title: Detecting intimate partner violence: more than trauma team education is needed.
abstract: BACKGROUND
  Intimate partner violence (IPV) is an underappreciated cause of morbidity and mortality in female trauma patients. We investigated the impact of a domestic violence education program for trauma residents on the detection of IPV.
  
  
  METHODS
  In January 2008, an educational IPV program was implemented for all trauma residents. A retrospective review of all female patients evaluated by the trauma service before and after institution of the IPV program was performed. Medical records were reviewed for demographic data, injury mechanism, social habits, and IPV documentation. Chi-square and Fisher's exact tests were used to compare patients before and after institution of the educational IPV program.
  
  
  RESULTS
  The records of 645 female trauma patients evaluated in 2007 and 2008 were reviewed. Patients were not routinely asked about IPV, despite implementation of the educational program; 39.9% were asked about IPV in 2007 versus 46.1% in 2008 (p = 0.11). The positive disclosure of IPV did not increase from 2007 to 2008 (20.1% versus 21.2%; p = 0.83). Documentation about social habits increased considerably. In 2008, patients were asked more regularly about alcohol (71.8% versus 80.8%; p = 0.01), drugs (64.1% versus 73.7%; p = 0.01), and tobacco use (67.0% versus 78.1%; p = 0.002). Importantly, patients with documented IPV (n = 57) frequently presented to the trauma team with nonviolent mechanisms of injury (n = 30, 52.6%).
  
  
  CONCLUSIONS
  IPV is a frequent finding in female trauma patients. Despite increased education, questions about IPV are not documented routinely. In addition, screening at-risk patients by mechanism will underestimate the prevalence of IPV. Universal screening should be mandated to increase IPV detection and enhance opportunities for intervention.
authors.affiliation: Division of Traumatology, Surgical Critical Care, and Emergency Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. carrie.sims@uphs.upenn.edu
authors.forename: Carrie
authors.initials: C
authors.lastname: Sims
authors.forename: Daniel
authors.initials: D
authors.lastname: Sabra
authors.forename: Meredith R
authors.initials: MR
authors.lastname: Bergey
authors.forename: Elena
authors.initials: E
authors.lastname: Grill
authors.forename: Babak
authors.initials: B
authors.lastname: Sarani
authors.forename: Jose
authors.initials: J
authors.lastname: Pascual
authors.forename: Patrick
authors.initials: P
authors.lastname: Kim
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Datner
mesh_terms: D018585:Battered Women / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D004282:Documentation; D004503:Education, Medical, Graduate / Q000379:methods*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012747:Sexual Partners; D014481:United States