'It's a challenging environment' health worker perspectives on domestic violence presentations to emergency departments in New South Wales hospitals in the context of the COVID-19 pandemic.

Abstract

Background: Domestic and family violence (DFV) is a significant issue in Australia, with one in four women experiencing DFV in their lifetime. Emergency departments (EDs) within public hospitals are a priority setting for identifying, treating, and referring those at risk through sensitive clinical inquiry. However, there remains a dearth of evidence regarding health staff's knowledge, skills, and confidence in addressing the burden of DFV from their perspective. This research aims to address the evidence gap from the perspectives of health workers working within a diverse range of public hospital EDs in New South Wales (NSW), Australia, at the time of the COVID-19 pandemic.

Methods: Semi-structured interviews were conducted online, adhering with COVID-19 restrictions at the time, and thematic analysis performed.

Results: While EDs within NSW hospitals are often a first port of call for those experiencing DFV, clinician health staff perceive overwhelmingly, that they lack the capacity individually and institutionally to appropriately address presentations and had little knowledge of existing policies and procedures.

Conclusions: Policy and programmatic solutions to the capacity gap need to be current, highly feasible for an ED environment and ongoing to account for rotating staff and the evolving nature of DFV presentations. The preparedness of EDs within public hospitals in NSW will be crucial to the success of strategic initiatives and recent historic law reforms in supporting victim-survivors and preventing DFV.