Poster Presentation
Wednesday, 19 July 2006
9:30 AM - 10:00 AM
Wednesday, 19 July 2006
2:30 PM - 3:00 PM
This presentation is part of : Poster Presentations I
Domestic Violence Screening in the Rural Emergency Department
Vickie Poulin, RN, ADN, SANE-A, Emergency Department, Central Vermont Medical Center, Barre, VT, USA, Jean Petersen, MHSA, BSN, RN, Administration, Central Vermont Medical Center, Barre, VT, USA, and Sarah Jo Brown, PhD, RN, Dartmouth Hitchcock Medical Center, Central Vermont Medical Center, Barre, VT, USA.
Learning Objective #1: 1. The learner will identify 2 barriers to DV detection that are specific to a rural populations.
Learning Objective #2: 2. The learner will grasp that a single question when phrased with colloquial sensativity during triage can save a patient from ongoing domestic violence.
World-wide, 1.6 million people die each year as a result of domestic violence (DV) and many more are injured. Emergency Departments (EDs) are well positioned to improve the detection of domestic violence, however many have struggled with the most effective means of doing so, despite guidelines from several professional associations.  This was true in our community hospital where, like other rural hospitals, resources are scarce, numbers are few, and anonymity less assured than in EDs serving a larger population.  OBJECTIVE: This evidence-based practice project was undertaken to improve DV screening in the ED.  The two issues were: a) who should be screened, and b) how to phrase the questions to facilitate both detection and screener comfort. DESIGN OF THE CHANGE IN PRACTICE: Seven research studies of brief screening tools used in EDs were critically appraised and summarized.  Based on the research evidence, the decision was made to screen all women over age 13 and all men over age 65.  The screen consisted of one question, “We ask all of our patient about domestic violence.  Are you safe in your current living situation, or is someone harming you in any way?”   Eight months after changing the policy and the screening questions, data was obtained from retrospective review of medical records from all persons in the target population who presented at the Emergency Department during a one month period (n = 154).  RESULTS: Use of the DV Screening Tool increased screening from 65% to 93%.  In addition, detection of domestic violence was improved from  1%  to 3%, including four patients who presented with unrelated complaints.  CONCLUSION: Refinement of the DV policy and consistent use of a single question significantly increased both the screening rate and detection of domestic violence among women and elderly men in a rural population. 

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See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)