Screening for Intimate Partner Violence in Emergency Departments

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Identifier 2017
Title Screening for Intimate Partner Violence in Emergency Departments
Creator Burt, Erin
Subject Advanced Practice Nursing; Education, Nursing, Graduate; Systems Analysis; Quality Improvement; Intimate Partner Violence; Spouse Abuse; Social Problems; Communication Barriers; Emergency Service, Hospital; Inservice Training; Clinical Protocols; Mass Screening; Benchmarking; Confidentiality
Description Throughout the nation, Emergency departments (EDs) and primary care clinics identify twice as many intimate partner violence victims through routine screening as compared to other healthcare settings that do not routinely screen. The healthcare staffs' compliance to screening is essential to help rescue the most vulnerable and endangered victims. Routine screening serves to prevent and reduce the negative consequences of IPV, including depression/anxiety, substance abuse, gynecological disorders, chronic pain, headaches and fatal outcomes. Screening for IPV in the ED ensures patients a safe place to seek help, as well as a place for medical support, connection to trauma sensitive providers and follow-up care. The goals of this project were to increase staff adherence to IPV screening and to strengthen victim referrals to appropriate resources in a local ED. In a local ED, nurses and/or providers are required to asses every triaged patient for IPV per an established hospital protocol. The screening is commonly overlooked and not enforced, frequently allowing staff to neglect IPV discussions with their patients. Additionally, the established IPV questions do not adequately assess the patient's risk for IPV, and do not provide ED staff with resources for positive screenings. The first objective of this project was to assess baseline staff-reported adherence to the required IPV screening protocol, along with barriers and facilitators associated with the screening. Next, a training session on IPV screening and referral was presented to ED staff. Pre- and post-tests were used to evaluate changes in staff knowledge. Thereafter, staff-reported adherence to the required IPV screening protocol, along with barriers and facilitators associated with the screening were re-assessed to estimate impact of training on staff behavior. The ED director, case manager and staff were all informed of the results. Lastly, the project was disseminated to peers through professional podium or poster presentation. A total of 8 out of 21 participants (all registered nurses) completed all three components of the project (baseline staff interview, IPV training, and post-training staff interview). The mean score of the pre-test was 44% and compared to the mean score of the post-test, 95%. In the initial interviews, seven percent of participants indicated a screening rate greater than 90% of the time. After the IPV training, 50% of the participants indicated a screening rate of greater than 90% of the time. Barriers of "forgot to ask", "lack of IPV education", and "unsure how to handle positive responses" were noted before, but not after IPV training. The most common facilitator before and after IPV training was "suspicious behavior or concerning presentation". Increasing staff adherence to IPV screening is necessary for the safety and well-being of patients. Victims of IPV often leave the ED before their injury/illness is properly cared for because they fear abuser reprisal. With increased IPV surveillance in the ED, victims can feel empowered to disclose abuse and discover refuge before potentially life-threatening situations arise. Ensuring a supportive, nonjudgmental and compassionate environment while assessing IPV risks can rescue innocent lives, increase IPV awareness and help prevent the ongoing cycle of violence.
Relation is Part of Graduate Nursing Project, Doctor of Nursing Practice
Publisher Eccles Health Sciences Library, University of Utah
Date 2017
Type Text
Rights Management © 2017 College of Nursing, University of Utah
Holding Institution Eccles Health Sciences Library, University of Utah
Collection Nursing Practice Project
Language eng
ARK ark:/87278/s6gr0v7x
Setname ehsl_gradnu
Date Created 2017-11-09
Date Modified 2018-02-06
ID 1279410
Reference URL https://collections.lib.utah.edu/ark:/87278/s6gr0v7x
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