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Identification of Possible Abuse, Neglect and Exploitation

Child Abuse

In accordance with Section 43-21-105 of the Mississippi Code of 1972, Annotated, "Abused Child means a child whose parent, guardian or custodian or any person responsible for his/her care or support, whether legally obligated to do so or not, has caused or allowed to be caused upon the said child, sexual abuse, sexual exploitation, emotional abuse, mental injury, non-accidental physical injury or other maltreatment."


Types of Child Abuse and Neglect

  • Physical abuse
  • Emotional abuse (Psychological abuse)​
  • Child Neglect ​- Medical​, Educational​, Safety​, Emotional, Physical​
  • Sexual abuse ​
  • Abandonment​

Typical Indicators of Physical Abuse

Physical abuse is physical harm or injury that is a deliberate attempt to hurt a child or excessive physical punishment.

  • Injuries or bruises in various stages of healing as a result of non-accidental trauma​
    • Lacerations, scars, fractures, burns, ligature marks​
    • Unusual or unexplained bone fractures​
  • Injuries caused by weapon (gun, knife, object) at hands of caregiver, family member or intimate partner​
  • Injuries are inconsistent with patient or parent/caregiver explanation of how they occurred​
  • Injuries caused by punch, kick, slap, choking at hands of caregiver, family member or intimate partner
    • Bruise marks shaped like hands, fingers or objects​
    • Circular marks around wrists or ankles​
    • Ligature marks or hand print around neck​
    • Retinal hemorrhages​
    • Scalding "sock" burn patterns​
    • Cigarette burns​
  • Unexplained abdominal injury​
  • Sudden unexplained unconsciousness​

Emotional Abuse

Emotional Abuse can look like..

  • Rejecting the child​
  • Ignoring the child’s needs​
  • Isolating the child​
  • Enforcing deviant behavior​
  • Threatening or terrorizing the child​
  • Name-calling or other verbal abuse

Typical Indicators of Emotional Abuse

  • Patient flinches easily, fearful, anxious, and/or disclosed no emotion/flat affect​
  • Patient evasive, reluctant to speak in front of parent/caregiver, and/or avoids eye contact (Consider cultural or age norms)​
  • Parent/caregiver hovers over patient and/or answers questions directed to patient, or refuses to allow private evaluation (Consider cultural or age norms)​

Child Neglect

Child Neglect is the failure to provide the child's basic needs 

Types of Child Neglect:

  • Medical - withholding or not giving a child life sustaining medicines, overmedicating, not obtaining special treatment devices deemed necessary by a physician​
  • Safety - leaving child/children unattended or leaving child/children in the care of other children too young to protect them​
  • Educational - any child between the ages of 6 and 16 who are not enrolled or regularly receiving school based services to include home school.​
  • Physical – dressing children inadequately for weather, persistent skin disorders resulting from improper hygiene.
  • Nutrition - lack of sufficient quantity or quality of food, letting a child consistently complain of hunger.
  • Shelter - having structurally unsafe housing, inadequate heating, and unsanitary housing conditions.​

Sexual Abuse

Sexual Abuse is any inappropriate touching, contact or exposure of sexual content or nature by a friend, family member, or a stranger

  • Touching a child’s genital area​
  • Any type of penetration of a child​
  • Exposing a child to sexual content​
  • Watching or spying on a naked child​
  • Masturbating or having sex in a child’s presence​
  • Child Prostitution​

Typical Indicators of Sexual Abuse

  • Reports of sexual abuse by a parent or another adult caregiver​
  • Difficulty in walking or sitting​
  • Sudden weight change​
  • Frequent urinary or yeast infections not explained by medical condition​
  • Becomes pregnant or contracts venereal disease

UMMC Process for Reporting Child Abuse, Neglect and/or Exploitation

  • State law requires mandatory reporting for suspected child abuse, neglect or exploitation.​
  • Any person with reason to suspect that a child has been abused, neglected and/or exploited shall immediately notify their Department Manager or Administrative House Supervisor or the Department of Coordinated Care.​
  • UMMC Department of Coordinated Care serves as a liaison between UMMC and the mandated reporting agencies.​

    Policy:  Suspected Child Abuse and/or Neglect, Mandatory Reporting
    https://ummc.policytech.com/docview/?docid=3974​

Domestic Violence

  • Attempting to cause or intentionally, knowingly or recklessly causing bodily injury with or without a deadly weapon.​
  • Placing, by physical menace or threat, another in fear of imminent serious bodily injury.​
  • Includes the threat of violence.​
  • Seeks to establish power and control over another person through fear and intimidation.

Typical Indicators of Domestic Violence

  • Old and new injuries​
  • Choking sensations​
  • GI disorders, sexually transmitted diseases​
  • Frequent crying​
  • Alcohol and drug use​
  • Sleep disorders​
  • Hyperventilation​
  • Headaches​
  • Shyness, fright​
  • Increased startle reflex​
  • Passivity, increased anxiety, hypervigilance​
  • Chest, back pain​
  • Flashbacks​
  • Depression
  • Problem pregnancies​
  • Low self-esteem​
  • Somatic complaints​
  • Eating disorder​
  • Mood swings​
  • Suicidal behavior​
  • Extent/type of injury inconsistent with explanation​
  • Repeated emergency room visits​
  • Report of self-mutilation​
  • Self-induced abortions​
  • Multiple therapeutic abortions​
  • Lacerations and burns​
  • Emotional abuse or marital discord observed by staff

Emotional Indicators:

  • Fear​
  • Shame​
  • No support networks​
  • Feelings of worthlessness and hopelessness​
  • Feeling disassociated and emotionally numb​

Social/Financial:

  • Homelessness​
  • Unemployment​
  • No friends or family support​
  • Social/Familial isolation​

UMMC Process for Reporting Suspected Domestic Violence

  • There is no mandatory reporting to law enforcement in cases involving domestic violence unless  injuries or wounds were the result of “a gunshot or knifing” in accordance with Mississippi Code of 1972 SEC 45-9-31.​
  • Medical personnel may report with the patient’s consent.​
  • Under the Protection from Domestic Abuse Law, the victim does not have to press charges in his/her own name (Law Enforcement entity can file the charges).​
  • If you suspect your patient may be a victim of domestic violence, immediately contact the Department of Coordinated Care (Social Work)​

    Policy:  Domestic Violence​
    https://ummc.policytech.com/docview/?docid=4143​

Vulnerable Person/Adult

Who is Vulnerable?

  • Any person, regardless of aged, who is unable to care for or protect themselves from harm due to age or infirmity (i.e. bed-confined, wheelchair bound, etc.)​
  • Anyone being cared for in a care setting is by definition vulnerable, as they are dependent on others and do not have complete freedom of choice in how they live.​
  • The more dependent a person is on others for support, the more vulnerable they are likely to be, especially where there is also a degree of mental incapacity or mental disorder.​

Typical Indicators of Vulnerable Person/Adult Abuse and Neglect

  • Multiple bruising​
  • Fractures​
  • Burns​
  • Bed Sores​
  • Fear​
  • Depression​
  • Unexplained weight loss​
  • Malnutrition​
  • Untreated medical problems​
  • Bed Sores​
  • Confusion ​
  • Over-sedation​
  • Deprivation of meals​
  • Soreness around genitalia ​
  • Torn, stained or bloody underwear​
  • Sexually transmitted disease​

Vulnerable Person/Adult Exploitation

The illegal or improper use of a vulnerable person or his or her resources for another’s profit or advantage with or without consent of the vulnerable person, and includes acts committed pursuant to a power of attorney.​

UMMC Process for Reporting Vulnerable Person Abuse, Neglect and/or Exploitation

  • The Vulnerable Persons Act requires mandatory reporting of suspected abuse, neglect or exploitation of any vulnerable person.​
  • Any person with reason to suspect that a vulnerable person has been abused, neglected and/or exploited shall immediately notify their Department Manager or Administrative House Supervisor or the Department of Coordinated Care.​
  • UMMC Department of Coordinated Care will serve as a liaison between UMMC and the mandated reporting agencies.

What happens if the abuse, neglect or exploitation occurs on a UMMC campus?​ This could involve abuse by ​staff, providers, family or visitors while in our care.


Allegations of Abuse, Neglect and Exploitation that occurred at any UMMC location

​We are here to provide quality patient care so we do not routinely think in terms of “abuse/neglect” when our patients or their family make a complaint.​

The key is to listen closely to their complaint and if they allege abuse or neglect occurred on our campus, or infer it by what they are describing, it is your responsibility to report or make sure a report is made.​

Report Immediately

Respond to the patient/family in an empathetic, non-judgmental manner​

Report immediately to one of the following:

  • Charge Nurse​
  • Immediate Supervisor​
  • Administrative House Supervisor​
  • Risk Management (601-815-1995)​

Always complete an I-CARE report!

Risk Management will lead the investigation.​


Investigation Process

  1. Allegation​
  2. Manager obtains statements from all staff involved
  3. The Allegation of Abuse Committee reviews the facts​
  4. The Committee will make determination if abuse has occurred 
  5. If factual - report to Attorney General and Department of Health​
  6. Risk Management will follow up with person who made the allegation

    Policy:  Reporting Allegations of Abuse, Neglect and Exploitation of Patients on UMMC Campuses​
    https://ummc.policytech.com/docview/?docid=2130​

Final thought…

In your role as a caregiver, you also serve as an advocate for patients in our care.  If you observe actions or interactions with the vulnerable patient that concerns you, report it to your supervisor immediately.  In some cases it may be difficult for a patient to make an allegation, so your observations are crucial in safeguarding and protecting our patients and the organization.  If it gives you cause for concern, share it with your supervisor so necessary actions can be taken.

PROTECTING OUR PATIENTS IS EVERYBODY’S BUSINESS!​


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