Understanding management and support for domestic violence and abuse within emergency departments: A systematic literature review from 2000-2015.

Domestic violence and abuse has been shown to have a direct impact on the health and well-being of survivors who will often access emergency department services with direct injuries and associated medical conditions. This article is relevant to those working in the emergency department in raising awareness in a number of areas of practice for example the prevalence of male intimate partner violence survivors. Furthermore, patients do not always disclose domestic violence and abuse even in cases where there is clear sustained injury thus requiring staff to be vigilant to repeat attendees and patient history. This requires a well-maintained and effective reporting system for instances of suspected and disclosed domestic violence and abuse in order that staff can provide the appropriate care and support. Emergency department staff often deal with complex cases, this includes different aspects of domestic violence and abuse including physical, emotional and psychological abuse. Continual support and guidance, including educational interventions, would assist emergency department clinical staff to manage and discuss instances of domestic violence and abuse in their workplace and their interactions with domestic violence and abuse patients. Whilst training for emergency department staff is welcomed, there also needs to be a greater awareness of the potential complexity of domestic violence and abuse presentations beyond physical injury in order for staff to remain observant throughout consultations. It is also suggested that clear domestic violence and abuse assessment and referral mechanisms should be embedded into clinical practice, including emergency department, as described in the UK National Institute of Clinical Excellence guidelines (2014). Overall improvements in reporting mechanisms in emergency department for the identification, management and support for domestic violence and abuse survivors would add to the collective and growing body of evidence surrounding domestic violence and abuse and their presentations within healthcare settings. Such measures would enable those working in emergency department to support disclosure of domestic violence and abuse more effectively.