Intimate partner violence against women: findings from one state's ED surveillance system

Victims of intimate partner violence against women (IPVAW) often come into contact with various health care professionals, including emergency nurses. Michigan has implemented an ED surveillance system to monitor IPVAW in the state.

Twenty-three emergency departments participate in the Michigan Intimate Partner Violence Surveillance System. Female assault and maltreatment victims are identified using International Classification of Diseases Clinical Modification (ICD-9-CM) diagnostic and E codes (External Cause of Injury/Adverse Effects codes). For a 2-year period (1999-2000), patients' charts were reviewed, usually by an emergency nurse, to identify IPVAW victims.

A total of 3111 female assault and maltreatment victims were identified. Of the 2926 incidents for which physical and/or sexual violence was confirmed by chart review, 1136 (38.8% [95% confidence interval: 37.1% to 40.6%]) involved IPVAW.

A hospital ED surveillance system revealed that more than a third of female assault and maltreatment incidents were attributable to intimate partner violence, with a considerable proportion being young women abused by an ex-boyfriend. Surveillance also identified a need for improved documentation of female assault and maltreatment in ED records. We realized the benefits of using a public health surveillance process to monitor IPVAW incidence, identify high-risk groups, and reduce research costs.