Assessing paediatric safeguarding in rural Australian health services.

Children aged 2-6 are at higher risk for harm than previously recognised and children aged 0-2 years were over-represented in staff-suspected concerns. Those accompanied by police had significant association with confirmed safeguarding concerns which were under-suspected by staff or assumed to have been already reported. In rural practice, 'unreasonable delay' was found to be a better measure of concern than a discrete time value. Transient family arrangements, unsecured accommodation, geographical isolation, cultural safety and unique home environments must be taken into when completing injury assessments. For regional health services to successfully identify children at risk, interagency collaboration, staff education and local patterns of concern should be targeted. Rostering changes should increase after-hours assessment capacity by specialty paediatric staff.