Enabling Emergency Department Staff to Support Domestic Violence Victims of Strangulation

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ABSTRACT The study reported here investigated what enables emergency department (ED) staff to support domestic violence victim-survivors of strangulation, which poses potentially life-threatening medical and psychosocial risks. Informed by Appreciative Inquiry, interviews were conducted with twelve staff from eight emergency departments in New South Wales, Australia. Doctors, nurses, and social workers with experience in supporting victim-survivors of domestic violence-related strangulation were interviewed. De-identified transcripts were analysed using inductive thematic analysis. Themes identified from the data were the importance of recognising strangulation injuries, that understanding experiences of violence improves ED staff’s responses to victim-survivors of strangulation, the value of social work in multidisciplinary response, and that informal support sustains staff in this work. These themes highlight the need for emergency department staff education in identifying and responding to domestic violence and strangulation, which enables informed responses, positive patient engagement, and effective multidisciplinary care. IMPLICATIONS Multidisciplinary care for health and safety assessments are essential for domestic violence victim-survivors of strangulation presenting to emergency departments. 24-hour access to social workers in emergency departments facilitates safety planning and may mitigate the risks of escalating violence. Strangulation and domestic violence education is essential for emergency department staff. There is an evident need for increased social work roles in EDs, especially in rural hospitals, to support victim-survivors and to apply a social work approach to train ED staff to respond appropriately. Formalising supportive structures through enhancing social work and domestic violence education in emergency departments whilst encouraging informal support networks for staff may enhance safety for victims-survivors and maximise staff emotional wellbeing.