DNP Scholarly Projects

Niani Conerly

Abstract

Routine intimate partner violence (IPV) screening has been recommended for all health care settings to prevent subsequent short and long term health consequences of survivors. However, provider adherence remains low. The purpose of this quality improvement project is to evaluate current screening practices, identify the needs of, and provide resources to three family planning clinics within a metropolitan public health department. The project utilized Donabedian’s Structure, Process, and Outcomes Model to map current protocols within three family planning clinics to identify current practices. A chart review including 105 patient charts was done to identify documentation of IPV screening/discussion as well as referrals following a positive victim response. A focus group composed of three clinic managers and seven individual interviews with clinical staff members were conducted to identify key themes and any barriers to screening. The mapping of practices revealed the overall clinic flow, resources within the clinics, and questions regarding IPV asked. The chart review revealed 47% patients were not asked about IPV and no information regarding subsequent referrals was provided. Five key themes were identified for both the focus group and the individual interviews. The focus group revealed only patient disclosure barriers, while the individual interviews revealed institutional and personal provider barriers, in addition to patient disclosure barriers. Following the individual interviews and focus group an educational session was conducted, resources were provided, and a post-intervention survey was distributed to assess readiness to screen. The post-intervention survey from the managers revealed more psychiatric support resources could be provided to enhance readiness. The clinical staff members had sufficient scores to consider them ready to screen. Overall the study found that additional interventions are needed to ensure providers are prepared to screen and appropriately refer survivors. Evaluation of Intimate Partner Violence Screening in a Metropolitan Public Health Department.

Approximately 23 million women and 1.7 million men will experience intimate partner violence (IPV) in their lifetime (Centers for Disease Control and Prevention [CDC], 2017). To address this alarming incidence of IPV, the Department of Health and Human Services has responded by guaranteeing access to preventive services, including IPV screening, under the Affordable Care Act (Ramachandran et al., 2013). Routine screening for IPV is now recommended by the American Medical Association, the American Nurses Association, the CDC, and many more (DeBoer et al., 2013;Sormanti & Smith, 2009; Thackeray, Stelzner, Downs, & Miller, 2007). Despite national recommendations for routine intimate partner violence screening, provider adherence remains low. Studies assessing emergency departments reported that only 13% of patients were asked about IPV (Waalen et al., 2000). Additionally, studies found that only 10 to 39% of patients were screened for IPV at women’s health visits (Renker, 2008). Consequently, intimate partner violence is often underreported, unidentified, and improperly managed by health care providers.

Date

3-12-2018

First Advisor

Giese, Jeannie

Scholarly Project Team Member

Sullenberger, Sabrina

Scholarly Project Team Member

Prices, Joseph

Scholarly Project Team Member

Morse, Emily

Department

Nursing, School of

College

Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project

Degree

Doctorate of Nursing Practice (DNP)

Degree Level

Doctoral

Degree Grantor

Belmont University

Keywords

Intimate partner violence; Victims of family violence--Services for; Public health

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