How often do nurses suspect violence and domestic violence in local emergency medical communication centre? A cross-sectional study

OBJECTIVE: To assess the extent of violence that is revealed by screening at first contact with a local out-of-hours emergency medical communication centre (LEMC; Norwegian ‘Legevaktsentral’). DESIGN: Cross-sectional study. SETTING: Arendal LEMC, covering 10 municipalities in south-eastern Norway. All contacting patients (telephone or personal attendance) were asked by nurse whether the encounter was related to violence. SUBJECTS: All first patient encounters at Arendal LEMC. MAIN OUTCOME MEASURES: Number and proportion of cases where the nurses suspected violence, both domestic violence and other violence. Incidence rate of violence, age and gender distribution of patients, time of day and reason for encounter. RESULTS: Violence was suspected in 336 of 103,467 first patient encounters (0.3%), of which 132 (0.1%) was domestic violence. Patients were female in 50.6% of all violence cases, and in 79% of domestic violence cases. Incidence rates were 137 per 100,000 person-years for all violence, and 53 for domestic violence. CONCLUSIONS: This study indicates violence may be revealed in three of 1000 first encounters to an LEMC when nurses screen systematically for domestic or other violence. KEY POINTS: Violence as underlying reason for encounter with primary care emergency health services is probably often not discovered by health personnel. ; • We examined how often nurses reveal violence upon first contact when systematically asking all patients. • Violence was suspected in 0.3% of cases, and domestic violence in 0.1%. • Among patients with disclosed domestic violence, 79% were female.