chapter 15 ppt

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 15: Violence and Abuse


Violence

• Intentional

• Act committed by a person or persons against another person or persons in which there is a conscious choice to act violently

• Homicide

• School violence


Healthy People 2020 Injury Prevention Objectives

• Firearm-related deaths

• Identification of improper firearm storage in homes

• Surveillance of external causes of injury in emergency departments

• Decreased incidents of homicide, child maltreatment, and physical assaults

• Sexual assaults

• Weapon possession by adolescents on school property


Gender-based Violence

• Violence against women is a form of gender-based violence.

• Results in harm

– Physical

– Sexual

– Psychological


Intimate Partner Violence• Based on the desire for control on the part of the

perpetrator

• Pattern of assaultive and coercive behaviors

– Physical injury

– Psychological abuse

– Sexual assault

– Progressive social isolation

– Deprivation

– Intimidation and threats


Question

Is the following statement True or False?

Femicide is a term used to refer to a homicide that occurs in the context of intimate partner violence.


Answer

True

Rationale: Femicide is a term used to refer to a homicide that occurs in the context of intimate partner violence


Incidence and Prevalence of Intimate Partner Violence

• Incidence—the number of cases of disease with an onset during a prescribed period of time; often expressed as a rate

• Prevalence—number of cases of a disease, infected persons, or people with some other attribute present during a particular interval of time; often expressed as a rate

• Incidence and prevalence of children exposed to IPV estimated some 3.3 to 10 million children.


Intimate Partner Violence: Health Consequences in Children Who Witness Abuse• Following are the special issues in screening:

– Parent is not the client.

– Documentation in the medical record may provide information to a potential abusive partner.

– Assessment of a caregiver with a child present using tools validated in adult settings may not be practical or safe.


Intimate Partner Violence: Health Consequences in Children Who Witness Abuse (cont.)• Creative strategies have been explored to address these

issues and promising practices. Possibilities include

– Asking mothers indirectly

– Asking mothers directly, without the child present


Intimate Partner Violence: Health Consequences in Children Who Witness Abuse (cont.)

– Having providers inform parents about mandatory reporting laws prior to asking questions

– Being able to screen for safety and dangerousness of the situation

– Being aware of resources and referrals


Trauma-sensitive Care: Principles

• Demonstrate respect

• Establish and maintain rapport

• Share control

• Share information

• Respect boundaries

• Foster a mutual learning process

• Show compassion and avoid passing judgment


Lethality Assessment

• An assessment that identifies high-risk factors for intimate partner violence

• Although abuse and violence can be unintentional, it is the intentionality that impels nurses to be members of a health care team to assess and address policy to decrease the incidence of such acts in communities.


Lethality Risks

• Is there a gun in the house?

• Is the woman's partner unemployed?

• What is the worst “thing” the partner has ever done to the victim?

• Does the victim feel that the partner is capable of hurting her? Carrying out his threats?

• Has the woman’s partner ever been arrested?

• Is the woman's partner using drugs? Drinking excessively?


Risk Factors That Indicate Significant Concern for the Safety of the Children

• Threats to kill the caretaker, children, and/or self; caretaker fears for the children's safety.

• A child was physically injured in an incident where the caretaker was the target.

• A child was coerced to participate in or witness the abuse of the caretaker.

• A weapon was used or threats were made to use a weapon, and the caretaker believed that there was intention and ability to cause harm.


Safety Assessment and Planning in Intimate Partner Violence

• Components for safety planning include

– Crisis/disaster plan

– Place to go

– How to get there


Mandatory Reporting of Abuse

• When any health care provider suspects that abuse of an elderly person, a child or a person with a disability has occurred, he or she is mandated to report the abuse to the appropriate agency.


Considerations When Making a Mandatory Report

• Talk with the adult victim about the possibility of filing a mandatory report

• Consider the safety concerns of filing

• Determine how the perpetrator may respond to a report being filed

• Determine if it will be safe to inform the children about the report

• Identify resources available to victim (family, friends, clergy, co-workers)


Considerations When Making a Mandatory Report (cont.)

• Consider filing in concert with the adult victim

• Share concerns of safety with the Child Protective Agency

• Address safety planning with the non-offending victim

• Ask about the perpetrator's behaviors (what is the worst thing he or she has done? Does he or she own a gun? Has he or she been arrested? Does he or she use drugs? Do you think he or she is capable of hurting you or your children?)


Child Abuse and Neglect

• Any recent act or failure to act on the part of a parent or caretaker that results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act that presents an imminent risk of serious harm


Forensic Nursing

• Forensic nurses offer victims compassionate evidence-based care.

• Advance training focuses on

– Taking a history of the assault

– Collecting evidence

– Providing treatment and follow-up

chapter 15 ppt

Documents