Successful implementation of universal woman abuse inquiry

Abstract

Objective: This study investigated a year-long professional development strategy to improve Public Health Nurse (PHN) documented abuse inquiry among low-risk postpartum women. Strategies included workshops and small group work at regular intervals.

Design: A retrospective chart audit of cross-sectional data collected as part of the Healthy Babies/Healthy Children Program was conducted 1 year before and after the introduction of the Routine Universal Comprehensive Screening (RUCS) Program.

Sample: Charts of all postpartum women who lived in one Ontario county (Canada) and who received a PHN home visit were reviewed (pre-RUCS, n=1,151; post-RUCS, n=1,193).

Measurement: Information regarding mother's age group and parity, month of PHN visit, abuse inquiry, and whether or not the woman was a single parent was abstracted.

Results: Originally, there was documentation of abuse inquiry on only 0.8% of low-risk postpartum client charts. Women aged <20 years and single parents were significantly (p<.001) more likely to be asked, suggesting case-finding among PHNs. Post-RUCS abuse inquiry increased to 20.5% with no demographic differences between those groups asked.

Conclusion: Policy changes providing specific expectations and documentation cues can improve routine abuse inquiry. New policies can be effectively combined with existing programs and infrastructure, facilitating the longer term success of new initiatives.