Use of Chaperones for the Pediatric and Adolescent Encounter: Policy Statement

Abstract

Pediatric inpatient and outpatient encounters often include examinations that may be perceived as intrusive or uncomfortable by patients because of examination of sensitive body areas. The presence of a chaperone during these examinations can serve to optimize the patient's sense of comfort and safety, as well as protecting the physician. Chaperones should usually be clinical staff members, although providing adequate staffing may not be feasible for many small practices. Thus, the decision to use a chaperone and the specific choice of chaperone should be made jointly by the patient, parent and clinician providing care, considering the wishes of all parties to the encounter. Certain situations, including telemedicine encounters, unaccompanied minors, patients with intellectual disability, those suffering from abuse, exploitation or trafficking and those who are otherwise unable to assent to care or participate in shared decision making require special consideration for sensitive examinations, with attention paid to principles of trauma-informed care. All outpatient practices and inpatient services should develop policies addressing the situations which might prompt the need for a chaperone, and address their ability to provide one, and be prepared to involve the patient and family in the decision-making process.