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Discussion

Questions about abuse...

Sorry for multiple post tonight I have not had time to be on here in a minute.

Can anyone tell me how I can get some sort of policy in effect to make sure we are screening better for people at risk of abuse. Where can I get information, some sort of guidelines or template I could look at to make a questionare that becomes part of the chart with referrals made if neccesary.

My boss wants me to to work on this and I have NO CLUE where to start, would appreciate any help or to hear what your policy is.

Thanks in advance!!

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    • Featured Replies

    Do you have an elderabuse, or crisis hotline in your area that can help with a referral to a local agency, that might have some ideas? :) Some hotlines have a list of the agencies that deal with elder/child/domestic abuse....

    It might at least be a place to start. There are generally social workers at these agencies that deal with this regularly :up:

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    • Author

    Yes we have a crisis line, but I was looking for maybe some questions you can ask to determine risk along those lines. Maybe a referral sheet for those having suspicious injuries, etc.

    Thanks for the advice though, I appreciate it, and I will contact them so I can see what information they can give me.

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    Yes we have a crisis line, but I was looking for maybe some questions you can ask to determine risk along those lines. Maybe a referral sheet for those having suspicious injuries, etc.

    Thanks for the advice though, I appreciate it, and I will contact them so I can see what information they can give me.

    The reason I thought of them was seeing some screening info for elder abuse that came from a crisis hotline type number on a poster in a grocery store bathroom. :twocents:

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    What type of abuse - elder, domestic, child? There are agencies that work specifically with each group, and they can all give you information for screening. I'm sure there's plenty of information on the internet from the various abuse support groups outlining what to look for and/or what to ask which will vary according to group/type. Once you gather the information, you will be able to piece it together to come up with a template to suite your particular situation.

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    • Expert

    Everyone is now "screened" for abuse. I have always asked .."Is there anyone emotionaly or physically hurting you?"

    Most if not all states have abuse screening laws and The JC also requires screening.

    The Joint Commission Standards

    In addition to state screening requirements, the Joint Commission specifies standards for screening and treatment of these patients, some of which are:

    1. Possible victims of abuse are identified using criteria developed by the hospital.

      1. Objective criteria should exist to identify victims of abuse and this should be used throughout an institution. Staff should be trained on these criteria.
      2. Staff should maintain lists of private and public community agencies that can provide help and make appropriate referrals.

        3. [*]Possible abuse victims have special assessment needs.

        1. Policies and procedures should exist to define the hospital's responsibility in collecting, retaining and safeguarding information and evidence.
        2. The following should be documented in the patient's medical record: consents, chain of evidence, legally required notification and release of information to authorities, referrals made.

        [*]Leaders ensure that the competence of all staff is assessed, maintained, demonstrated and improved continually.

        Family Violence State Statutes

        http://www.aaos.org/about/abuse/ststatut.asp

        Policy....http://www.vahealth.org/Injury/projectradarva/documents/older/pdf/CHIIP_PROGRAM_Domestic_Violence_Hospital_Policy.pdf

        http://www.nnvawi.org/pdfs/alo/Koziol_universal_screening.pdf

        http://www.rnao.org/Storage/12/655_BPG_Women_Abuse.pdf

        http://www.mincava.umn.edu/documents/bridges/bridges.html

        http://www.mincava.umn.edu/documents/bridges/bridges.html

        Domestic abuse is not mandated to be reported in most states on suspicion or admission of abuse unless the violence is involving traume. Hospitals I have seen have the screening question as a part of the admission process and a part of the triage process in the ED with a referal policy for Yes answers to SService.

        I hope this helps.

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    My mom recently had to visit the hospital for some tests.

    Admitting nurse sat and asked her a number of questions regarding abuse/domestic violence as part of their routine check in (standard in most hospitals here)...but my mom laughed at her.

    My dad ( the sweetest kindest man on the planet) was sitting by her the entire time.

    Why would you ask these questions in front of ANYONE who could be the abuser...not to mention if they ARE abusing their family member....it would make them anxious to not leave them alone so they can tell....

    I think questioning clients is a good thing..but in privacy. Maybe during the exam...when the client is ALONE.

    My dad even said...it was soo weird.

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    • Author

    MisMatch:I agree it can be uncomfortable, our facility uses some questions during triage for example: Do you feel safe at home....etc

    But I think my boss is looking for me to come up with something to identify those that maybe did not feel comfortable during triage process, lets say maybe their spouse is sitting right there. Thanks for all info

    3

    ESME12-Appreciate your response, we do have questions asked during triage but most times the person that brought them in is right there, whether it be a parent or a spouse, etc...

    I REALLY appreciate the information you guys have given me, I just want to find a way to make our system BETTER for all people that experience abuse in any format and with any age group.

    Hope you all are having a great day it is BEAUTIFUL here!!

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    Ask them if they feel safe at home. Take cues from there.

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    When I am triaging a patient in the ER, I take them to the BR to get a urine specimen (we get them on virtually everyone :rolleyes:) and ask them while we're there or en route. I preface it by saying I prefer to ask certain questions in private - ask about weight, last menses, and abuse.

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    Since I work in OB all of our patients provide a Urine specimen when they check in. We have a questionnaire to screen for Domestic Violence that we leave for them to fill out while they are alone in the bathroom.

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    "Domestic abuse is not mandated to be reported in most states on suspicion or admission of abuse unless the violence is involving traume."

    Wow, that's sad :(

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