Objective: To obtain information concerning the following: (1) the proportion of Canadian emergency departments with domestic violence intervention policies and procedures, (2) how hospitals identify and provide service to patients who have been abused, and (3) measures that have been problematic/helpful in implementing domestic violence protocols in emergency departments.
Design: A cross-sectional survey of a stratified random sample of 230 Canadian hospitals with emergency departments.
Participants: Head nurses/nurse managers of the sample emergency departments in July and August 1994.
Measures: Informational and attitudinal questionnaire items concerning domestic violence policies and procedures in the emergency department, including services provided to patients, staff roles, perceived support and effectiveness of the policy/procedures, how problem areas were addressed.
Results: One hundred ninety-eight hospitals (198 of 230) returned questionnaires (86%). Of the 198, 39% (78) indicated there were policies and procedures concerning domestic violence for the emergency department. Large teaching hospitals were no more likely than smaller community hospitals to have policies or protocols in place. Screening all patients for domestic violence was reported by 26 hospitals (13% of all respondents, 33% of the group of hospitals with domestic violence policies). Referral services were provided by 61 hospitals (31% of all respondents; 78% of the subgroup with policies). On-site counseling was reported by 46 hospitals (23% of all respondents; 59% of the subgroup with policies).
Conclusions: The actual implementation of domestic violence policies and procedures is far from universal and may well be as low as 10% or 20%. Hospital and ED resources are needed to identify and support staff members who will implement educational activities and monitor compliance with guidelines for cases of domestic violence.
PIP: A cross-sectional research survey aimed to obtain information concerning 1) the proportion of Canadian emergency departments with domestic violence intervention policies and procedures; 2) how hospitals identify and provide service to patients who have been abused; and 3) measures that have been problematic/helpful in implementing domestic violence protocols in emergency departments. The study sample included 230 Canadian hospitals with emergency departments. Results showed that 198 hospitals returned the questionnaires, of which 39% indicated that there were policies and procedures concerning domestic violence for the emergency departments. Large, major hospitals were more likely than smaller community hospitals to have policies or protocols in place. About 26 hospitals reported screening all patients for domestic violence and 61 hospitals provided referral services and 46 hospitals provided on-site counseling. Physicians were principally involved in the physical examination, referral and identification. Follow-up, emotional support, and safety planning were provided by social workers. Findings of this survey encourage hospitals and individual health care providers to adopt guidelines concerning domestic violence to ensure a widespread adoption and implementation.