Date Available


Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Leslie Scott

Clinical Mentor

Dr. Mollie Aleshire

Committee Member

Dr. Jaime Pittenger


Child abuse is a serious, yet preventable problem in the United States. Child abuse is defined in The Child Abuse Prevention and Treatment Act as “Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation or an act or failure to act, which presents an imminent risk of serious harm” (United States Department of Health and Human Services [USDHHS], Children’s Bureau, Child Maltreatment 2009, 2010).

In 2010, there were an estimated 3.3 million referrals to Child Protective Services for the suspected abuse or neglect of a child in the United States, and of those children approximately 1,560 died as a result of the abuse or neglect. The duplicate victim rate, the rate of children victimized more than once, is 10.9 victims per 1,000 children in the population, indicating that children are often times victimized more than once (USDHSS, Children’s Bureau, Child Maltreatment 2009, 2010).

Pediatric emergency room and critical care nurses are frequently exposed to potentially abused children in their workplace. They are also considered mandatory reporters in 48 states, including Tennessee (USHHS, Child Welfare Information Gateway, Mandatory Reporters of Child Abuse and Neglect, 2013). In order to provide the best care to children, nurses need to be educated on how to recognize and report child abuse.

After conducting a literature review on nurse's comfort level with recognizing and reporting child abuse a study conducted by Feng and Levine (2005) was found. Their research concluded that although nurses feel a professional responsibility to report child abuse, most do not feel knowledgeable or comfortable recognizing or reporting suspected child abuse. Feng and Levine (2005) recommended that future practice included training for nurses at their workplace on recognizing and reporting potential child abuse. The literature review found that it was unknown how nurses' in the United States currently felt about recognizing and reporting suspected child abuse and thus led to this DNP project as was listed as a gap in the literature.

This DNP capstone project contains three manuscripts addressing child abuse and nurses’ comfort with recognizing and reporting child maltreatment. The first manuscript is a review of the literature related to nurses’ comfort levels with recognizing and reporting child abuse. The second manuscript reports the principal investigator’s findings related to nurses’ comfort levels with recognizing and reporting suspected child abuse in a southern urban children’s hospital. The final manuscript provides a cost benefit analysis of the implementation of a nursing education program to assist pediatric inpatient nurses in recognizing and reporting suspected child abuse.