Factors Influencing Clinicians', Health Visitors' and Social Workers' Professional Judgements, Decision-Making and Multidisciplinary Collaboration When Safeguarding Children with Burn Injuries: A Qualitative Study

Abstract

Burns are a common injury to young children, sometimes related to neglect or physical abuse. Emergency department (ED) clinicians, health visitors and social workers must work collaboratively when safeguarding children with burns; however, little is known about the factors influencing their professional judgements, decision-making and multidisciplinary collaboration. Objective was to explore factors affecting ED clinicians', health visitors' and social workers' professional judgements and decision-making when children present to the ED with burns, and experiences of multidisciplinary collaboration, to identify areas for improvement. This was a qualitative semi-structured interview study using purposive and snowball sampling to recruit participants. Data were analysed using ‘codebook’ thematic analysis. Four themes were identified: ‘perceived roles and responsibilities when safeguarding children with burn injuries’, ‘factors influencing judgment of risk and decision-making’, ‘information sharing’ and ‘barriers and facilitators to successful multidisciplinary collaboration’. There is limited understanding between the groups about each other's roles. Each agency is dependent on one another to understand the full picture; however, information sharing is lacking in detail and context and hindered by organisational and resource constraints. Formal opportunities for multiagency team working such as strategy meetings can be facilitators of more successful collaborations. Professionals may benefit from multiagency training to improve understanding of one another's roles. Greater detail and context are needed when notifying health visitors of burn injuries in children or making a referral to children's services.