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Quality Improvement: Intimate Partner Violence Screen in Nurse Home Visit Program

Purpose: Women are disproportionately impacted from intimate partner violence (IPV). Their children also experience long-term adverse consequences. Effective IPV prevention and intervention efforts are vital. This quality improvement project addressed the lack of an evidence-based IPV training and protocol in a nurse home visit program. Methods: Stakeholder engagement and an evidence-based practice intervention were implemented. Training effectiveness was examined by the pre-post-training assessments; completed by 17 nurses. To measure the IPV practice change, 196 pre- and 107 post-intervention charts were reviewed. Results: The training significantly increased nurse knowledge and comfort (t=5.9, p< .001). Only 22% of those referred due to recent IPV history were screened before the intervention; 65% after the intervention. Multivariate analysis of screening rates was performed; predictors included county, mental health status, education, subprogram, and IPV referral reason. Due to low power, a one-tail test was employed. One county was 14 times less likely to screen than the other county (p= .023). 93% of those referred due to IPV history were enrolled in the crisis response subprogram, only offered by the other county. Those referred due to IPV history were three times more likely to be screened (p=.042) than those referred for other reasons. There was no significant change observed on IPV disclosure and intervention practice. Conclusions: The adoption of an evidence-based IPV training and protocol is a key to provide effective IPV interventions. Consistent monitoring and support to remove barriers as well as the strong collaboration are essential to keep this practice change effective and sustainable.