Policy and procedures for domestic violence patients in Canadian emergency departments: a national survey.

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.