Knowledge Mobilisation in Safeguarding Adults and Children for Healthcare in England

Table 1

Data extraction and evidencing change in safeguarding KMb for healthcare.

Source	Community/population	Participants	Type of knowledge shared	How knowledge is shared/mobilised	Who is doing KMb?	Function/purpose of KMb	Evidence of change
Arulrajah and Steele [42]	Medical students/victims of human trafficking	Medical schools/students	Curriculum content on human trafficking	Training and education in medical curriculum	Academics	Improve training and education of medical students (HT)	Call for action: improved awareness of the gaps in the provision, context, and delivery of human trafficking education in the current curriculum for medical students in the UK
Bellman et al. [43]	Nurses working at advanced level of practice (adult infection control)	Academic and practice	Knowledge to action framework	Publication on knowledge transfer methods and role in improving evidence-based nursing care	Academic and practitioners	To learn if knowledge transfer programmes, structures, frameworks, and theories are working, and if not, why not	Call for systematic use of KT frameworks to improve the utilisation of research in practice
Botham [44]	Health visitors and school nurses	Academic (HV)	Literature review on effectiveness of safeguarding children supervision	Published literature review (professional journal)	Academic HV	To examine and define safeguarding supervision in relation to both health visitors and school nurses	Supervision remains undefined
Crawford and L’Hoiry [45]	Policing and children’s safeguarding partners in Leeds	Social work (20), the police (15), health (7), youth services (5), and third sector organisations (3)	Examining the best elements of “boundary work” for communities of practice	Leadership relating to strategic goals of shared commitment and purpose	Policing leadership, embedded in aspirations towards community of practice	Build a safeguarding community of practice in Leeds	Evidenced knowledge brokering. The cluster model colocated “the front door” and mature networked relations of trust and open conflict management. Opportunities for critical reflection on practices and possibilities for cultural transformation to effect change. Cultivate creative “boundary work” rooted in shared experiences
Dodsworth [46]	Safeguarding children’s board/practitioners	Safeguarding professionals, Northamptonshire	Toolkit (CSE) designed by Northamptonshire Safeguarding Children Board	National guidance overview	Local safeguarding board	To collate key research, practice tools and protocols to increase awareness of CSE	Useful guide
				Local response (template)			Not evaluated
				Individual agency responses
Domac and Haider [47]	Patients and service users of health and social care services	Social workers, two occupational therapists, a nurse and a safeguarding adult trainer	Personal experiences of professionals regarding past safeguarding training and the way in which meaning arises in these experiences	Two-part qualitative semi structured interviews to explore adult safeguarding training needs	Academics	To develop an interagency safeguarding adults training pathway that will allow health and local authorities to deliver training jointly and to learn together	Developed an interprofessional safeguarding training path
Drewett et al. [48]	Children and families at the point of contact with healthcare practitioners	International conference attendees with an interest in using technology to influence behavioural change. 70 professionals from the pharmaceutical industry, the charity sector, health psychologists, ethicists, medical doctors, academics, and computer scientists. In the first part of the study, GPs from local surgeries	Expert views on the use of virtual reality based safeguarding training	A panel discussion held at the Centre for Behaviour Change, 4th Annual Conference at University College London on 21 February 2018	Academic research	To improve role-play training in medical professions, to overcome ethical issues related to engaging children in role play in safeguarding training	The panel discussion itself, recognition of shortcomings (cost and more realistic VR needed), previous GP’s responses that participation made them aware of missed safeguarding cues
Fanneran et al. [49]	Vulnerable adults in mental health services	33 NHS mental health services	A review of self-reported practices and procedures related to safeguarding at institutional level	Cross-sectional survey with a mixed-method design	Academics and academic practitioners	To investigate the organisational structure, implementation, and development of adult safeguarding in NHS mental health services	Training and attitudes were identified as main barriers to practice, and results were used for further research to build a grounded theory of adult safeguarding in NHS mental health trusts
Fleming [50]	Children and young people in health organisations	Employees of an NHS trust/a safeguarding educator	Review of actions taken to improve safeguarding training compliance in a large NHS trust	Evaluation reports and reflective review of the process	A safeguarding educator at an NHS trust	To review actions taken to improve training compliance and understanding why children and young people safeguarding training is important across the trust and professions	Compliance increased and positive responses from the evaluation forms indicating that knowledge and understanding has increased
Franks and Howarth [51]	Children in health services	4 nurse consultants who specialised in safeguarding children and six stakeholders	Personal perception of existing skills and training needs	Semistructured interviews and review of documents such as job descriptions	Academic researchers	To establish learning needs and most appropriate education strategies to prepare for the role	Developmental needs identified to ensure professional development
Gibson et al. [52]	Adults at the point of contact with GP	GP safeguarding leads and authors	Practise based experience	Policy/literature summary and development of a safeguarding pathway	Practitioners and safeguarding adults leads in GPs and NHS trusts	To review the role of GPs in adult safeguarding	Practical impact not assessed; summarises policies GP surgeries should implement regarding safeguarding adults; details core competencies required of GPs regarding safeguarding adults; presents how CCGs can seek assurance from GP surgeries regarding safeguarding adults; and presents straightforward pathways for specific safeguarding adults scenarios
Gilhooly et al. [53]	Banking, health professionals and older people	20 banking and 20 health professionals	Recognising financial elder abuse	Decision cues that raise suspicions of financial abuse, how such abuse comes to the attention of professionals who do not have a statutory responsibility for safeguarding older adults, and the barriers to intervention	Banking professional, healthcare professionals	Recognising cues that enable decision making	Marked difference in the type of abuse noticed by banking and health professionals, drawing attention to the ways in which context influences the likelihood that financial abuse will be detected. The study revealed that even if professionals suspect abuse, there are barriers which prevent them acting
Gough and Kerlin [54]	Older adults in residential care homes	Key informants who had strategic responsibility for implementation of MCA training and managers/deputy managers of care homes within a local authority	Practice based views of MCA training and implementation	Semistructured interviews and focus group	Academics	To evaluate the impact of MCA training within older persons’ care homes	Suggested methods of delivery of the Mental Capacity Act which offer a tailored, engaging and cost-effective alternative to conventional “away day” training sessions
Hackett et al. [55]	Children with harmful sexual behaviours in any setting	147 professionals from various health, social care, and youth justice agencies in the participating local safeguarding children’s boards	An evaluation of the effectiveness of a training course	21-item self-report questionnaire and the knowledge and attitudes towards young people with harmful sexual behaviours scale	Academics	To evaluate effectiveness of an interagency training course	Strong evidence of overall improvements in scores on most of the scale items. Concerns raised about the small number of criminal justice professionals participating compared to child welfare professionals
Heslop et al. [56]	People with intellectual disabilities	n/a	Lessons learned from a confidential inquiry into premature deaths	Document/evidence review	Academics and practitioners	To report the findings of the confidential inquiry into premature deaths of people with intellectual disabilities (CIPOLD) in relation to the Mental Capacity Act (England and Wales) (MCA) 2005	First paper that associated a lack of adherence to MCA to premature death within a safeguarding framework and other evidence of change not explored
Humphries [57]	Adults in health and social care settings	Four local authorities and partner agencies	Lessons learned for a pilot programme of peer reviews	Summary of findings from the peer reviews	Academic	To assist the improvement of safeguarding policy and practice	The pilot was successful, and the four local authorities received actionable feedback on strengths and areas for development
Kirk-Batty [58]	Children at the point of contact with a midwife	Practicing midwife	Literature review and experience-based reflection	Literature review	Midwife and practitioner	To explore safeguarding practice from a midwifery perspective, which includes looking again at the fundamental, basic principles of midwifery in order to advance practice further. To encourage reflection and skills improvement	Not assessed
Lawrence and Banerjee [59]	Adults in care homes	14 care home managers and 24 members of care home staff across 14 care homes	Experiences and views of changes in practice resulting from establishment of a support team	In-depth interviews	Academics	To assess the impact of the support team	The support team lead to improved development and facilitated access to training
Lewis et al. [60]	Social work, healthcare (acute)	Designated safeguarding leads: doctors, nurses, midwives, and social workers	Good practice examples (joint working)	Training supported by visual prompts and awareness raising (after training)	Social work authors	To understand how acute trust paediatric and LA services work together in suspected cases of child maltreatment, and what is viewed locally as good practice	Case studies show good practice illustrates how collaborative practice identifies child maltreatment
Lewis et al. [61]	Children at the point of contact with GPs	11 general practices and 88 clinicians	Training pack was developed collaboratively using clinical, academic, front-line practitioner, service user, and training expertise in DVA, CS, and health	Intervention: through training with focus on multiagency	Academics	To fill gaps in knowledge and practice on the interface between DVA and CS revealed by the responds research	Training pack developed and successfully piloted
				Intervention evaluation: mixed methods study including observations, questionnaires, qual analysis
Littler [62]	Children at the point of contact with nurses	Children’s nursing students	Academic, research-based and experience-based knowledge and skills	Integrated in the formal university curriculum	Academics through formal university education	To prepare student nurses for their career	Safeguarding education was provided consistently throughout their preregistration training over the three years, in university and practice settings, via a blended educational approach. This includes modules, individual sessions, online learning, study days, and workshops
Lushey et al. [63]	Unborn children	22 practitioners involved in prebirth assessment (five practitioners from health-related fields)	Guidance (or rather a lack of comprehensive guidance), and experienced-based knowledge (from interviews but also mentioned as the main way of gaining knowledge from other peers)	Documentary analysis of the guidance and interviews with practitioners	Academics through the article	To explore prebirth assessment	Not assessed
					Peer practitioners
McGarry et al. [64]	Vulnerable adults and children at the point of contact with nurses	Preregistration nursing students	Academic, research-based and experience-based knowledge and skills	Integrated in the formal university curriculum	Academics through formal university education and safeguarding lead coordinator for education and practice	To prepare student nurses for their career	New approach to safeguarding curriculum developed with a lead coordinator role established, successfully completed by a cohort of students
McGarry et al. [65]	As above	As above	As above	As above	As above	As above	As above
Moore [66]	Older adults in care homes	Qualified nurses	Academic and practice-based knowledge and guidance	Integrated in formal vocational or professional qualification	Independent researcher through the article and training providers	The article: to find out whether safeguarding training prevents abuse	Recognised training for those who provide care in care and nursing homes is of limited efficacy in the prevention of abuse
						Training itself: to prepare nurses for their roles and integrate safeguarding principles in their practice
Norrie et al. [67]	Adults known to social services	People who have been safeguarded and their representatives	Personal experiences of being “safeguarded”	Face-to-face interview based on 7-question survey	Academics gaining knowledge from SUs	To test the feasibility of using this survey to “seek feedback” from adults at risk about adult safeguarding services	Survey helps professionals understand SU experiences
Northamptonshire Children’s Safeguarding Board [68]	Children and families in any setting	Frontline practitioners	Comprehensive, applied guide on many aspects of child neglect	Toolkit, information dense in “bite-sized” sections, with practical examples and tools for practice use	Local Safeguarding Board (multiagency)	To develop a toolkit for neglect (for local practice)	Developed evidence-based toolkit for use in local practice
Northamptonshire Children’s Safeguarding Board [69]	Children in any setting	Frontline practitioners	Comprehensive, applied guide on many aspects of CSE	Toolkit, information dense, with practical examples and tools for practice use	Local Safeguarding Board (multiagency)	To develop a toolkit for CSE (for local practice)	Developed evidence-based toolkit for use in local practice
Ochieng and Ward [70]	Adults at risk	Registered nurses (n = 51) working in primary or secondary care in east England	Evaluation of safeguarding of vulnerable adults CPD course	50-item questionnaire administered online to evaluate SOVA-CPD	Academic/trainer seeking knowledge about nurses’ learning from SOVA-CPD	To provide insights into the effect of SOVA-CPD training for nurses	Nurses reported enhanced competence and skills but an impact on care limited by challenges experienced in making changes in practice settings
Patrick et al. [71]	Children at risk	Healthcare assistants, nurses, dentists, and doctor	Audit to identify and address the barriers of reporting, safeguarding concerns amongst the hospital team	Audit questionnaire to review child safeguarding training courses	Academic practitioners seeking knowledge about existing child safeguarding training	To review current and training and identify required modifications to programme	Best approaches identified are (i) focused training on diagnosis and local protocols, (ii) bespoke teaching for specific specialties, (iii) exploring modern methods of learning, and (iv) use of structured forms and local policies familiar to clinicians
Peckover and Golding [72]	Children and people at risk of domestic abuse	Multiagency teams	Evaluation of activities to improve domestic abuse/safeguarding children practice	Telephone interviews with project participants, analysis of case mapping, and project reports	Academics reporting on a funded research project conducted by voluntary sector organisation in LAs	To share learning from project, to provide recommendations for improving multiagency work to achieve better outcomes for women and children experiencing domestic abuse	Not assessed
Phair and Heath [73]	Older people in formal care setting	Readers of this article	Codified information about safeguarding legislation and policy	Reading article	Nurse/safeguarding experts	To inform readers	Not assessed
Phelan [74]	Care home residents	Readers of this article	Literature summary and formal codified knowledge on safeguarding issues	Reading article	Academic	To inform readers	Not assessed
Pike et al. [75]	Adults at risk	H&S staff and volunteers, Cornwall	Basics of safeguarding (and linking with MCA and EDI)	E-learning for basics, face-to-face for advanced course	Educators from practice and academia	To provide safeguarding training to multiagency staff groups including statutory, independent and voluntary sectors	Not assessed at the time of publication
Pike et al. [76]	Primary care, adult social care	Healthcare workers and social workers	Safeguarding adults from abuse	Training transfer	Academics and social work	To clarify the relationship between safeguarding adults training, staff knowledge and confidence	Training contributed to an approximately 20 per cent increase in knowledge and a ceiling effect was noted. Confidence linked knowledge and action. More confident staff offered more sophisticated responses regarding improving safeguarding processes
Plastow and Lowenhoff [77]	Clients of HVs	HV practice teachers, mentors, and students	Learning from SCRs	“Snakes and ladders” game with cards conveying learnings from SCRs and examples of good practice	Local CYP lead + PH expert	To produce a practice focused, portable and interactive resources for use by HV students	Qualitative feedback: (i) useful resource, (ii) works with different learning styles, and (iii) supports service delivery and performance indicators but not yet any “hard” evidence of this
Preston-Shoot [78]	LSAB	LSAB	How organisations have worked together, and how local safeguarding adults board (LSABs) have supported and scrutinised their collaboration	Incorporating knowledge of national and local geography into SCRs	Academic	To draw on systemic and psychodynamic theories to subject published serious case reviews (SCRs) involving self-neglect to a deeper level of scrutiny, in order to understand how complex contexts impact on self-neglect work	Supports systemic theory: how practitioners work with adults who self-neglect and simultaneously are shaped by that work. This adds to the practice, management, and organisational evidence base for working with adults who self-neglect
	Individuals and populations who self-neglect
Preston-Shoot [79]	Vulnerable adults in any settings	None	Practise-based and experience-based knowledge derived from the reviews	Review of how SARs are used and to extract knowledge on self-neglect cases	Academics and practitioners (safeguarding adults boards)	To update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis, and to address the challenge of change	Contributes new perspectives to the process of following up SARs by using the findings and recommendations systematically within a framework designed to embed change in policy and practice
Preston-Shoot [80]	Adult safeguarding specialists LSAB	SABs	SARS and thematic literature review	Secondary data analysis: updates to SARS	Academic	Update the core data set of self-neglect safeguarding adult reviews (SARs) and explore the degree to which SARs draw upon available research and learning from other completed reviews	Answering “why” question (partially) builds on what is known from SARS about the components of effective practice
Simic et al. [81]	Adults: independent sector services	Local authority staff and independent sector domiciliary and residential care providers	Evaluation of key organisational processes in managing safeguarding	Telephone survey and focus groups with staff	Local safeguarding experts	To better understand current organisational processes and how these may be improved	As a result of knowledge generated, guiding principles for practice established and practice challenges identified
Smickle [82]	Nurses safeguarding children and young people	Safeguarding lead/specialist NHS)	Supervision frameworks	Supervisory models and relationships	Safeguarding lead in NHS	To better improve offer safeguarding supervision to front-line colleagues with case management responsibilities for vulnerable children and young people	12 supervisors provided feedback, nine months after completing a nationally accredited child protection supervision skills course, on how they were using their new skills and knowledge in clinical practice
Spencer-Lane [83]	Health and social care professionals safeguarding adults	Lawyer: academic	Legal and regulatory frameworks	Legal updates on mid staffs inquiry, impact of professional regulation)	Lawyer: academic	Implementing policy: to consider the final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry and the law commission’s review of health and social care professional regulation, and how these will impact on the professional regulation bodies	Not evaluated
							Author influences policies that relate to and affect healthcare
							Responsible for the UK Law Commissions’ review of the regulation of health and social care professionals
Stalker [84]	Deaf and disabled children	Multiprofessionals	Case studies from practice	Case scenario learning using multimedia CD and DVD	Academic and practitioners	Disseminate best practice through resource review	Not evaluated
	Professional training
Stevens and cook [85]	Adults and children at risk	Adult nursing students	Students’ assignments	Review of nursing student reflective assignments	Local safeguarding practitioner + learning facilitator	To identify safeguarding concerns relating to vulnerable adults and explore implementation of safeguarding policy and procedures in practice	Audit tool to evaluate the knowledge of preregistration students was developed. Safeguarding adults’ policies implemented in one academic institution
Stupple et al. [86]	Vulnerable adults	Clinical staff, safeguarding and governance experts, and local multiagency safeguarding hub (MASH)	Literature and clinical practice experience	Not specified	Clinical staff, safeguarding and governance experts, local multiagency safeguarding hub (MASH)	To develop a safeguarding tracker tool	Safeguarding tracker tool was developed. Minimal evaluation was reported
Szilassy et al. [87]	Domestic violence and child safeguarding	General practice staff	DV and safeguarding policy and practice	Synthesised evidence from literature reviews, mapping of available training and qualitative data from general practice combined with DV and safeguarding policy and practice used to develop training programme	Multidisciplinary research team guided by professional and service user experts	To develop an evidence-based training programme for primary care	Evidence based responds training programme; 2-hour training designed for individual general practice teams delivered on practice premises
Thacker et al. [88]	Social services/social work	Social work authors	Secondary research: practice review of literature including SARS/SCRs	Disseminated through publication	Practitioners (social work)	Suggesting “professional curiosity” is an element of safeguarding effectiveness	No
Theakstone-Owen [89]	Neonates	Readers of this article	Current legislation which guides practice, using a case study to illustrate areas of interagency working	Reading article	Single author: speciality not specified	To examine interdisciplinary approaches to information sharing and collaboration in safeguarding	Not assessed
Willow [90]	Teenagers with lived experience of care	Teenagers academic	Film made by teenagers explaining their experience and hopes for safeguarding interventions/care	Voice of the child DVD training resource	Teenagers with lived experience of care	Disseminate lived experience through a training resource made by teenagers	Not evaluated
Wyllie and Batley [91]	Children’s nursing	Students/children’s nursing	Situations where children may have been subject to abuse or neglect	Simulated case learning	Impact of simulated learning on decision making and performance	Improve learning outcomes for safeguarding in children nursing	Yes. Fidelity of simulation design. Evidence from students’ accounts suggests an increase in their level of confidence in matters relating to safeguarding practice to the extent that they had felt able to challenge and question more senior colleagues and staff
			Theoretical knowledge and practical skills for safe practice		Safeguarding lead and child health nurse lecturer
Yoeli et al. [92]	Adult safeguarders	Lay members	Scenario learning using forum theatre to elicit responses	Forum theatre frameworks (scenario)	Academic and social work	To explore how a variety of professional and lay groups understood, related to and engaged with how the Care Act (2014) defines and describes “adult safeguarding”	Not evaluated
		Social workers
		Health care practitioners