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Improving domestic violence screening practices in the emergency department: an Australian perspective
  1. Amy Lynn Sweeny1,2,
  2. Caitlin Bourke3,4,
  3. Thomas Martin Torpie1,
  4. Sally Sargeant5,
  5. James Hughes6,7,
  6. Julie Watson8,
  7. Sheree Conroy9,
  8. Angel Carrasco10,
  9. Kym Tighe10,
  10. Neale Stuart Thornton11,
  11. Amber-Shea Cumner1,12,
  12. Kathleen Baird13,14
  1. 1Emergency Department, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
  2. 2School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
  3. 3Emergency Medicine, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  4. 4Faculty of Medicine, Bond University, Gold Coast, Queensland, Australia
  5. 5School of Health and Human Services, Southern Cross University - Gold Coast Campus, Coolangatta, Queensland, Australia
  6. 6Emergency and Trauma Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
  7. 7School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
  8. 8Social Work, Townsville Hospital and Health Service, Townsville, Queensland, Australia
  9. 9Emergency Department, Darling Downs Hospital and Health Service, Toowoomba, Queensland, Australia
  10. 10Social Work and Support Services, Gold Coast Hospital and Health Service, Southport, Queensland, Australia
  11. 11Emergency Department, Mackay Base Hospital, Mackay, Queensland, Australia
  12. 12School of Social Work, Griffith University Faculty of Health, Gold Coast, Queensland, Australia
  13. 13Midwifery, University of Technology Sydney, Sydney, New South Wales, Australia
  14. 14School of Nursing and Midwifery, Griffith University Faculty of Health, Gold Coast, Queensland, Australia
  1. Correspondence to Amy Lynn Sweeny, Emergency Department, Gold Coast Hospital and Health Service, Southport, QLD 4215, Australia; amy.sweeny{at}health.qld.gov.au

Abstract

Introduction Domestic violence (DV) is a major cause of morbidity worldwide. The ED is a location recommended for opportunistic screening. However, screening within EDs remains irregular.

Objective To examine intrinsic and extrinsic barriers to routine screening in Australian EDs, while describing actions taken after identification of DV.

Methods Emergency clinicians at nine public hospitals participated in an anonymous online survey. Factor analysis was performed to identify principal components around attitudes and beliefs towards screening.

Results In total, 496 emergency clinicians participated. Universal screening was uncommon; less than 2% of respondents reported screening all adults or all women. Although willing, nearly half (45%) reported not knowing how to screen. High patient load and no single rooms were ‘very or severely limiting’ for 88% of respondents, respectively, while 24/7 social work and interpreter services, and online/written DV protocols were top enablers. Factor analysis identified four distinct intrinsic belief components: (1) screening is not futile and could be done in ED, (2) screening will not cause harm, (3) there is a duty to screen and (4) I am willing to screen.

Conclusion This study describes a culture of Queensland ED clinicians that believe DV screening in ED is important and interventions are effective. Most ED clinicians are willing to screen. In this setting, availability of social work and interpreter services are important mitigating resources. Clinician education focusing on duty to screen, coupled with a built-in screening tool, and e-links to a local management protocol may improve the uptake of screening and subsequently increase detection.

  • emergency nursing
  • quality improvement
  • guideline
  • domestic
  • emergency departments

Data availability statement

Data are available upon reasonable request. Data are available from the corresponding author on reasonable request.

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Data availability statement

Data are available upon reasonable request. Data are available from the corresponding author on reasonable request.

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Footnotes

  • Handling editor Katie Walker

  • Twitter @EpidemicAmy, @perfectednurse

  • Contributors Study conception and design: AS, TT, KB, SS, AC, KT. Acquisition of data: CB, AS, JH, JW, SC, NT. Analysis and interpretation of data: CB, AS, KB, SS. Drafting of the manuscript: CB, AS. Critical revision of the manuscript for important intellectual content: AS, JW, JH, NT. Statistical expertise: AS. Acquisition of funding: AS, TT, AC, KB, SS. AS is responsible for the overall content as guarantor.

  • Funding This study was funded by a grant from the Emergency Medicine Foundation, Australia. (Grant EMSS-283R27-TORPIE-2017)

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.