Aims and Objectives This audit aimed to assess how well staff are complying with NHS Clyde protocol regarding paediatric patients who leave the department prior to completion of assessment.

Child protection describes the processes involved in preventing harm occurring in at-risk children. NHS health boards have the duty to ensure there are clear child protection protocols implemented in their hospitals. All NHS health practitioners have the responsibility to be aware of and identify indicators of abuse and neglect in paediatric patients. Where signs are identified, action needs to be taken to protect the child from possible harm. Emergency department (ED) staff are often the first point of contact for paediatric patients. It is important to assess how well ED staff are able to comply with child protection protocol.

There has been no prior audit assessing good medical practice in this area.

Method and Design This was a retrospective audit of 475 paediatric patients who presented to Clyde EDs during the 2022 calendar year and did not wait to be seen. Data was collected through manual review of the patients’ notes on the Trakcare and Clinical Portal.

Results and Conclusion The audit uncovered a number of areas for improvement. Only 19.2% of patients had complete documentation available for their visit to the ED. Additionally, protocol-required comments about child protection concerns were absent from the vast majority (80.0%) of patients’ notes. The rate of comments was not significantly higher in children who had previous concerns raised regarding their safety. A lack of attempts to contact the carers and health visitors of patients who did not wait to be seen was also noted. In an effort to improve adherence to the protocol, a flowchart has been created for use in EDs (flowchart attached as supporting file). There are also plans for questionnaires to uncover reasons for staff not complying with the protocol.