Evaluation of the impact of a community-based nurse-led model of care on access to healthcare for women experiencing domestic and family violence in Brisbane

Introduction: Women experiencing domestic and family violence (DFV) face significant social and financial barriers when accessing healthcare. In 2021, the Brisbane Domestic Violence Service (BDVS) implemented a nurse-led service for women temporarily accommodated in hotels or refuges following DFV. This study evaluates the impact of this nurse-led model of care on access to healthcare for women experiencing DFV.

Methods: A mixed-methods approach was used, analysing deidentified client health and demographic data from the first 18 months of the nurse-led service. Semi-structured longitudinal interviews with 15 clients explored experiences of the service and of accessing healthcare. Follow-up interviews at six months explored the longer-term picture.

Results: Between Jan 2021 and May 2022, 126 women aged between 17-57 years accessed the service. Most were referred by police or BDVS Safer Lives Mobile Service, with first nursing contact occurring <1 day later. Almost half presented with DFV related injuries, 18% were pregnant, 22% had dependent children and 6% reported injury to a child. Clinical interventions included physical and mental health assessments, wound care, referrals, and health service navigation. During longitudinal interviews, women described precarious lives impacted by violence, unstable housing, and social isolation. The nurse’s gentle, person-centred approach to clinical interventions helped foster trust at a time of great vulnerability. Active referrals to health and social care agencies helped women build stronger support networks. Driving women to and from appointments provided opportunities for conversations that allowed women to process and validate their experiences. This comprehensive nursing care empowered women to take positive steps in prioritising health and wellbeing for themselves and their children.

Conclusion: The nurse-led model of care provided effective outreach, assessment, treatment, and health service navigation for women and children experiencing DFV, which positively impacted access to healthcare for this underserved population. Flexible, gentle, and person-centred approaches are essential for success.