How to Screen for Abuse in Emergency Rooms

Abuse can come in many forms, such as domestic abuse, child abuse, elder abuse, neglect, abandonment or emotional abuse. Various forms of self-inflicted abuse can occur, too, leading to visits to the emergency room.



Without proper screening methods, a large percentage of abuse cases might go unidentified. With proper screening, victims of abuse can be identified and referrals can be made to protect and help the victims.

Things You'll Need

• Personal Violence Screen (PVS)
• Spousal Assault Risk Assessment Guide
• The Child Abuse Potential Inventory

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Instructions

• 1

  Educate yourself on the subject of abuse. All hospital personnel who come into contact with patients benefit from being educated on this subject. Hospital personnel who are educated in identifying and dealing with situations of abuse can go about their daily routines in the emergency room setting with confidence.

• 2

  Get to know the various screening formats and questions found on the Personal Violence Screen (PVS), the Spousal Assault Risk Assessment Guide and the Child Abuse Potential Inventory.

• 3

  Look for signs of abuse when patients enter the emergency room. Signs of abuse might include broken limbs, black eyes, bruises on the body, scars or burns, including burns from cigarette butts. Additional signs of domestic or child abuse can be fearfulness of caregivers, withdrawn behavior, frequency of visits to the emergency room and and sleep disorders.

• 4

  Ask questions from the Personal Violence Screen (PVS), which takes only about 20 seconds, or the Spousal Assault Risk Assessment Guide. The questions can be given to emergency room patients in written form or can be administered orally.

  Examples of questions used in this assessment include the following: Have you been hit, kicked, punched, or otherwise hurt by someone within the past year? If so, by whom? Are you currently in a relationship in which you have felt afraid? Is there a partner from a previous relationship who is making you feel unsafe now?

  It would be best to speak to patients when they are alone, rather than when the patient is with friends or family, as they might be more receptive to answering questions honestly. The same could be said for any short written surveys.

• 5

  Record responses from patients in their records. Keeping clear written records is of benefit even if there is not direct proof of abuse, as patients who are being abused may make repeated visits to the emergency room.