anytime an adult or older teen uses a child in a sexual way Non-touching offenses Indecent exposure/exhibitionism Exposing children to pornographic material Deliberately exposing a child to the act of sexual intercourse Masturbation in front of a child Touching offenses Fondling Making a child touch an adult s sexual organs Any penetration of a child s vagina or anus, no matter how slight, that does not have a valid medical purpose

7 Abuse of Children Emotional or Psychological Destructive criticism Verbal abuse (name calling, humiliating remarks or gestures) Consistent disrespect of feelings, rights or opinions Isolation Emotional withholding

8 Abuse of Children Risk Factors of Abuse Sociologic situations Unemployment Inadequate housing Dangerous environment Profound poverty Low self-esteem Parental factors History of abuse Inability to provide nurturing love Victim of domestic abuse Caretaker stress Single parent Young mother Illness Many small children Hyperactive child Child with disabilities Addicted child Parental alcohol or drug use Lack of impulse control

9 History given by parent/caretaker, is inconsistent with existing injury Inconsistencies or changes in the history itself Absence of any history or explanation for injury Patient/caretaker reluctant to give information Abuse of Child Clues of Abuse Patient is developmentally incapable of specified self-injury Delay in seeking medical care History of repeated injuries or hospitalizations Inappropriate response to severity of injury

10 Example of child abuse Hand Tying

11 Grabbing with Force

12 Examples cont. Cigarette Burn Beating

13 Abuse of the Elderly Five Types Physical / Sexual Neglect Personal Rights Psychological or Emotional Financial

14 Abuse of the Elderly Physical Abuse Pain, injury, and/or physical confinement; an act of violence that results in bodily harm or mental distress, including sexual abuse Bruises Welts Lacerations Fractures Burns Rope marks Medication Overdose Inadequate medication Unexplained venereal disease or genital infection

15 Abuse of the Elderly Neglect Neglect is the most common form of elder abuse. It is the deliberate refusal to meet basic needs, withholding assistance vital to performance of activities of daily living or behavior that causes mental anguish. Dehydration Malnutrition Decubitus ulcer Poor hygiene Lack of compliance with medication regimen

16 Abuse of the Elderly Emotional or Psychological Verbal aggression, intimidation, and humiliation Threats to deprive the elderly of property or services, to place in a nursing home or remove financial support Unreasonable demands; deliberately ignoring the person

17 Abuse of the Elderly Emotional or Psychological Psychological abuse Berated verbally Harassed Intimidated Threatened punishment or deprivation Elderly treated like an infant Isolate from family, friends, or activities Psychological neglect Left alone for long periods Ignored of given the silent treatment Failure to provide companionship Changes in routine, news or information

18 Abuse of the Elderly Violation of Personal Rights Deprivation of inalienable rights, i.e., personal liberty, personal property, free speech, privacy, and /or voting.

19 Abuse of the Elderly Financial Abuse Unauthorized use of money and/or goods for personal gain, includes petty theft or declaration of the elderly as incompetent to confiscate property; failure to pay bills. Financial/material abuse Denial of home for the elderly Stolen money or possessions Coercion of the elder to sign contracts Assign durable power of attorney Purchase goods Change the elder s will Lack of substantial care in the home despite adequate financial resources Patient confused about or unaware of financial situation Sudden transfer of assets to a family member

20 Abuse of the Elderly Risk factors of Abuse Advanced age Greater dependency on caregiver increases Alcohol abuse - elderly Alcohol abuse- care giver Past history of abuse Caregiver inexperience Economic stress Caregiver mental illness Lack of support system Cramped living conditions Sudden, unwanted, or unexpected dependency of the elderly on the caregiver

21 Abuse of the Elderly Clues of Abuse Pattern of healthcare shopping Series of missed appointments Previous unexplained injuries Presence of old and new bruises Poor personal hygiene Sexually transmitted diseases Extreme mood changes Depression Fearfulness Excessive concern with healthcare costs

22 Abuse Cycle Parent & Child Only Role Model is Abuse Lack of Understanding of Children & Discipline Crisis Crisis Lacks Understanding Frustration Becomes Parent Abuse Child Grows Up

23 Reporting Laws/Policy & Protocol Who Must Report? Anyone who suspects abuse Where to Report? Call Social Work

24 Nurse s Responsibility Care for the patient Support the patient Even if you suspect someone of abuse, he/she is still your customer Regardless of the allegations, treat him/her with respect Focus on providing medical care to the patient Leave judging to courts

25 Non Clinical Associates Non Clinical Associates are also responsible for reported suspected abuse. If you suspect abuse of a patient, you should report suspicions To the patients nurse To your immediate supervisor To the nursing supervisor To the compliance hotline

26 Documentation RN/LPN Nursing Assessment Form Have you been hurt by anyone? MD s order Document in Nurse s Notes Social Work LeCan Assessment Physician Assessment

27 What Does Social Work Do? Patient assessment Discussion with team (MD, nurse) Makes referral to DCS*, Police, MSAPC** (depending on type and severity of abuse) * DCS - Department of Child Services ** MSAPC - Memphis Sexual Assault Resource Center

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