Abuse/Neglect Question

  1. Hi Everyone,

    How many of you address abuse and neglect with your OB patients on the admission assessment? Do you ask only a few questions or do you have a detailed questionnaire?

    Just wondering...I would love to hear what everyone else is doing.

    Thank-you,

    Layna
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  2. 14 Comments

  3. by   shoelace
    My good friend is pregnant and said that she was asked this question. I was pretty shocked, actually. I'm NOT trying to be a smartass here, but I was a little confused that anything *could* be done about abuse/neglect during such a life-changing situation. Like, "Gee, Mrs. Patient, is there any way we can help you resolve your domestic violence problem while you're currently going through this life changing event?"
    Okay, that was pretty smartassish. Clearly I am not an OB nurse So tell me - how many times do you get an affirmative answer to these questions? What do you do about it when you do?
  4. by   SmilingBluEyes
    WE screen EVERYONE with EVERY visit, even if they are frequent fliers. Have a very specific questionaire they can fill out in silence ( I rarely interview them verbally if ANYone else is in the room, or ask them to leave). Also, we must document any suspicious bruising, burns or other injuries noted on the patient at the time of their admission. Its a big JCAHO special -interest item and if anyone is NOT doing this, they will be very soon if they are JCAHO-accredited.
  5. by   emily_mom
    If they admit to abuse, we are required to report it in WI when they are pregnant. If she weren't, then no. It's done to protect the baby.
  6. by   layna
    Hi Everyone,

    Thank-you for your replies. SmilingBlueEyes is correct. This has to be a part of our assessment. We are just adding this aspect of nursing assessment to our admission process. I am interested in receiving copies of questionnaires from other OB departments.
    Thank-you!
    Layna
  7. by   angelbear
    I dont know and I am not in OB. However when my sister who was abused was pregnant she was told by MD and counsilor that abusive behavior tends to increase with pregnancy. I would think that this would make it a valid thing to screen for. JMHO
  8. by   at your cervix
    Originally posted by SmilingBluEyes
    Have a very specific questionaire they can fill out in silence
    SmilingBluEyes, I would love to see the questions that you ask!!! I think this is a great idea!!!!!!
  9. by   SmilingBluEyes
    I will get a copy at work and post them here for you guys next week, ok?
  10. by   anitame
    That would be great Deb.
    We ask something along the lines of: Do you feel threatened, controlled, afraid or abused in your relationship with anyone? It's written on the admit form. If they're alone we ask, otherwise we hand them the paper to read. There's a prepared statement to read to them first; something along the lines of "We are required to ask everyone this question." Never had anyone actually admit to D.V. via that form though. The ones that come in for a labor check after a D.V. incident are referred to police.
  11. by   emily_mom
    We visited a women's shelter last Friday and this was addressed. They said that 25% of pregnant women that suffer abuse do so during this time.

    They are hoping by healthcare asking the questions that they will know (if abused) that someone cared enough to ask and may return. They don't expect them to admit it through casual conversation.
  12. by   HazeK
    Due to our high volume, a written questionaire might be difficult ...
    .
    (I still want to see it, though, ...also, do you have it in Spanish?)
    We do have a big poster in the bathroom, bilingual, with 'tear off tabs' that offers counseling and support for abused women...so when they are in their alone in the bathroom, they can take a number...

    Personally, I TAKE (not send) each woman into the bathroom, give her a gown, explain a clean catch urine sample AND, at this PRIVATE time, ask her if she is safe in her home! I include physical, emotional and sexual assault in my line of questioning. If they look shocked or offended at the questions, I just let them know that statistically pregnant women are at GREATER risk of being abused than nonpregnant women and that I am just trying to be sure they are safe!

    Now, if anyone can tell me how to protect the obviously abused patient, who denies it vehemently!!!!!
  13. by   sbic56
    Now, if anyone can tell me how to protect the obviously abused patient, who denies it vehemently!!!!!
    HazeK

    I think this is one of those areas that bothers nurses in a big way because we are such fixers. Problem is, there is nothing we can do until they are willing to accept help. It has to be their decison to leave a bad situation. Letting them know, repeatedly, that they do not have to endure such treatment is the best we can do. There are so many issues at hand here. Self esteem issues, mainly. They need to know they can make it without the abuser; that they are worthy individuals. Of course, when the welfare of the child is involved, we have to protect that unborn child, thus opening up a whole new set of problems...sure wish the answers were easy!!
  14. by   GailWHNP
    In FL, every health-care provider is required to inquire re domestic violence. As a nurse practitioner, I include a short assessment usually during the initial interview when I send the accompaning party outside to complete a bit of registration paperwork. If she admits to DV, she is referred to the social worker who will see her at her home, when she's alone.

    The hospital also has a general statement on their admitting form as someone else has indicated above. There's *always* paperwork to be completed at registration, so I send the family members to complete that. I never, never, never ever ask in front of family, although I have seen some nurses do this, which boggles my mind. Again, if the answer is yes, the social worker talks with the pt.

    I have actually had about 10 pts go from my office to the abuse shelter, usually after their first appt. They get their important papers together, come for 2nd or 3rd appt, then go. Unfortunately, they didn't all stay there!
    Gail

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