Dv training unit 4 10.18.11


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Dv training unit 4 10.18.11

  1. 1. Unit 4: Roles and Responsibilities of Nurses in Addressing Domestic Violence Rosa Maria Gonzalez-Guarda, PhD, MPH, RN, CPH Assistant Professor School of Nursing & Health Studies University of Miami [email_address]
  2. 2. How do nurses address family violence? <ul><li>Prevention of domestic violence </li></ul><ul><li>Screening for domestic violence </li></ul><ul><li>Intervening if domestic violence is identified or suspected </li></ul><ul><ul><li>Helping clients develop a safety plan </li></ul></ul><ul><ul><li>Reporting abuse </li></ul></ul><ul><ul><li>Making referrals to other providers (e.g., mental health counselor) and community resources </li></ul></ul>
  3. 3. I. Prevention <ul><li>Educating women, children & societies that violence is wrong </li></ul><ul><li>Promoting healthy parent-child & partner relationships (e.g., enhancing communication) </li></ul><ul><li>Promoting stress reduction, problem solving & skill development programs </li></ul><ul><li>School-based programs targeting gender equality and healthy relationships </li></ul><ul><li>Policies discouraging abuse and gender inequities </li></ul>
  4. 4. II. Recommended Screening for Domestic Violence <ul><li>Screen female and male adolescents and adults, parents and caregivers </li></ul><ul><li>Screening conducted by qualified and trained health care providers with established rapport with patients, including nurses </li></ul><ul><li>In in-patient and out-patient health care settings such as primary care, emergency departments, family planning and women’s health clinics, mental health settings, pediatric settings </li></ul><ul><li>(The Family Violence Prevention Fund, 2004) </li></ul><ul><li>New guidelines for requiring complete insurance coverage, without co-pays, of DV screening and counseling as part of women’s health care </li></ul><ul><li>(Department of Health & Human Services, 2011) </li></ul>
  5. 5. II. Screening for Abuse Should: <ul><li>Screen male and female adolescents, adults, parents, and caregivers </li></ul><ul><li>Be part of a routine assessment </li></ul><ul><li>Be part of a face-to-face health care encounter </li></ul><ul><li>Included in written or computer based questionnaires </li></ul><ul><li>Inquire about current and lifetime victimization </li></ul><ul><li>Be direct and nonjudgmental, using culturally appropriate language </li></ul><ul><li>Take place in private </li></ul><ul><li>Be confidential- make sure to disclose reporting requirements </li></ul><ul><li>Use professional translator </li></ul>The Family Violence Prevention Fund, 1999
  6. 6. II. Assessing for Danger/Risk for Homicide <ul><li>If abuse is identified, the severity and danger of that abuse needs to be assessed </li></ul><ul><li>The Danger Assessment (Campbell, 1995, 2000)- Nurse developed screening tool to assess for risk of homicide </li></ul><ul><ul><li>www.dangerassessment.org </li></ul></ul><ul><li>The 5 most dangerous signs of abuse (in order) </li></ul><ul><ul><li>Partner used or threatened with a weapon </li></ul></ul><ul><ul><li>Partner threatened to kill </li></ul></ul><ul><ul><li>Partner tried to choke/strangle </li></ul></ul><ul><ul><li>Partner violently and constantly jealous </li></ul></ul><ul><ul><li>Forced sex </li></ul></ul><ul><ul><li>(Campbell et al., 1995, 2000) </li></ul></ul>
  7. 7. III. Intervention <ul><li>Provide validation of abuse and risk </li></ul><ul><ul><li>“ I am concerned for your safety”; “You are not alone” </li></ul></ul><ul><li>Provide information </li></ul><ul><li>Respond to safety issue by assisting in safety planning (Slide 8) </li></ul><ul><li>Referrals to local and national resources (Slide 13-14) </li></ul>
  8. 8. III. The Safety Plan <ul><li>Recognize that most dangerous period for a battered woman is when she is in the process of leaving </li></ul><ul><li>Safety Plan: </li></ul><ul><ul><li>Cell phone with number to hotlines & contact information </li></ul></ul><ul><ul><li>Pack emergency bag, copy of important documents, keys, hidden money, etc. </li></ul></ul><ul><ul><li>Identify a Safe House to escape to </li></ul></ul><ul><ul><li>Obtain restraining orders </li></ul></ul><ul><li>Collaborate with social workers, physicians, psychologist and others </li></ul>
  9. 9. III. Mandatory Reporting for Nurses <ul><li>Mandatory if suspected : </li></ul><ul><ul><li>Child Abuse </li></ul></ul><ul><ul><li>IPV and Elder/Vulnerable adult (e.g., disabled) abuse </li></ul></ul><ul><li>Mandatory reporting in FL: </li></ul><ul><ul><li>Child & Elder/Vulnerable Adult needs to be reported </li></ul></ul><ul><ul><li>IPV is not mandated unless </li></ul></ul><ul><ul><ul><li>Children are witnessing it- considered child abuse </li></ul></ul></ul><ul><ul><ul><li>There are firearm injuries or life-threatening wounds </li></ul></ul></ul><ul><ul><ul><li>Reporting suspected domestic violence without the informed consent of the woman is unethical and may cause the abuser to retaliate; however, if children are at risk, then it must be reported by law </li></ul></ul></ul>
  10. 10. III. How to Report <ul><li>By phone (1-800-96ABUSE), fax or web ( http://state.fl.us/cf_web ) </li></ul><ul><li>Be Prepared to Provide: </li></ul><ul><ul><li>Victim name, address or location, approximate age, race and sex; </li></ul></ul><ul><ul><li>Physical, mental or behavioral indications that the person is infirm or disabled; </li></ul></ul><ul><ul><li>Signs or indications of harm or injury, including a physical description if possible; </li></ul></ul><ul><ul><li>Relationship of the alleged perpetrator to the victim, if possible. If the relationship is unknown, a report will still be taken if other reporting criteria are met. </li></ul></ul>
  11. 11. III. Tips for Documentation <ul><li>Take pictures, if possible </li></ul><ul><li>Take verbatim quotes </li></ul><ul><li>Thick descriptions of abuse and person </li></ul><ul><li>Use a body map to document physical injuries (see picture on right) </li></ul>
  12. 12. III. Caring for Victims and Perpetrators <ul><li>Treatment for long-term physical and psychological effects </li></ul><ul><li>Finding alternative coping strategies (e.g., spirituality, helping other victims) </li></ul><ul><li>Preventing reoccurrence </li></ul><ul><ul><li>Batter’s Intervention Programs </li></ul></ul><ul><ul><li>Substance Abuse Treatment </li></ul></ul><ul><ul><li>Mutual-help groups </li></ul></ul><ul><ul><li>Respite care for caretakers </li></ul></ul>
  13. 13. III. Referral Resources <ul><li>Local </li></ul><ul><ul><li>Coordinated Victim Assistance Center (CVAC) 2400 South Dixie Highway Miami, FL 33133-4309 (305) 285-5900 </li></ul></ul><ul><ul><li>Victims Response, Inc/The Lodge Hotline number: 305-693-0232 PO Box 470728 Miami, FL 33147 Admin Phone: 305-693-0499 Admin Fax: 305-542-4128 </li></ul></ul><ul><li>National </li></ul><ul><ul><li>National DV Hotline (800) 799-SAFE, TTY (800) 787-3224 </li></ul></ul>
  14. 14. III. Referal Resources <ul><li>National Center for Violence Prevention & Control, CDC: http://www.cdc.gov/ncipc/dvp/dvp.htm </li></ul><ul><li>The Family Violence Prevention Fund: http://endabuse.org/resources/facts/ </li></ul><ul><li>The World Health Organization: http://www.who.int/topics/violence/en/ </li></ul><ul><li>Florida Department of Children & Families: http://www.myflorida.com/cf_web </li></ul>
  15. 15. References <ul><li>Centers for Disease Control & Prevention, CDC (2010). Intimate partner violence: Definitions. Retrieved on August, 8 2011, from http://www.cdc.gov/violenceprevention/intimatepartnerviolence/definitions.html </li></ul><ul><li>Department of Health & Human Services (2011). Affordable care act ensures women receive preventive services at no additional cost. Retreived on August 17, 2011, from http://www.hhs.gov/news/press/2011pres/08/20110801b.html </li></ul><ul><li>Eleventh Judicial Circuit of Florida, http://www.jud11.flcourts.org </li></ul><ul><li>Family Violence Prevention Fund, FVPF (2004). National consensus guidelines on identifying and responding to domestic violence in health care settings. FVPF: San Francisco, CA. </li></ul><ul><li>Humphreys, J. & Campbell, J. (2010). Family Violence and Nursing Practice, 2nd Edition. New York, NY: Springer. </li></ul><ul><li>Sheridan, D. J. & Nash, K. R. (2007). Acute Injury Patterns of Domestic Violence Victims. Trauma, Violence and Abuse, 8 (3), 281-289. Available at: http://tva.sagepub.com/cgi/content/refs/8/3/281 </li></ul><ul><li>Wrangle, J., Fisher, J. W. & Paranjape, A. (2008). He Sentido Sola? Culturally Competent Screening for Intimate Partner Violence in Latina Women. Journal of Women's Health, 17 (2), 261-267. </li></ul>