Safeguarding children at risk of maltreatment: Role of the Australian Child and Family Health Nurse

Introduction In New South Wales, Child and Family Health Nurses (CFHNs) are community-based specialist nurses working with families that have children under five years of age. Working from a universal health service, they are placed in a position of profound responsibility to prevent child maltreatment. Research interest is growing in the ways that services are responding to meet this preventative objective as part of the public health approach to child protection. Aim To examine what actions are used by CFHNs to continually support families through the process of considering, suspecting, and reporting child maltreatment? Practice strategies and practice drivers used to retain families were explored. Methods A sequential exploratory mixed methods research design using McCurdy and Daro’s (2001) conceptual model of the Integrated Theory of Parent Involvement was used. A cohort of 129 CFHNs completed a comprehensive questionnaire in phase 1. Qualitative data from focus group discussions with 27 participants were collected in phase 2. Results Participants were experienced, knowledgeable and confident in their practice, though commonly sought consultation to guide practice. Little variation was found in practice when families disengaged. The emotional toll on nurses had implications in all phases of family involvement even when engagement was fractured. An extension to the Model of Parent Involvement was proposed to consider ways to reconcile service delivery when families disengage hastily. Conclusion The study has contributed valuable knowledge of safeguarding practice used with families. Engagement of families relies on practice that is also multifaceted, advanced and flexible. A practice response requires nurses to integrate knowledge and confidence by drawing on experience, education, policy and support to meet the needs of families accessing universal health services