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Nursing

Abuse And Neglect-Orientation Project And Community Assessment

Abuse And Neglect-Orientation Project And Community Assessment

Violence is a universal problem that affects people and their health throughout their lives. Physical abuse, neglect, sexual abuse, and emotional abuse are the four major types of (child) maltreatment (DFPS, n.d.). Imagine a place where everyone interacts and actively participates in preventing maltreatment of others before an actual event of abuse or neglect occurs. Consider this community, where many preventative services go far beyond providing direct services to specific families, such as education efforts that change societal standards and behavior, neighborhood activities that engage parents and caregivers, and public policies and institutions that assist at-risk families. According to Zimmerman and Mercy (2010), child abuse prevention programs have focused on the person and family dynamics rather than a community-based or societal strategy aimed at preventing child maltreatment. Unfortunately, “the child protection system sees only a fraction of the total number of children who experience abuse or neglect, and its involvement occurs after the fact” (Zimmerman & Mercy, 2010).

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Federal and State Definitions of Child Abuse and Neglect

The Federal

Child Abuse Prevention and Treatment Act is the federal legislation that guides states (CAPTA). CAPTA defines child abuse and neglect by a minimum number of actions or behaviors. According to the Child Welfare Information Gateway (2018), the CAPTA Reauthorization Act of 2010 revision defines child abuse and neglect as behaviors or crises that place a child in imminent danger. The described act focuses on the risk of serious harm or danger that a parent or caregiver places a child in, including death, severe physical and emotional injury, and sexual abuse or exploitation.

State

Each state that receives federal funds is required by law to define child abuse and maltreatment. Texas Family Code Section 261.101 (a) (DFPS, n.d.) criminalizes acts of bodily, emotional, and sexual maltreatment of a child. Third parties with knowledge of abuse are even legally required to report their suspicions to the appropriate authorities. The Texas Department of Protective and Regulatory Services will be notified (DFPS). Failure to report suspected physical, sexual, and emotional abuse is a misdemeanor, while failure to report sexual abuse is a felony. According to the Texas Family Code, both misdemeanors are punishable by law.

The Nurse’s Role in Child Abuse and Neglect Prevention

Nursing professionals with the necessary training and support are the most effective at assisting children and their families to thrive. Too often, nurses are placed in positions they were not adequately trained, and preventable abuse goes undetected and unreported. Reporting suspected child abuse and neglect is a fundamental responsibility of the healthcare professional, as mandated by state and federal legislation. “Nurses have many roles and experiences in keeping children safe, but they frequently felt they lacked the knowledge, skills, and support to act in this area” (Lines et al., 2017). According to Fraser et al. (2010), the proper education and training to recognize how and whom to report to are critical to effecting effective change.

The Child Welfare Information Gateway (2018) describes the nurse’s role in primary, secondary, and tertiary child abuse prevention. Primary prevention focuses on the entire population and preventing any abuse or maltreatment from occurring. The primary prevention nurse aims to raise education and awareness levels through educational programs and support groups. Secondary prevention targets higher-risk populations. Impoverished communities, caregivers who abuse substances (drugs/alcohol), teen parents, people with mental health issues, and caregivers or children with disabilities are among these populations. The nurse’s goal for secondary prevention measures is to concentrate on services that benefit the community or neighborhood where these risk factors are prevalent. When maltreatment or abuse has already occurred, tertiary preventative measures are used. The goal of tertiary treatment measures for nurses is to reduce the adverse effects of maltreatment and prevent abuse from recurring.

Child Abuse Warning Signs and Symptoms

The most serious problem with child abuse is that most children do not know where to turn or how to ask for help. Too often, children who are abused or neglected are too young or afraid to seek help because the people who are supposed to protect them are harming them. Healthcare providers are uniquely positioned to detect and report signs of abuse. According to the Texas Department of Family and Protective Services, n.d., signs of child abuse include frequent injuries with bizarre stories, numerous complaints of pain without apparent injury, burns and bruises in unusual patterns (indicating an instrument of some sort was used), an absence of reaction to pain, fear of returning home or seeing their caregiver, and inappropriate clothing for the weather (e.g., pants and sweater in 90+ degree weather). Neglect of a child is the failure of a parent or caregiver to meet the child’s basic needs for survival and health. Healthcare workers should be able to identify signs and symptoms of neglect, such as obvious malnourishment, a lack of personal hygiene, and ripped or dirty clothing. Sexual abuse symptoms may include but are not limited to difficulty sitting or walking, signs of genital injury, unusual knowledge about sexual acts, and details. Emotional abuse is visible as an apparent impairment in a child’s growth, development, or psychological functioning, usually due to harsh punishment. A child subjected to emotional abuse may be overly compliant, have low self-esteem, suffer from anxiety, aggression, and depression, have difficulty making friends, and even lash out without warning.

Reporting Abuse of Children

Texas has civil and criminal laws in place to protect children from abuse and neglect. If a person has reason to believe that a child is being abused or neglected, Texas Family Code Section 261.101 (a) requires that it be reported. If the presumed abuse or neglect involves a person responsible for the child’s guardianship, care, or welfare, contact the Texas Department of Family and Protective Services (DFPS). If a person not responsible for the child’s care lives in the home with the child and is suspected of abusing the child, the DFPS is also contacted. Child Protective Services (CPS) is a Department of Family and Protective Services division that conducts civil investigations into alleged abuse or neglect by caregivers or household members. Abuse or neglect may also be reported to local or state law enforcement agencies. The criminal aspect of investigations, which focuses on determining who committed a crime, is handled by law enforcement agencies. The CPS investigation is a civil court focused on the child’s and family’s well-being (DFPS, n.d.).

Intervention and Treatment Resources

Numerous state and private organizations offer treatment and support services to abused children and those abandoned or neglected by their parents or legal guardians. Kings Angels, for example, is a non-profit organization that serves Bexar County. They provide resources and service connections to help remove stressors that may lead to child abuse. The Texas Department of Family and Protective Services also offers county-based programs. Helping through Intervention and Prevention is one such program (HIP). This program provides evidence-based parent education in the home. The HIP is intended to promote positive outcomes for the entire family by promoting healthy, nurturing, and safe homes for children.

Conclusion

According to federal and state laws, every citizen must report actual and suspected abuse. In addition to providing knowledge and structuring capability, it is also necessary to establish a strategy for completing the actions required to execute advances in child maltreatment promotion and prevention issues at the national, state, and local levels. The world would be a better place if everyone worked together and actively engaged in preventing the maltreatment of others before an actual event of abuse or neglect occurred. There is a need for more preventative services that go beyond providing direct services to specific families. Education efforts that change societal standards and behavior, as well as community activities that engage parents and caregivers, should be included in these efforts.

Other Related Post: Nursing Reflective Journal

References

Child Welfare Information Gateway. (2019). About CAPTA: A legislative history. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.

Child Welfare Information Gateway. (2018). Improving Child Welfare Through Primary Prevention. Retrieved June 03, 2020, from https://www.childwelfare.gov/topics/preventing/overview/framework/

Fraser JA, Mathews B, Walsh K, Chen L, & Dunne M. (2010). Factors influencing child abuse and neglect recognition and nurse reporting: a multivariate analysis. International Journal of Nursing Studies, 47(2), 146–153. https://doi.org/10.1016/j.ijnurstu.2009.05.015

Johnson, R., & Fisher, H. L. (2018). Assessment of the psychometric properties of the Graded Care Profile version 2 (GCP2) tool for measuring child neglect. Child & Family Social Work, 23(3), 485–493. https://doi.org/10.1111/cfs.12441

KJ’s Angels are non-profit. (2019). Retrieved June 05, 2020, from https://www.kjsangels.com/

Lines, L. E., Hutton, A. E., & Grant, J. (2017). The integrative review: nurses’ roles and experiences in keeping children safe. Journal of Advanced Nursing (John Wiley & Sons, Inc.), 73(2), 302–322. https://doi.org/10.1111/jan.13101

Lines, L., Grant, J., & Hutton, A. (2018). How Do Nurses Keep Children Safe From Abuse and Neglect, and Does it Make a Difference? A Scoping Review. Journal of Pediatric Nursing, 43, e75–e84. https://doi.org/10.1016/j.pedn.2018.07.010

Logan, G. P., & Semanchin Jones, A. (2018). Predicting chronic neglect: Understanding risk and protective factors for CPS‐involved families. Child & Family Social Work, 23(2), 264– 272. https://doi.org/10.1111/cfs.12414

Nies, M. A., & McEwen, M. M. (2015). Community/Public Health Nursing (6th edition). Missouri, MO: Elsevier Saunders.

Taylor, J., & Bradbury-Jones, C., (2015). Child maltreatment: Every nurse’s business. Nursing Standard, 29(29), 53.

Texas Department of Family and Protective Services (DFPS). (n.d.) Retrieved June 03, 2020, from https://www.dfps.state.tx.us/Child_Protection/Child_Safety/report_abuse.asp

Texas Institute for Child & Family WellbeingWellbeing (TXICFW). (2020). Uniting Research and Practice. (2020). Retrieved June 03, 2020, from https://txicfw.socialwork.utexas.edu/

The Texas Alliance for Child and Family Studies (TACFS). (2020). Child Abuse Prevention. Retrieved June 03, 2020, from https://www.tacfs.org/child_abuse_prevention.php

Zimmerman, F., & Mercy, J. A. (2010). A Better Start: Child Maltreatment Prevention as a Public Health Priority. Zero to Three (J), 30(5), 4–10.

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Question 

There are two parts to this assessment. In this assessment, you gather information for a family assessment and examine the medical history and social influences on a family unit. You will conduct a windshield survey of the community in which your chosen family resides.

Abuse And Neglect

Abuse And Neglect

Part 1: Family Assessment

Select a family within your community as the basis for completing assessments in this course. The family must have at least one child under 18 living in the home.

Complete and submit a signed Family Release of Confidentiality form to your course instructor before your first point of contact with the selected family.

Review the critical points of therapeutic conversation.

Formulate key questions for obtaining valuable information.

Ensure your family assessment addresses the following:

  • Identifying data
  • Developmental stage and history of family
  • Environmental data
  • Family structure
  • Family functions
  • Family stress and coping
  • Family composition
  • Parenting styles

Provide a brief overview of the family members.

Define child abuse and neglect using your state’s terminology. Note any parenting weaknesses that might indicate possible abuse and neglect.

Write a minimum 875-word summary of Part 1.

Note: Remove all personally identifying information, such as the family members’ names. Refer to family members by initials only.

Part 2: Community Assessment 

Review the Windshield Survey Aid.

Review the Windshield Survey Resources 

Observe your family’s community by driving around the area.

Consider aspects of the community that could affect residents’ health and any HealthyPeople Leading Health Indicators that may apply to the community.

Conduct a windshield survey that addresses the following components:

  • The age, nature, and condition of the community’s available housing
  • Infrastructure needs—roads, bridges, streetlights, and so on
  • The presence or absence of functioning businesses and industrial facilities
  • The location, condition, and use of public spaces
  • The amount of activity on the streets at various times of the day, week, or year
  • The noise level in various parts of the community
  • The amount and movement of traffic at various times of day
  • The location and condition of public buildings—the city or town hall, courthouse, and so on
  • The walkability of community: walking paths/biking paths/safety and proximity for walkability to community resources
  • Public transportation availability, cost, accessibility
  • Social service centers, such as public libraries, parks, churches, community centers, recreation centers
  • Healthcare facilities, including how many, such as clinics and hospitals, and accessibility of healthcare resources
  • Food/nutrition, including details such as food deserts, grocery stores
  • Homeless population and homeless services details
  • Police and fire department presence
  • Schools and their location, including the physical condition of schools, and note whether daycare, preschool, elementary, middle school or high school.
  • Community resources related to child abuse and neglect, spousal abuse, or elder abuse

Compile your windshield survey data using the Windshield Survey Template to include the following:

  • Data overview of all community components as identified in the Community Tool Box Resource (in the Windshield Survey Resources below)
  • Strengths of the community as evidenced by a windshield survey
  • Weaknesses (gaps in service) as evidenced by a windshield survey
  • Develop one family nursing diagnosis based on an identified gap in community resources as an indicator of potential poor health outcomes
  • Develop one family diagnosis based on an identified gap in community resources as an indicator of potential poor/weak parenting

Format your assessment as noted:

  • 18- to 20-slide presentation
  • The slides should only contain essential information and as little text as possible. Do not design a slide presentation made up of long bullet points. Your speaker notes convey the details you would give if you were presenting. See the Create Speaker Notes page from Microsoft for more help.

Submit your assignment.

Windshield Survey Resources 

Review these resources for information about completing a windshield survey: