Child maltreatment: what nurses look for, record and report
- Assessment
Nurses notice injuries that do not fit the story, record exactly what they see and hear, and make sure protection is activated without delay.
What it is
Colombian law defines child maltreatment as any harm, punishment, humiliation, physical or psychological abuse, neglect, negligent treatment, sexual abuse or exploitation, and any violence against a person under 18 by parents, carers or anyone else. Ley 1098 de 2006 obliges the health system to train its staff to detect maltreatment and to report it to the competent authorities. The nurse does not investigate or prove abuse: the nurse notices warning signs, keeps the child safe, records facts objectively and makes sure the case reaches the team and the protection route.
Reference values
- Types: physical abuse, emotional abuse, sexual abuse and neglect; the code also protects children from economic and sexual exploitation.
- Some severe injuries are not visible, such as brain injury from forcefully shaking an infant or toddler.
- Sexual abuse warning signs include genital pain, itching, bleeding or discharge, difficulty walking or sitting, sexually transmitted infections, and sexual interest unusual for age or regression.
- Emotional abuse can show as low self-esteem, severe depression or anxiety, unusual aggression, extreme withdrawal or failure to learn.
What you need
- A private, calm space for the assessment.
- The clinical record and the institutional maltreatment protocol.
- The contact details of the protection route: ICBF line 141, family commissioner, police.
How to measure it (and why)
- Make sure the child is safe and treat urgent problems first — protection and life come before the record.
- Listen calmly to what the child and carer say about how the injury happened — the history is part of the assessment.
- Compare the story with the injury and with what the child can do at this age — a mismatch is a key warning sign.
- Examine the skin, including soft areas such as the abdomen, inner thigh and under the arm — bruises at these sites are listed warning signs.
- Record objective findings: site, size, shape and colour of each injury — objective notes describe, they do not interpret.
- Write statements in quotation marks, for example: the mother reports, followed by her words — quotation keeps the exact meaning.
- Inform the nurse in charge and the doctor during the same shift — the team activates the institutional protocol.
- Make sure the case reaches the protection route (ICBF line 141, family commissioner or police) — reporting is a legal duty of the health system.
How to read it
- Suspicion is enough to report; the protection authorities investigate.
- A report includes what happened and the nature of the abuse or neglect as specifically as possible, and the child and carer details; if information is incomplete, report what is known.
- Untreated medical or dental needs and failure to thrive can be signs of neglect: link them with the AIEPI assessment.
- Keep the family engaged with care and protect the child's privacy in records and conversations.
Next step: when to call for help
- Immediate danger, severe injury or suspected sexual abuse: tell the nurse in charge and the doctor at once and follow the institutional protocol.
- Any suspicion: report during the same shift; reporting does not require proof.
- If the child is not safe going home, the team contacts the ICBF or the police before discharge.
- Document what was reported, to whom, when and by whom.
Test yourself
Think of the answer, then tap the question to see it.
Which feature of the history is a key warning sign of physical abuse?
A story that does not fit the injury or the child's development, and a delay in seeking care.
How should a nurse record what the child or carer says?
As subjective data in quotation marks, starting with words such as "the mother reports", without interpretation.
Does a nurse need proof before reporting suspected maltreatment?
No. Suspicion is enough; the protection authorities investigate.
Which free 24-hour line receives reports of child maltreatment in Colombia?
The ICBF national line 141.
Elsewhere in DurgiPedia
- Child maltreatment: signs that should raise concern
- Abusive head trauma (shaken baby)
- Mandatory reporting: public health, violence and abuse
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Nursing: Mental Health and Community Concepts, 15.4 Abuse and Neglect (Open RN, CC BY 4.0) (Open Resources for Nursing (Open RN) / LibreTexts, 2022); Nursing Fundamentals, 4.3 Assessment (Open RN, CC BY 4.0) (Open Resources for Nursing (Open RN) / LibreTexts, 2021); Ley 1098 de 2006, Código de la Infancia y la Adolescencia (Gestor Normativo) (Departamento Administrativo de la Función Pública, Colombia, 2006); Línea 141 del ICBF (Instituto Colombiano de Bienestar Familiar, 2026).
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Representative model, for educational purposes only.