{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T04:30:29Z","timestamp":1776486629974,"version":"3.51.2"},"reference-count":13,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,1]]},"abstract":"\n BACKGROUND AND OBJECTIVE:<\/jats:title>\n Evidence-based medical care of sexual abuse victims who present to the pediatric emergency department (PED) is necessary to facilitate forensic evidence collection and prevent pregnancy and sexually transmitted infections. Adherence to testing and treatment guidelines remains low in PEDs, despite recommendations from the American Academy of Pediatrics and Centers for Disease Control and Prevention. We aimed to increase the proportion of patient encounters at a PED for reported sexual abuse that receive algorithm-adherent care from 57% to 90% within 12 months.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n Our team of PED and child abuse pediatricians outlined our theory for improvement, and multiple plan-do-study-act cycles were conducted to test interventions that were aimed at key drivers. Interventions included the construction of a best practice algorithm derived from published guidelines, targeted clinician education, and integration of an electronic order set. Our primary outcome was the proportion of patient encounters in which care adhered to algorithm recommendations. Data were abstracted from the records of all patient encounters evaluated in the PED for reported sexual abuse.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n We analyzed 657 visits between July 2015 and January 2018. The proportion of patient encounters with algorithm-adherent care improved from 57% to 87% during the study period. This improvement has been sustained for 13 months. Failure to test for hepatitis and syphilis constituted the majority of nonadherent care.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Using improvement methodology, we successfully increased algorithm-adherent evaluation and management of patients presenting for sexual abuse. Targeted education and an electronic order set were associated with improved adherence to a novel care algorithm.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2018-1811","type":"journal-article","created":{"date-parts":[[2018,11,9]],"date-time":"2018-11-09T08:24:29Z","timestamp":1541751869000},"source":"Crossref","is-referenced-by-count":10,"title":["Improving Emergency Department Care for Pediatric Victims of Sexual Abuse"],"prefix":"10.1542","volume":"142","author":[{"given":"Erin F.","family":"Hoehn","sequence":"first","affiliation":[{"name":"Division of Emergency Medicine and"},{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin M.","family":"Overmann","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine and"},{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nafeh","family":"Fananapazir","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine and"},{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten","family":"Simonton","sequence":"additional","affiliation":[{"name":"Mayerson Center for Safe and Healthy Children, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathi L.","family":"Makoroff","sequence":"additional","affiliation":[{"name":"Mayerson Center for Safe and Healthy Children, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berkeley L.","family":"Bennett","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Nationwide Children\u2019s Hospital, Columbus, Ohio; and"},{"name":"Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena M.","family":"Duma","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine and"},{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eileen","family":"Murtagh Kurowski","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine and"},{"name":"Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2018,12,1]]},"reference":[{"key":"2021121104072365400_B1","volume-title":"Findings From the 2012 National Intimate Partner and Sexual Violence Survey","author":"Sexual Violence in Youth","year":"2012"},{"issue":"4","key":"2021121104072365400_B2","first-page":"1","article-title":"Youth risk behavior surveillance\u2013United States, 2013 [published correction appears in MMWR Morb Wkly Rep. 2014;63(26):576].","volume":"63","author":"Kann","year":"2014","journal-title":"MMWR Suppl"},{"issue":"2","key":"2021121104072365400_B3","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.annemergmed.2006.10.015","article-title":"National estimates of sexual violence treated in emergency departments.","volume":"49","author":"Saltzman","year":"2007","journal-title":"Ann Emerg Med"},{"issue":"3","key":"2021121104072365400_B4","doi-asserted-by":"crossref","first-page":"e20164243","DOI":"10.1542\/peds.2016-4243","article-title":"Care of the adolescent after an acute sexual assault [published correction appears in Pediatrics. 2017;139(6):e20170958].","volume":"139","author":"Crawford-Jakubiak","year":"2017","journal-title":"Pediatrics"},{"key":"2021121104072365400_B5","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines, 2015 [published correction appears in MMWR Recomm Rep. 2015;64(33):924].","volume":"64","author":"Workowski","year":"2015","journal-title":"MMWR Recomm Rep"},{"issue":"6","key":"2021121104072365400_B6","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2015-2093","article-title":"Testing and treatment after adolescent sexual assault in pediatric emergency departments.","volume":"136","author":"Schilling","year":"2015","journal-title":"Pediatrics"},{"issue":"6","key":"2021121104072365400_B7","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2007-3100","article-title":"Compliance in Rhode Island emergency departments with American Academy of Pediatrics recommendations for adolescent sexual assaults.","volume":"121","author":"Merchant","year":"2008","journal-title":"Pediatrics"},{"issue":"2","key":"2021121104072365400_B8","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.jpag.2015.01.007","article-title":"Updated guidelines for the medical assessment and care of children who may have been sexually abused.","volume":"29","author":"Adams","year":"2016","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"23","key":"2021121104072365400_B9","doi-asserted-by":"crossref","first-page":"2779","DOI":"10.1001\/jama.2008.827","article-title":"Has this prepubertal girl been sexually abused?","volume":"300","author":"Berkoff","year":"2008","journal-title":"JAMA"},{"key":"2021121104072365400_B10","doi-asserted-by":"crossref","first-page":"S856","DOI":"10.1093\/cid\/civ786","article-title":"Sexual assault and sexually transmitted infections in adults, adolescents, and children.","volume":"61","author":"Se\u00f1a","year":"2015","journal-title":"Clin Infect 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