Increasing Child Maltreatment Risk Factor Screening with the Safe Environment for Every Kid Model

Abstract

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to assess the feasibility and effectiveness of the Safe Environment for Every Kid (SEEK) model in a Northern Arizona pediatric primary care practice to identify its advantages, barriers, and associated staff perspectives.Background: Child maltreatment is an ongoing concern among children within the United States. Pediatric primary care is an ideal setting to institute preventive methods due to its nature of consistent and trusting caregiver-provider relationships. By using evidence-based screening tools to identify risk factors, providers can implement timely interventions. The SEEK model, as supported by literature, includes a risk factor screening tool as well as provider and staff resources to effectively address areas of concern among caregivers. Methods: This DNP project consisted of an educational session on SEEK for staff members, a plan for application of the model within the practice, and pre and post-surveys that assessed staff-perceived feasibility. The implementation process occurred over one month and included applying the SEEK screening tool as well as resources such as algorithms and handouts. The surveys were administered to staff members who chose to participate to assess knowledge, perceptions of feasibility, and desire to continue using the model. Results: Data collected showed a stable administration process of SEEK PQ-R forms over the course of one month. It revealed an increase in the use of a child maltreatment risk factor screening form from 0 to 57 over one month and an overall improvement of staff perceptions of using evidence-based screening tools for child maltreatment prevention. The caregiver participation rate was at 91% with a 46% positive screening rate. Resources were provided for 62% of caregivers with positive screening forms. All staff members either agreed or strongly agreed that they would like to continue using SEEK within the practice. Conclusion: Results from this DNP project confirm a critical need for the implementation of a child maltreatment risk factor screening tool in pediatric primary care settings. Results from the pre- and post-implementation surveys confirm that based on staff perceptions, implementation of the SEEK model was feasible and effective within the applied setting.