The Role of Emergency Medicine in Intimate Partner Violence: A Scoping Review of Screening, Survivor Resources, and Barriers

Abstract

At the front line of our medical system and population health, emergency medicine (EM) settings serve as a commonly perceived place for safety. Survivors of intimate partner violence (IPV) may present to the emergency department (ED) with injuries, illness, or specifically to seek help for IPV. In 2018, the U.S. Preventive Services Task Force (USPSTF) recommended screening women of reproductive age for IPV across all healthcare settings. Our objective was to examine the application of IPV interventions, resource allocation, and persistent barriers for screening within the EM setting following the USPSTF recommendation. This scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). Our initial search of two major databases, PubMed and CINAHL, found 259 articles. After screening for inclusion and exclusion criteria, 15 articles met the full study criteria. Inconsistencies in screening women for IPV in EM are still prevalent. No study used the same validated IPV screening tool and four did not specify the tool. Significant barriers to screening included time constraints, patient acuity, language barriers, staff education, and inability to connect patients to resources. There is a need for more consistent IPV screening in the EM setting, which may include the development of a standardized, inclusive screening tool, as well as additional research and sharing of best practices. Advancement of IPV identification must go beyond a recommendation with greater awareness and education changes at all levels: personal, institutional, and policy.