Author : Theresa M. Fay-Hillier
Publisher :
ISBN 13 :
Total Pages : 304 pages
Book Rating : 4.:/5 (97 download)
Book Synopsis A Qualitative Study on Intimate Partner Violence Screening Practices by Registered Nurses in the Emergency Department by : Theresa M. Fay-Hillier
Download or read book A Qualitative Study on Intimate Partner Violence Screening Practices by Registered Nurses in the Emergency Department written by Theresa M. Fay-Hillier and published by . This book was released on 2016 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Approximately 30% of women and 10% of men in the United States have been the victims of intimate partner violence (IPV)—which is defined and divided into four types of violence: physical violence, sexual violence, threats of physical or sexual violence, and psychological or emotional abuse. Intimate partners include current or former spouses, significant others and dating partners. Victims of IPV are frequently evaluated by registered nurses (RNs) at a hospital emergency department (ED). Although health care providers are encouraged to screen for IPV, most studies have indicated that routine screening does not consistently occur. The purpose of this study is to explore the experiences, views, and perceptions of RNs working in the ED with regard to screening for IPV. Methods: This qualitative study developed using Bandura’s social cognitive theory as the theoretical framework, involved 21 semi-structured interviews with ED RNs. The transcripts were analyzed using Interpretative Phenomenological Analysis (IPA). Results: Most of the nurses indicated a lack of clinical preparedness through their formal educational experiences, or through hospital in-services, to address screening for IPV. Three key factors in motivating nurses to screen for IPV were the assessment prompts of the electronic medical record (EMR), a perceived role as a patient advocate, and suspicion that the patient may have been abused. All participants stated that the design of their EMR system included a component that addressed domestic violence. Although most nurses said that they function as a patient advocate when screening for IPV, they varied as to how they applied this perception to the actual screening experience. Supporting the patient’s autonomy, credibility of the nurse and/or patient, and screening the patients alone were perceived obstacles in screening for IPV. For most nurses, supporting the patient’s autonomy meant letting the patient decide whether to disclose the abusive relationship and affected how the nurse proceeded if any abuse was mentioned. Perceived credibility was an obstacle in two ways; nurses were often unsure if the patient was providing accurate responses when screened and felt unsure of whether they were the best people to provide appropriate interventions to patients who disclosed abuse. Although all the nurses agreed that it is preferable to screen patients with no one else present, some of them indicated difficulties in being able to do so. Some nurses described techniques that they implemented in order to screen patients privately, whereas others did not attempt to gain privacy. Conclusions: This study found that nurses are not usually involved in the development of or in providing feedback on the tools used to screen for IPV, the clinical flow and practice design of the environment (hospital unit) to support screening patients privately, the type and timing of educational training (if any is even provided), or assessment of the effectiveness of resources available to provide to identified victims. Moreover, they do not receive follow-up information as to what impact their intervention and resources had on the victims. Nurses should be included in the development of these procedures and of laws and policies that directly impact their role in addressing identified victims of IPV (such as mandatory reporting of victims).
