title: Universal screening for interpersonal violence: inability to prove universal screening improves provision of services.
abstract: OBJECTIVE
  Universal screening for interpersonal violence is recommended despite a lack of confirmed efficacy. We hypothesized that the detection of violence via universal screening would result in high intervention rates for victims.
  
  
  METHODS
  Women aged 18-65 years presenting to an emergency department were screened using a standard protocol. Medical and social work records were reviewed for positively screened patients. Outcomes included whether victims received counseling/referral services. Secondary outcomes were the documentation of services offered and safety assessment performed.
  
  
  RESULTS
  A total of 1732 patients were evaluated; 615 (35.5%) responded positively to at least one query. Patients had a mean age of 34.7+/-12 years, 79% were non-white, 19% were married, and 76% had completed high school. Twenty-five out of 606 victims (4%) had documentation of violence. Residents were more likely than faculty or nurses to document domestic violence [3.3% (95% confidence interval 1.8-4.8%) versus 2.1 (0.9-3.4) versus 0.7 (0.0-1.4)]. The documentation of police contact, suicide/homicide risk, weapon presence, safety assessment and outside resource referrals occurred in less than 2% of charts. Only two victims were referred to social work (0.3%; 0-0.9%).
  
  
  CONCLUSIONS
  Even in an institution with a heavy emphasis and training on interpersonal violence and alternative mechanisms for universal screening we could not prove that the identification of victims resulted in counseling/referral being offered in the emergency department.
authors.affiliation: Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA. edatner@mail.med.upenn.edu
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Datner
authors.forename: Martin
authors.initials: M
authors.lastname: O'Malley
authors.forename: Raquel M
authors.initials: RM
authors.lastname: Schears
authors.forename: Frances S
authors.initials: FS
authors.lastname: Shofer
authors.forename: Jill
authors.initials: J
authors.lastname: Baren
authors.forename: Judd E
authors.initials: JE
authors.lastname: Hollander
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004282:Documentation / Q000706:statistics & numerical data; D017579:Domestic Violence / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010414:Pennsylvania; D011446:Prospective Studies; D012947:Social Work / Q000706:statistics & numerical data