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Ohio Children’s Hospitals Develop New Interventions to Prevent Repeat Child Abuse

10/25/2016

(COLUMBUS, Ohio)— Today Ohio Attorney General Mike DeWine and the Ohio Children’s Hospital Association (OCHA) announced new interventions and findings that aim to reduce the occurrence of child abuse in infants six months and younger.

Ohio Attorney General Mike DeWine funded the Timely Recognition of Abusive Injuries (TRAIN) Collaborative with a $1 million grant to OCHA. The purpose of TRAIN is to prevent repeat child abuse in the most vulnerable population, infants six months and younger. The TRAIN Collaborative has developed several tools that, once implemented by medical providers, may significantly reduce repeat instances of child abuse. The completed milestones include developing a comprehensive list of more than 50 different sentinel injuries, developing a physical examination that helps medical providers detect sentinel injuries and creating a bundle of care to confirm if abuse has occurred and if follow up care is needed. 

The TRAIN Collaborative analyzed what the medical community refers to as “sentinel injuries.” Sentinel injuries are minor injuries known to the medical provider that should prompt concern that the child is being abused. Unfortunately, sentinel injuries are often missed by medical providers placing the infant at risk for further abuse. The TRAIN study identified several sentinel injuries, including bruising, fractures, head injuries, abdominal injuries, burns, genital injuries and oral injuries. To ensure sentinel injuries are no longer missed by medical providers, the study developed a recommended comprehensive physical examination for infants under six months of age that includes examination of the face, mouth, ears, neck, torso, genitals and buttocks.

If a medical provider discovers a sentinel injury, there is now a recommended protocol or “bundle of care,” which was developed by the TRAIN Collaborative. The bundle of care assists in the identification of abuse and ensures the infant receives appropriate follow-up care. The bundle of care includes a skeletal survey of the infant, psychosocial assessment of the caregivers and pediatric consultation.

TRAIN researchers established a baseline frequency of sentinel injuries and found that one in 10 Ohio children seen for child abuse has been seen previously with a sentinel injury and less than one in three receives the necessary physical examination and follow-up. OCHA is confident that arming medical providers with the tools and information that resulted from the TRAIN Collaborative will significantly reduce child abuse. OCHA will be partnering with 19 regional hospitals across Ohio to implement their findings, including the following:

  • Bay Park Community Hospital
  • Memorial Fremont
  • Wood County Hospital
  • St. John's Westshore
  • University Hospitals/Elyria
  • University Hospitals/Ahuja Medical Center
  • University Hospitals Avon
  • St. Joseph Warren Hospital
  • St. Elizabeth Boardman Hospital
  • Aultman Medical Center 
  • Fairfield Medical Center
  • Adena Regional
  • Marion General
  • Springfield Regional
  • Upper Valley Medical Center
  • Atrium Medical Center
  • Mercy Anderson
  • Mercy Fairfield
  • Fort Hamilton
“It is our responsibility to protect children who are too young to understand their injuries or even to speak for themselves. By establishing evaluation techniques that identify early signs of child abuse, we hope to prevent more serious abuse in the future.  The work we are doing with the children’s hospitals and extending to the community hospitals, and the resulting action being taken at the diagnostic level, are lending a voice to children and are advocating for improved efforts when caring for Ohio’s next generation,” said DeWine.

“This initiative would not be possible without the commitment shown by the Attorney General,” said Nick Lashutka, President of OCHA.  “It is our hope that, through this cutting-edge research, we can help healthcare providers recognize the earliest signs of child abuse.”

“We are proud to collaborate with Ohio Attorney General Mike DeWine and OCHA to enhance this program's impact to other communities in our state,” said Mike Abrams, Ohio Hospital Association president and CEO. "By working together hospitals can align their extensive clinical and wellness services to bring quality preventive care to these patients."

More information about TRAIN is available at www.ohiochildrenshospitals.org.

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Media Contacts

AGO: Lisa Hackley: 614-466-3840
OCHA: Angela Krile: 740-974-3948