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A Lethality Assessment Program in the Emergency Department: Program Implementation and Evaluation

Publication ,  Journal Article
Howard, C; Silva, SG; Waldrop, J; Stone, E; Schafer, BP; Gonzalez-Guarda, RM
Published in: Journal of Emergency Nursing
January 1, 2025

Introduction: Despite routine screening for intimate partner violence and validated screening tools for lethality, intimate partner violence assessment and linkage to services remain inconsistent in health care settings. This program aimed to implement and evaluate a lethality assessment program, a nurse-led screening and prevention program for intimate partner violence homicide in an emergency department that partnered with a local community agency. Methods: A single group pre−post design was used to evaluate changes in knowledge of intimate partner violence and the lethality assessment program protocol and confidence in implementing the protocol among 143 registered nurses in the emergency department. Program outcomes were assessed during a 4-month post-implementation period. Focus group interviews were conducted and analyzed to identify barriers and facilitators of implementation. Results: Significant improvements in the nurses’ knowledge and confidence in implementing the protocol (all P< .001) were observed. Fourteen lethality screens were completed during the 4 months, with 13 indicating high intimate partner violence homicide danger. Eight victims received 20 services (1-5/person) from the local community organization: emergency shelter, safety planning, legal aid, and domestic violence protection order. Barriers to implementation included time, privacy, training, and access to screening forms. Facilitators included champions, resources to allow for implementation, and prompts. Discussion: The lethality assessment program is a feasible protocol in a health care setting to increase intimate partner violence awareness, link high-risk intimate partner violence victims to needed services in real time, and potentially reduce intimate partner violence homicides. Programs like this are essential to address this public health concern.

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Published In

Journal of Emergency Nursing

DOI

EISSN

1527-2966

ISSN

0099-1767

Publication Date

January 1, 2025

Volume

51

Issue

1

Start / End Page

41 / 50

Related Subject Headings

  • Nursing
  • 4205 Nursing
  • 3202 Clinical sciences
  • 1110 Nursing
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Howard, C., Silva, S. G., Waldrop, J., Stone, E., Schafer, B. P., & Gonzalez-Guarda, R. M. (2025). A Lethality Assessment Program in the Emergency Department: Program Implementation and Evaluation. Journal of Emergency Nursing, 51(1), 41–50. https://doi.org/10.1016/j.jen.2024.09.004
Howard, C., S. G. Silva, J. Waldrop, E. Stone, B. P. Schafer, and R. M. Gonzalez-Guarda. “A Lethality Assessment Program in the Emergency Department: Program Implementation and Evaluation.” Journal of Emergency Nursing 51, no. 1 (January 1, 2025): 41–50. https://doi.org/10.1016/j.jen.2024.09.004.
Howard C, Silva SG, Waldrop J, Stone E, Schafer BP, Gonzalez-Guarda RM. A Lethality Assessment Program in the Emergency Department: Program Implementation and Evaluation. Journal of Emergency Nursing. 2025 Jan 1;51(1):41–50.
Howard, C., et al. “A Lethality Assessment Program in the Emergency Department: Program Implementation and Evaluation.” Journal of Emergency Nursing, vol. 51, no. 1, Jan. 2025, pp. 41–50. Scopus, doi:10.1016/j.jen.2024.09.004.
Howard C, Silva SG, Waldrop J, Stone E, Schafer BP, Gonzalez-Guarda RM. A Lethality Assessment Program in the Emergency Department: Program Implementation and Evaluation. Journal of Emergency Nursing. 2025 Jan 1;51(1):41–50.
Journal cover image

Published In

Journal of Emergency Nursing

DOI

EISSN

1527-2966

ISSN

0099-1767

Publication Date

January 1, 2025

Volume

51

Issue

1

Start / End Page

41 / 50

Related Subject Headings

  • Nursing
  • 4205 Nursing
  • 3202 Clinical sciences
  • 1110 Nursing
  • 1103 Clinical Sciences