Current Content
Volume 48 - Number 3
May/June 2022


Helping Nurses Identify and Report Sentinel Injuries of Child Abuse in Infants

Elizabeth A. Cleek, Joan P. Totka, Lynn K. Sheets, Joshua P. Mersky, and Kristin A. Haglund

Sentinel injuries (SIs) are some of the earliest and most readily identifiable red flags of child abuse. SIs are unexpected bruising or intra-oral injuries in pre-mobile infants and highly correlated with child abuse. However, SIs are not always recognized and reported as red flags of child abuse. Infants are left at risk for continued harm when SIs are not identified and reported. Although increasing nurses' knowledge of SIs is important, child abuse researchers and behavioral theorists have identified that knowledge alone does not predict nurses' behaviors when identifying and reporting suspected child abuse. Other predictors may include implicit biases, interpersonal and interprofessional relationships, and nurses' understanding of mandatory reporting laws. Nurses may improve their recognition and comfort of reporting SIs and all suspected child abuse by being alert for SIs, being aware of potential implicit biases, communicating in non-technical language with families, understanding the clinical evaluation of suspected child abuse, and understanding the processes of Child Protective Services (CPS). Using these steps, nurses can fulfill their legal and ethical responsibilities to protect and advocate for victimized children.