Identifying Opportunities to Improve Intimate Partner Violence Screening in a Primary Care System

Abstract

Background and Objectives: Intimate partner violence (IPV) is a silent epidemic affecting one in three women. The US Preventive Services Task Force recommends routine IPV screening for women of childbearing age, but actual rates of screening in primary care settings are low. Our objectives were to determine how often IPV screening was being done in our system and whether screening initiated by medical assistants or physicians resulted in more screens. Methods: We conducted a retrospective chart review to investigate IPV screening practices in five primary care clinics within a university-based network in Northern California. We reviewed 100 charts from each clinic for a total of 500 charts. Each chart was reviewed to determine if an IPV screen was documented, and if so, whether it was done by the medical assistant or the physician. Results: The overall frequency of IPV screening was 22% (111/500). We found a wide variation in screening practices among the clinics. Screening initiated by medical assistants resulted in significantly more documented screens than screening delivered by physicians (74% vs 9%, P<0.001). Conclusions: IPV screening is an important, but underdelivered service. Using medical assistants to deliver IPV screening may be more effective than relying on physicians alone.

Nurse Training in Gender-Based Violence Using Simulated Nursing Video Consultations during the COVID-19 Pandemic: A Qualitative Study

“…Consequently, it should be noted that both nursing students and nurses should be properly trained to assist GBV victims, as they are frequently the first contact for these victims when they seek help in health systems [26]. However, the detection rate of GBV is still low in these services [65]. Therefore, more formal training on this type of violence is needed for both nursing students and registered nurses to improve care for these women [10,14,26,29,60,66].…”

Gender Issues in Trauma-Informed Physical Therapy

“…10 Despite the high prevalence of GBV among women patients, only 22% of health care providers routinely screen for GBV across all health care settings. 11 Access to health services is limited or nonexistent for global vulnerable populations and contributes to cumulative trauma experience, especially for women. Estimates report 1.5 billion women did not have access to preventive health care in the last 1 year.…”

“…GBV is associated with anxiety, depression, posttraumatic stress disorder, injuries, infections, diseases, miscarriages, substance abuse, chronic pain, adverse effects on maternal and infant health, and preterm birth and is a major source of trauma for women throughout the lifespan 10. Despite the high prevalence of GBV among women patients, only 22% of health care providers routinely screen for GBV across all health care settings 11…”

Domestic Violence:

“…These trainings and resources seek to strengthen the frequency and efficacy of health care-based domestic violence screenings and referrals, targeting the low rates of screening among health care providers. 5 , 6 …”