Increasing the identification of intimate partner violence in the emergency department through routine screening

Background: Intimate Partner Violence (IPV) has been recognized as a public health concern with increasing prevalence in Canada. IPV is defined by the World Health Organization as physical, sexual, or psychological harm that is caused by a current or former partner or spouse. Stigma and shame represent significant barriers to the disclosure of IPV in healthcare settings, with many patients remaining silent unless explicitly asked. Social Workers (SW) in the Emergency Department (ED) note that many instances of IPV are not identified until after a social work consult, and nurses express uncertainty about how to ask about IPV. In 2025, a current state analysis in an urban, academic hospital ED showed 62 consults to ED SW for IPV, with only 9 of these ordered by a nurse. This quality improvement project takes place in a downtown Toronto ED and aims to (1) increase the number of IPV cases referred to SW by nurses, (2) increase nursing confidence in identifying and asking about IPV, and (3) increase the level of IPV education provided to nurses. Methods: Using the Model for Improvement Plan-Do-Study-Act, this project implemented an IPV screening tool for use by ED nurses when patients presented with clinical indicators for IPV. Co-facilitated by an ED SW and Registered Nurse, education sessions on IPV screening were provided to ED nurses in January 2026. Data sources include electronic medical record system reports and staff surveys. The outcome measure is the number of SW consults for IPV ordered by nurses. Process measures are the number of nurses attending education sessions, and the number of times the screening tool is used. Balancing measures evaluate nursing confidence in identifying and asking about IPV, and impact on nursing and SW workload. Results: 40% of ED nurses (n = 43) attended education sessions on IPV screening. Barriers to session attendance included staffing shortages and hospital-wide capacity alerts. The average number of ED SW consults for IPV increased by 1.78 consults per week after education sessions were held. Pre- and post-survey results indicated a 50% (n = 32) increase in the number of nurses who reported feeling confident identifying risk factors for IPV, and a 49% (n = 30) increase in the number of nurses who reported feeling confident asking about IPV during patient assessments. Implications and lessons learned: The findings from this project indicate that education on IPV screening may improve nursing confidence in both identifying IPV risk factors, and in asking about IPV. Results also suggest that introducing an IPV screening tool enhances the use of trauma-informed approaches in nursing practice and aids in the identification of IPV cases, thereby improving the quality of care provided in the ED.