Pediatric Trauma Society

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Hit-Free Zones
Pam Pieper, PhD APRN TCRN1; Randell Alexander, MD PhD2; Deana Lashley, DO MS2; Jessica Winberry, BSH3
1Wolfson Children's Hospital, Jacksonville, FL; 2University of Florida - Jacksonville, Jacksonville, FL; 3Player's Center, Wolfson Children's Hospital, Jacksonville, FL

Background: There are negative health associations with hitting children as well as a definitive link between corporal punishment and child physical abuse. Corporal punishment is banned in all settings in over one-quarter of the world's countries. Many more limit corporal punishment in schools. In countries that still allow corporal punishment, there are few comprehensive programs denouncing the acceptability of hitting children.

Methods: A Hit-Free Zone is an environment in which no adult may hit another adult, no adult may hit a child, no child may hit an adult, and no child may hit another child. The entire staff of our hospital was educated about the facility becoming a Hit-Free Zone. They were also taught how to safely attempt to de-escalate situations in which someone might be hit and how to divert when hitting is occurring. Signage similar to that for no smoking zones was placed throughout the hospital property to clearly identify it as being a Hit-Free Zone.

Results: Our hospital, States Attorney's Offices in 3 counties, Family Support Services in 2 counties, a domestic violence shelter, the District Medical Examiner's Office, and the Child Protection Team Offices in 8 counties have implemented Hit-Free Zones. Other local hospitals are also considering implementing this policy. We are currently collecting data to evaluate the program's effectiveness.

Conclusions: Hit-Free Zones are a step toward changing social norms about corporal punishment and reducing child physical abuse. They are becoming more frequent in children's hospitals in the USA, with plans for them to become universal.


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