Strategies Used by Emergency Department Clinical Champions to Sustain Improvements in Intimate Partner Violence Screening: A Longitudinal Qualitative Study

TL;DR

This study explores how clinical champions in emergency departments sustain improvements in screening for intimate partner violence through various strategies.

Contribution

The study identifies unique strategies used by nurse champions in promoting intimate partner violence screening in healthcare settings.

Findings

Champions used narrative practice to normalize enquiring about intimate partner violence.

They focused on building understanding and ownership among staff to sustain practice change.

Education and managing resistance were key strategies in implementing routine screening.

Abstract

Aim: To identify the strategies that clinical champions implemented within emergency departments to initiate and sustain routine intimate partner violence (IPV) screening.

Background: For effective IPV identification and responses to occur within healthcare settings, new attitudinal and practice changes are required. This paper adds to the body of knowledge about champions and their role within healthcare settings to achieve this end.

Design: This qualitative study involved semistructured interviews with 23 individuals over a 2-year period who identified as champions and worked to introduce routine IPV screening in two hospital emergency departments. Data from transcribed interviews were analysed thematically using an interpretive framework and a process of constant comparison.

Results: Champions detailed a range of strategies they employed to foster practice change. The primary strategies were as follows: normalising enquiring about IPV through narrative practice, building understanding and ownership, providing accompaniment, serving as an educator and resource person, and managing resistance.

Conclusions and Implications: This paper highlights the specific complexities champions face when bringing about practice change in the area of IPV. The findings suggest nurse champions, particularly those working in the IPV space, adopt unique strategies compared to those described in the mainstream literature on champions. This evidence has implications for best practice and can ensure that the champion role is more effectively utilised by health services to better meet the needs of individuals experiencing IPV. It is recommended that champions be established as part of any IPV practice change process. Introduction of IPV education into nursing undergraduate and postgraduate education and workplace ongoing education and training is also recommended to strengthen the capacity of nursing staff to serve as IPV practice change champions.