Confronting barriers to universal screening for domestic violence.

Nationally, domestic violence has reached epidemic proportions. Universal screening is a vital means to identify those women who suffer in abusive relationships with intimate partners. Collaborative efforts between a community shelter for abused women and a local medical center's emergency department resulted in the development and implementation of a universal screening process. Barriers encountered by the emergency department nursing staff during the initial phase of screening included lack of information about domestic violence issues as well as about the tool, personal perceptions and feelings about domestic violence, and institutional barriers such as lack of time, space, and privacy in the emergency department. Of these, informational and affective barriers of nursing staff are viewed as the most significant. Discussion includes a call for emphasis on domestic violence in the curricula of nursing programs and those of other health care providers and use of universal screening to identify and assist abused women. Interdisciplinary methods of formal education, in-service training, and continuing education are encouraged to augment existing universal screening, as well as to assist those who have yet to implement such a process.