NURS FPX 4050 assessment 4 final care coordination plan

Sample Answer

In the US, family and domestic violence is a common problem that affects around 10 million people a year. Research suggests that domestic violence involves a significant proportion of the population, with approximately one in four women and one in nine men experiencing such violence (Grillo et al., 2019). Healthcare practitioners often encounter patients who have suffered from family or domestic abuse. Abuse of any kind, including financial, physical, sexual, mental, and psychological, may be classified as domestic or family violence and can affect people of all ages, including adults, children, and the elderly. Domestic violence hurts one’s physical and mental health, as well as productivity, quality of life, and, in some cases, fatality. This paper aims to outline the key priorities for a care coordinator when discussing a plan to address domestic violence with a patient and their family members.

Patient-Centered Health Interventions

The Healthy People 2030 initiative, which addresses domestic violence, aims to lower various forms of violence, including physical assaults, sexual assaults, and gun-related injuries (Rauhaus et al., 2020). When the victim is afraid, it may be difficult to identify domestic violence, especially when they go to the ER or a doctor’s office. Creating an evaluation process and being aware of the possible connection between domestic and family abuse and the symptoms and indications that the patient is presenting with is essential. More than 80% of victims of family and domestic abuse go to hospitals for treatment; other victims may see therapists, dentists, and other medical professionals (Grillo et al., 2019). Patient-centered care for these individuals primarily focuses on assessing and managing physical injuries, pain, and psychological trauma.

All healthcare practitioners, such as nurses, physicians, doctor’s assistants, dental practitioners, nurse practitioners, and pharmacists, should conduct routine screening. Interdisciplinary screening coordination is crucial for safeguarding victims and reducing adverse health outcomes within 24 hours (Lutgendorf, 2019). Proving the correlation between injuries and domestic abuse poses a significant challenge. The primary focus is on injuries that significantly risk one’s life or physical well-being. Following stabilization and physical assessment, laboratory tests and imaging modalities such as X-rays, CT scans, or MRI scans may be necessary. Healthcare professionals should prioritize addressing the root cause of the patient’s condition upon their arrival at the emergency department.

After confirming the patient’s stability and absence of pain, it is essential to conduct a comprehensive assessment of individuals who have disclosed experiencing abuse. The primary focus is on evaluating safety. Utilizing a set of predetermined questions can assist in reducing ambiguity during the patient’s assessment. In imminent peril, it is advisable to promptly seek assistance from an advocate, a shelter, a victim hotline, or legal authorities within 24 hours (Lutgendorf, 2019). In the absence of imminent peril, the evaluation should prioritize the examination of mental and physical well-being while also ascertaining the presence of any prior or ongoing instances of abuse. The responses determine the suitable intervention.

Survivors of intimate partner violence demonstrate elevated rates and severity of depression, with symptoms potentially enduring for up to five years following the cessation of violence (Grillo et al., 2019). Survivors of intimate partner violence (IPV) also experience higher rates of anxiety, posttraumatic stress disorder (PTSD), and issues related to alcohol and substance abuse. In an ideal world, the hospital would allow patients to speak privately with a medical professional, be prepared to handle emergencies, offer consolation measures like information, support, and emotional support, and be able to connect patients with local social service organizations. The Institute of Medicine (IOM) and the U.S. Preventive Services Task Force recommend IPV screening and counseling for all adolescent and adult women as part of preventive care. The Department of Health and Human Services has also adopted these recommendations as part of the preventive care provided through the Affordable Care Act.

Ethical Decision

Obtaining authorization promptly is crucial when providing treatment to clients affected by domestic violence. Specific individuals who engage in domestic violence may exhibit psychological defense mechanisms, such as prematurely terminating an interview or refusing to cooperate in various ways. If the therapist communicates with the probation officer who referred the client without obtaining proper authorization, it could violate the law and ethical standards that safeguard the client’s right to confidentiality (Lutgendorf, 2019). Therapists must obtain signed consent before conducting the assessment interview to mitigate this vulnerable situation. A limited release enables the therapist to acknowledge the client’s participation in the assessment process (Rauhaus et al., 2020). After obtaining limited authorization, the therapist can legally contact the referring agency. After the client consents to the assessment process or treatment program, a more extensive approval will enable the clinician to disclose specific information about the diagnosis or treatment.

Relevant Health Policy Implications

Global policies emphasize the imperative to address abuse and domestic violence promptly. An authorizing legal or societal framework can reinforce organizational-level policies and procedures. These policies enhance awareness of abuse, including routine discussions of the issue in clinical settings. Each state has specific child abuse statutes as mandated by the Federal Child Abuse Prevention and Treatment Act (CAPTA) (Iverson et al., 2022). Federal legislation establishes criteria for determining what actions qualify as child abuse. According to the guidelines, child abuse encompasses an act or recent failure that poses a significant and immediate threat of severe harm.

Child maltreatment refers to any recent action or inaction by a parent or carer that leads to the death, emotional or physical harm, sexual assault, or exploitation of a child. The Elder Justice Act aims to reduce elder neglect, exploitation, and abuse by implementing various strategies (Hegarty et al., 2020). The Patient Safety and Abuse Act, a component of the Violence Against Women Act, establishes a federal offense for individuals who engage in interstate stalking, harassment, or physical harm against their partners. It also criminalizes the violation of a protective order when crossing national borders.

Making Changes Based Upon Evidence-Based Practice

Care coordinators should prioritize addressing domestic violence victims by providing treatment that acknowledges the impact of trauma and abuse on their health. They should also ensure that patients are connected to appropriate specialists for comprehensive recovery. Care coordinators should make adjustments based on evidence-based practices when discussing the care plan with patients and their family members. Exiting an abusive relationship or living situation presents significant difficulties, encompassing both emotional and practical aspects.

The process entails recognizing the presence of abuse, seeking assistance to exit the position safely, and addressing the emotional and psychological aftermath (Iverson et al., 2022). Survivors can engage in a gradual process of self-esteem reconstruction following the detrimental effects experienced in the relationship. Survivors may benefit from self-care routines, professional mental health counseling, and the establishment of a nonjudgmental support network to effectively manage the fallout from the relationship. Society can support abuse victims by providing access to resources, affordable mental health care, and effective prevention programs. Workplaces can mitigate the impact of intimate partner violence on employees by implementing policies that provide protection and support, particularly about financial strain.

Conclusion

Domestic and family violence encompasses various forms of abuse, such as economic, sexual, physical, emotional, and psychological, targeting individuals across different age groups, including children, adults, and elders. Domestic and family violence poses challenges in terms of identification, with a significant number of cases remaining unreported to healthcare providers and legal authorities. Healthcare professionals, such as psychologists, nurses, chemists, dentists, doctor’s assistants, registered nurses, and physicians, are responsible for assessing and potentially providing care to individuals involved in domestic or family violence, given its widespread occurrence in our society. Healthy People 2030 aims to decrease various forms of violence, such as physical assaults, sexual assault, and gun-related injuries.

References

• Grillo, A., Danitz, S. B., Dichter, M. E., Driscoll, M., Gerber, M. R., Hamilton, A. B., Stirman, S. W., & Iverson, K. M. (2019). Strides toward Recovery from Intimate Partner Violence Elucidating Patient-Centered Outcomes to optimize a brief counseling intervention for women. Journal of Interpersonal Violence, 36(15–16), NP8431–NP8453. https //doi.org/10.1177/0886260519840408
• Hegarty, K., McKibbin, G., Hameed, M., Koziol‐McLain, J., Feder, G., Tarzia, L., & Hooker, L. (2020). Health practitioners’ readiness to address domestic violence and abuse A qualitative meta-synthesis. PLOS ONE, 15(6), e0234067. https //doi.org/10.1371/journal.pone.0234067
• Iverson, K. M., Danitz, S. B., Driscoll, M., Vogt, D., Hamilton, A. B., Gerber, M. R., Stirman, S. W., Shayani, D. R., Suvak, M. K., & Dichter, M. E. (2022). Recovering from intimate partner violence through Strengths and Empowerment (RISE) Development, pilot testing, and refinement of a patient-centered brief counseling intervention for women. Psychological Services, 19(Suppl 2), 102–112. https //doi.org/10.1037/ser0000544
• Lutgendorf, M. A. (2019). Intimate partner violence and women’s health. Obstetrics & Gynecology, 134(3), 470–480. https //doi.org/10.1097/aog.0000000000003326
• Rauhaus, B. M., Sibila, D., & Johnson, A. F. (2020). Addressing the increase of domestic violence and abuse during the COVID-19 pandemic a need for empathy, care, and social equity in collaborative planning and responses. The American Review of Public Administration, 50(6–7), 668–674. https //doi.org/10.1177/0275074020942079