Breaking the silence: Improving domestic violence screening in an emergency department

The purpose of this study was to investigate the knowledge, attitudes and beliefs of nurses regarding domestic violence screening. Stemming from a chart audit that revealed domestic violence screening was lacking in 30% of the emergency department visits at this rural New England hospital, a descriptive questionnaire was created and distributed to a convenience sample of thirty emergency room nurses. The results from the survey were used to create recommendations for a quality improvement intervention to meet The Joint Commission's guidelines for domestic violence screening. Participation in this survey was voluntary and anonymous. Nurses who worked in the Emergency Department were invited to participate. The five-item questionnaire assessed nurses' knowledge, attitudes and beliefs about domestic violence screening. The surveys were placed in the locked drop box in the staff room for anonymous completion and return. A summative content analysis was conducted and recommendations were made based on the results. There was a 17% response rate. Two common themes surfaced from the data analysis. First, that screening for domestic violence is often times awkward and second, if the person being screened does not respond as the nurse expects, it is assumed by the nurse that something might be wrong. This leaves the level of screening open to the discretion of the nurse. The majority of the nurses felt they possessed the nursing skill to conduct the screening. Recommendations to the hospital included opportunities for role-play, strategies for discussion of difficult topics, policy and procedure review and time for self-reflection.