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Usability and Technology Acceptance of an Electronic Child Abuse Screening Tool in a Pediatric Emergency Department

Author: Angela Hayes, MS (2022)

Primary advisor: Susan Fenton, PhD

Committee members: Amy Franklin, PhD, Christopher Greeley, MD, MS

DHI Translational Project, The UTHealth Houston School of Biomedical Informatics



Up to half of all child physical abuse victims with major abuse injuries seen in hospitals had sentinel injuries assessed by medical providers. Universal screening for child abuse and neglect in the emergency department can potentially increase detection at lower levels of injury. However, we must consider usability for the electronic health record embedded child abuse and neglect-screening tool to be most effective. The user most likely to interact with the screening tool is the bedside nurse. The interface of the initial screening tool and the process of inputting information must be perceived as useful, usable, and satisfying to the bedside nurse. The alert for a positive screen needs to achieve the right balance in visual hierarchy and workflow while avoiding alert fatigue and information overload in an already busy space. This project addresses the lack of robust universal child abuse and neglect screening in the Texas Children’s Hospitals’ emergency department. It also aims to address the gap in the literature on electronic health record-embedded child abuse and neglect screening tool usability. In addition, it seeks to address the gap in the literature on child abuse, neglect screening, and response protocols, as well as expand those protocols so they encompass support services for families affected by the sequela of poverty to avoid future states of neglect.