Emergency Department staff experiences of screening and response for intimate partner violence in a multi-site feasibility study: Acceptability, enablers and barriers

Author(s):  
Jo Spangaro ◽  
Jacqualine Vajda ◽  
Emily Klineberg ◽  
Sen Lin ◽  
Christine Griffiths ◽  
...  
CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S66 ◽  
Author(s):  
J. Vonkeman ◽  
P.R. Atkinson ◽  
J. Fraser ◽  
R. McCloskey

Introduction: Domestic violence (DV) rates in smaller cities been reported to be some of the highest in Canada. It is highly likely that emergency department staff will come across victims of intimate partner violence (IPV) in their daily practice. The purpose of this study is to better understand current practices for detecting IPV as we are currently uncertain whether patients are assessed for IPV and what the current documentation practices are. Methods: A standardized retrospective chart review, following principles outlined by Gilbert et al. 1996, was completed by two researchers to capture domestic violence documentation rates in patients presenting to the ED between January and April 2015 with injuries that may have been caused by IPV. To assess self-reported documentation/questioning practices, a cross-sectional online survey was distributed to ED staff via staff email lists three times between July and October 2016, with a response rate of 45.9% (n=55). The primary outcome was DV field usage. Secondary outcomes included documentation in patient charts and current questioning habits. Results: Overall, we found documentation in 4.64% of all included patient charts (n=366). No documentation was noted in the DV field. 52.4% patients with deliberate injuries had no documentation of assailant identity. With regards to self reported documentation practices, 16.4% of ED staff never questioned female patients about intimate partner violence, 83.6% asked when thought appropriate, and none asked routinely. None of the staff used a structured screening tool. 60% of ED staff documented their questioning but 92.7% did not use the DV-field for documentation. 58.2% of ED staff could not identify the DV field and 45.5% of respondents did not know how to interpret the DV field if positive. Conclusion: Our findings suggest that the current documentation tool (DV-field) is not being utilized. Furthermore, low rates of IPV documentation, and potentially questioning, in high risk patients indicates that there is need to improve current practises.


CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S120
Author(s):  
J. Vonkeman ◽  
P.R. Atkinson ◽  
J. Fraser ◽  
R. McCloskey

Introduction: Domestic violence (DV) rates in smaller cities have been reported to be some of the highest in Canada. It is highly likely that emergency department staff will come across victims of intimate partner violence (IPV) in their daily practice. However, elsewhere we have found a lack of knowledge of current tools as well as lack of training in ED staff. Furthermore, these findings may also be reflected by low rates of IPV documentation, especially in high-risk cases. The purpose of the current study is to determine if ED staff would be willing to implement a brief IPV screening tool, the Partner Violence Screen (PVS) in their daily practice. It consists of the 3 questions: Have you ever been hit, kicked, punched or otherwise hurt by someone within the past year, and if so, by whom? Do you feel safe in your current relationship? Is there a partner from a previous relationship that is making you feel unsafe now? Methods: A cross-sectional online survey was distributed to ED staff (LPNs, NPs, Physicians, Residents, RNs) via staff email lists three times between July and October 2016, with a response rate of 45.9% (n=55). The survey included a 5-question Likert scale. The primary outcome was whether ED staff are willing to implement a new case-finding tool in their daily practice. The secondary outcome was to assess whether staff would find this tool beneficial in case-finding for IPV. Results: 43.6% of staff responded that they are likely to use the tool routinely, 29.1% were unsure, and 2.7% very likely. 7.27% and 3.64% stated their predicted use as unlikely and very unlikely, respectively. In addition, 43.6% of staff thought that the PVS would be beneficial in case finding for IPV, 40% were unsure, 12.7% thought very likely, 1.82% unlikely, and 1.82% very unlikely. Conclusion: These findings suggest that emergency department staff may be receptive to and find the introduction of the PVS beneficial in identifying cases of IPV. Future directions will include the introduction of this tool through a knowledge translation education piece in order improve the identification process for and awareness of a high-risk condition in a vulnerable population group.


Cureus ◽  
2019 ◽  
Author(s):  
Janeske Vonkeman ◽  
Paul Atkinson ◽  
Jacqueline Fraser ◽  
Rose McCloskey ◽  
Adrian Boyle

2003 ◽  
Vol 18 (2) ◽  
pp. 131-141 ◽  
Author(s):  
Steve J. Weiss ◽  
Amy A. Ernst ◽  
Elaine Cham ◽  
Todd G. Nick

A five-question Ongoing Abuse Screen (OAS) was developed to evaluate ongoing intimate partner violence. Our hypothesis was that the OAS was more accurate and more likely to reflect ongoing intimate partner violence than the AAS when compared to the Index of Spouse Abuse (ISA). The survey included the ISA, the OAS, and the AAS. During the busiest emergency department hours, a sampling of 856 patients completed all aspects of the survey tool. Comparisons were made between the two scales and the ISA. The accuracy, positive predictive value, and positive likelihood ratio were 84%, 58%, and 6.0 for the OAS and 59%, 33%, and 2.0 for the AAS. The OAS was more accurate, had a better positive predictive value, and was three times more likely to detect victims of ongoing intimate partner violence than the AAS. Because the OAS was still not accurate enough, we developed a new screen, based on the ISA, titled the Ongoing Violence Assessment Tool (OVAT).


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