Dissemination Strategies of a Nonfatal Strangulation Program: Success of an Interagency Initiative

Abstract

BackgroundNonfatal strangulation has been identified as a common occurrence in intimate partner violence and can be associated with significant injuries and, at times, increased mortality. ObjectiveThis article describes a county interagency nonfatal strangulation initiative that efficiently disseminated an educational program for police, emergency medical services, emergency department staff, forensic nursing teams, and prosecuting attorneys, along with a forensic nurse response program. Prior to initiation of this program, no educational programs existed and no forensic examinations were being offered to victims of nonfatal strangulation. MethodsEarly cooperation between agencies was crucial, particularly between the two major health care systems in the county. A standardized forensic evaluation tool was developed, along with nonfatal strangulation courses. Education of forensic nurses together with prosecutors was unique and training of police, emergency medical services, and emergency department staff was coordinated. Forensic nurses traveled to meet victims for standardized examinations at 11 emergency departments. Creation of a secure Research Electronic Data Capture database captured forensic examination information and a strangulation task force provided means to assess the goals. ResultsThis initiative educated > 80% of the county’s first responders and 79% of emergency department staff within 3 months. During the first year of the program, 259 forensic nurse examinations for nonfatal strangulation were recorded. Police reported a total of 367 arrests for felony assault by strangulation. ConclusionsProfessionals providing legal and medical care to victims of nonfatal strangulation can be educated and forensic nurse examinations can be implemented successfully in an expeditious period of time with a county collaborative program approach.