Outcome evaluation of an emergency department protocol of care on partner abuse.
OBJECTIVE
To evaluate the impact of a protocol on partner abuse (PA) at increasing identification and improving acute management of abused women by emergency department (ED) staff.


METHODS
A community intervention trial compared two public hospital EDs at baseline and following implementation of a PA intervention. The intervention involved training staff at one ED in a protocol for the identification and acute management of abused women. Outcomes were assessed by reviewing a random sample of women's medical records. Identification of PA was assessed for each record on a yes/no basis. Identified cases were classified as 'confirmed' or 'suspected' PA. Acute management was assessed by ascertaining staff documentation of abuse and use of interventions.


RESULTS
Approximately equal numbers of records were reviewed at each ED, pre and post implementation (total n = 8,051). Eighty-nine per cent of ED staff were trained. No difference in the overall identification of PA was found (chi 2 = 0.13, p = 0.72), but logistic regression analyses showed other significant changes. At the intervention site, there was an increase in confirmed cases of PA (chi 2 = 7.6, p = 0.006), a trend towards increased documentation (chi 2 = 3.5, p = 0.06) and a significant increase in interventions offered (chi 2 = 13.8, p = 0.002). Changes at the comparison site failed to reach significance.


CONCLUSIONS
Implementation of this protocol resulted in a moderate increase in confirmed cases of abuse and improved the acute management offered to identified victims. The findings reinforce recommendations for widespread implementation of training and protocols to address partner abuse.
Fanslow
J L
JL
Injury Prevention Research Centre, Faculty of Medicine and Health Science, University of Auckland, New Zealand. jlf7@cdc.gov
Norton
R N
RN
Robinson
E M
EM
Spinola
C G
CG
D000293:Adolescent; D000328:Adult; D002985:Clinical Protocols / Q000592:standards*; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007318:Inservice Training / Q000458:organization & administration*; D016015:Logistic Models; D008485:Medical Audit; D008505:Medical Staff, Hospital / Q000193:education*; D009741:Nursing Staff, Hospital / Q000193:education*; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D013179:Spouse Abuse / Q000175:diagnosis* / Q000517:prevention & control*