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Ann Emerg Med. 1996 Jun;27(6):754-60.

Development and validation of an emergency department screening and referral protocol for victims of domestic violence.

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1
University of North Carolina School of Medicine, Department of Emergency Medicine, Chapel Hill, USA.

Abstract

STUDY OBJECTIVE:

To describe the development, design, and validation of an emergency department protocol for the identification, documentation, and referral of victims of domestic violence.

METHODS:

We based protocol development and design on a departmental needs assessment. The validation component involved the screening of women 16 years and older treated in the ED during a 2-week period at both triage (stage 1) and nursing assessment (stage 2). Sensitivity and specificity of the triage screen were determined.

RESULTS:

The departmental needs assessment revealed several important limiting factors that motivated the design of the protocol. In response, the protocol design included a two-stage screening process, stage 1 taking place at triage and stage 2 as part of the nursing assessment. During the 2-week validation study, 595 women 16 years and older were treated in the ED, but complete two-stage screening data were obtained for only 114 (19%). Of the patients who were appropriately screened, eight screened positive at stage 1 and two of the eight were confirmed at stage 2. Two additional cases were identified at stage 2 in whom violence had not been suspected at stage 1. Triage screen sensitivity was 50%, specificity 95%. Of the women properly screened at both stages, 3.5% were identified as victims of domestic violence.

CONCLUSION:

We identified many obstacles to implementation of an ED domestic violence screening and referral protocol, demonstrating that evaluation is imperative in determining actual clinical impact.

PMID:
8644964
DOI:
10.1016/s0196-0644(96)70195-6
[Indexed for MEDLINE]

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