Darrow JB, Sherck JP, Yoder MK, Yonaka L. Barriers to screening for domestic violence in the emergency department. J Contin Educ Nurs. 2007;38(1):37-45.

Domestic violence occurs when a family member, partner, or expartner attempts to physically or psychologically dominate another. It is important for nurses to identify victims of domestic abuse to prevent additional violence and injury. The article describes a pilot project on screening for domestic violence undertaken at 1 urban center. The primary aim of the project was to identify perceived barriers to screening for domestic violence among the ED nursing staff. The secondary aim was to identify the educational and training needs of these nurses to facilitate screening for domestic violence in the emergency department.

REVIEW

Victims of domestic violence are often reluctant to acknowledge abuse to a healthcare professional. The researchers became interested in this topic after performing multiple chart reviews in the emergency department, which indicated that the nurses had not administered domestic violence screening. The researchers performed a literature review from 1995 to 2003 that displayed multiple articles indicating that domestic violence is a widespread problem and patients are not being screened for domestic violence.

This study aims to recognize factors that might be affecting emergency department nurses when screening potential victims of domestic violence. The sample consisted of 33 emergency department registered nurses in a large urban trauma center. The instrument used was an anonymous questionnaire that contained 3 parts: the attitudes and beliefs about screening for domestic violence, demographics, and questions regarding the selection process when screening patients.

The results of the study showed that 87% of the subjects showed an interest in receiving training about how to ask questions about abuse. Some barriers identified when screening patients were language difference, personal or family history of abuse, and a lack of training in how to deal with abuse. Another finding from the participants was that time issues affected their ability to adequately screen patients. The authors note multiple limitations to the study including the use of a modified tool, a convenience sample at a single site, and a small sample size.

COMMENTARY

Domestic violence is a public health problem that greatly affects society. Emergency department nurses are in an optimal position to screen patients for domestic violence, because the emergency department often is the initial entry into the healthcare system. The nurse treats patients from various backgrounds and socioeconomic classes and can be the critical person to stop the cycle of domestic violence. By identifying the barriers to screening and the educational needs of trauma nurses, this study represents a vital first step in making that happen.