Increasing identification of domestic violence in emergency departments: A collaborative contribution to increasing the quality of practice of emergency
Melanie Boursnell
Academic/Lecturer, University of Newcastle, Callaghan NSW, Australia
Sue Prosser
Violence Prevention Consultant, Northern Sydney Central Coast Area Health Service, New South Wales, Australia
PP: 035 - 046
Abstract
This project was initiated to improve the quality of identification and response practices of Emergency Department (ED) nursing staff dealing with possible victims of domestic violence (DV).
Nursing staff were trained to identify three key actions in the pathway for domestic violence presentations in the ED. A survey of ED staff was taken pre-training to determine a base-line measure of self-reported knowledge regarding domestic violence policies and practices. The survey was re-administered 1 month and 6 months post-training. A file audit was also undertaken prior to and following the training.
Results show the training improved the nurses' confidence, practice and skills in the identification of, and response to, domestic violence, particularly in relation to children. ED nurses are well placed to identify and respond to domestic violence as the ED provides a gateway into health services for women and their children.
This paper reports on a participatory action research project which aimed to improve quality and practice around DV for ED staff. The dissemination of the results in this paper are considered to be essential to health services due to dearth of information and research about best practice initiatives for responding to and recognizing domestic violence in the ED.
Keywords
domestic violence; emergency department; nursing; participatory action research; children; quality improvement
References
Allen NE, Lehrner A, Mattison E, Miles T and Russell A (2007) Promoting systems change in the health care response to domestic violence. Journal of Community Psychology 35(1), 103-120.
Astbury J, Atkinson J, Duke J, Easteal P, Kurrie SW, Tait P, et al (2000) The impact of domestic violence on the individual. Medical Journal of Australia 173, 427-431.
Bacchus L, Mezel G and Bewley S (2003) Experiences of seeking help from health professionals in a sample of women who experienced domestic violence. Health & Social Care in the Community 11(1), 10-24.
Balousek S, Plane MB and Fleming, MF (2007) Prevalence of interpersonal abuse in primary care patients prescribed opioids for chronic pain. Journal of General Internal Medicine 22(9), 1268-1273.
Bonomi AE, Thompson RS, Anderson ML, Reid RJ, Dimer JA, Carrell D, et al (2006) Intimate partner violence and women's physical, mental and social functioning. American Journal of Preventive Medicine 30(6), 458-466.
Boyle A, Jones P and Lloyd S (2004) The association between domestic violence and self harm in emergency medicine patients. Journal of Emergency Medicine 23, 604-607.
Boyle A, Robinson S and Atkinson P (2004) Domestic violence in emergency medicine. Patients, Emergency Medical Journal 21, 9-13.
Campbell JC (2002) Health consequences of intimate partner violence. Lancet 359, 1331-1336.
Campbell JC, Coben JH, McLoughlin E, Dearwater S, Nah G, Glass N, et al (2001) An evaluation of a system-change training model to improve emergency department response to battered women. Academic Emergency Medicine 8(2), 131-138.
Cooley B and Frazer C (2006) Children and domestic violence: a system of safety in clinical practice. Australian Social Work 59(4), 462-473.
Ergonen TA, Salacin S, Karademir S, Gursel S and Musal, B (2007) A domestic violence course for medical students: A study on its effectiveness. Journal of Family Violence 22(6), 441-447.
Feder G, Ramsay J, Dunne D, Rose M, Arsene C, Norman R, et al (2009) How far does screening women for domestic (partner) violence in different health-care settings meet criteria for a screening programme? Systematic reviews of Nine UK National Screening Committee criteria. Health Technology Assessment 13(16), 1-347.
Fulfer JL, Tyler JJ, Choi NJS, Young JA, Verhulst SJ, Kovach R, et al (2007) Using indirect questions to detect intimate partner violence the SAFE-T Questionnaire. Journal of Interpersonal Violence 22(2), 238-249.
Hegarty K, Hindmarsh ED and Gilles MT (2000) Domestic violence in Australia: Definition, prevalence and nature of presentation in clinical practice. Medical Journal of Australia 173, 363-367.
Hillard PJ (1985) Physical abuse in pregnancy. Obstetrics and Gynaecology 66, 185-190.
Inoue K and Armitage S (2006) Nurses' understanding of domestic violence. Contemporary Nurse 21(2), 311-323.
Kann K, Withnell S, Shakespeare J, Doll H and Thomas J (2001) Domestic violence: A comparative survey of levels of detection, knowledge and attitudes in healthcare workers. Public Health 115, 89-95.
Koch T and Kralik D (2006) Participatory action research health care. Oxford UK: Blackwell.
Koziol-McLain J, Giddings L, Rameka M and Fyfe E (2008) Intimate partner violence screening and brief intervention: Experiences of women in two New Zealand health care settings. Journal of Midwifery & Women's Health 53(6), 504-510.
Kurz D (1990) Interventions with battered women in health care settings. Violence and Victims 5(4), 243-256.
Loxton D, Schofield MJ, Hussain R and Mishra G (2006) History of domestic violence and physical health in midlife. Violence Against Women 12(8), 715-731.
Mazza D, Lawrence J, Roberts G and Knowlden S (2000) What can we do about domestic violence? Medical Journal of Australia 20(1), 26-64.
McFarlane JM, Groff JY, O'Brien JA and Watson, K (2006) Secondary prevention of intimate partner violence: A randomized controlled trial. Nursing Research 55(1), 52-61.
McMurray A (2005) Domestic violence: Conceptual and practice issues. Contemporary Nurse 18(3), 219-232. http://www.contemporarynurse.com/archives/vol/18/issue/3/article/2093/domestic-violence
National Health and Medical Research Council (2003) When does quality assurance in health care require independent ethical review? Canberra: National Health and Medical Research Council.
New South Wales Children and Young Persons (Care & Protection) Act (1998).
New South Wales Health Department (2006) Policy and procedures for identifying and responding to domestic violence. Gladesville NSW: NSW Department of Health.
Plichta SB (2007) Interactions between victims of intimate partner violence against women and the health care system: policy and practice implications. Trauma, Violence & Abuse 8(2), 226-239.
Poleshuck EL, Dworkin RH, Howard FM, Foster DC, Shields CG, Giles DE, et al (2005) Contributions of physical and sexual abuse to women's experiences with chronic pelvic pain. Journal of Reproductive Medicine 50(2), 91-100.
Pope C, Ziebland S and Mays N (2000) Qualitative research in health care: Analysing qualitative data. British Medical Journal 320, 114-116.
Primary Health Care Research Network (2002) What is research? Research bites, 1, University of New South Wales. Retrieved 18 May 2009 from http://www.phcris.org.au/phcred/research_bites/research_bites_1.pdf
Ramsay J, Richardson J, Carter YH, Davidson LL and Feder G (2002) Should health professionals screen women for domestic violence? Systematic review. British Medical Journal 325, 314.
Reisenhofer S and Siebold C (2007) Emergency Department care of women experiencing intimate partner violence: Are we doing all we can? Contemporary Nurse 24(1), 3-14. http://www.contemporarynurse.com/archives/vol/24/issue/1/article/2210/emergency-department-care-of-women-experiencing
Richardson J, Feder G, Eldridge S, Chung WS, Coid J and Moorey S (2001) Women who experience domestic violence and women survivors of childhood sexual abuse: A survey of health professionals' attitudes and clinical practice. British Journal of General Practice 51(467), 468-470.
Rivara FP, Anderson ML, Fishman P, Bonomi AE, Reid RJ, Carrell D, et al (2007) Intimate partner violence and health care costs and utilization for children living in the home. Pediatrics 120(6), 1270-1277.
Roberts GL, Raphael B, Lawrence J, O'Toole B and O'Brien D (1997) Impact of an education program about domestic violence on nurses and doctors in an Australian emergency department. Journal of Emergency Nursing 23(3), 220-227.
Schoening AM, Greenwood JL, McNichols JA, Heermann JA and Agrawal, S (2006) Effect of an intimate partner violence educational program on the attitudes of nurses. Journal of Obstetric, Gynecologic, & Neonatal Nursing 33(5), 572-579.
Sethi D, Watts A, Zwi A, Watson J and McCarthy C (2004) Experience of domestic violence by women attending an inner city accident and emergency department. Emergency Medical Journal 21, 180-184.
Spangaro JM, Zwi AB and Poulos, R (2009) The elusive search for definitive evidence on routine screening for intimate partner violence. Trauma, Violence and Abuse 10(1), 55-68.
Thompson RS, Meyer BA, Smith-DiJulio K, Caplow MP, Maiuro RD, Thompson DC, et al (1998) A training program to improve domestic violence identification and management in primary care: Preliminary results. Violence Victims 13(4), 395-410.
Webster J (2006) Screening for domestic violence: The 'evidence' dilemma. Contemporary Nurse 21(2), 163-164. http://www.contemporarynurse.com/archives/vol/21/issue/2/article/699/screening-for-domestic-violence
Willson P (1998) Domestic violence: Are nurses hiding the facts? The Internet Journal of Advanced Nursing Practice 2(1), article 4.
Witting MD, Furuno JP, Hirshon JM, Krugman SD, Perisse ARS and Limcangco R (2006) Support for emergency department screening for intimate partner violence depends on perceived risk. Journal of Interpersonal Violence 21(5), 585-597.
Yam M (2000) Seen but not heard: Battered women's perceptions of the ED experience. Journal of Emergency Nursing 26(5), 464-470.

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