3065-Domestic Violence

Florida Statute 39.201

"Any person who knows, or who has reasonable cause to suspect, that a child is abused by any adult such as a parent, legal custodian, caregiver, or other person responsible for the child's welfare shall report such knowledge or suspicion to the department in the manner prescribed in subsection"

Florida Statute 790.24

"Any physician, nurse, or employee thereof and any employee of a hospital, sanitarium, clinic or nursing home knowingly treating any person suffering from a GSW or LIFE THREATENING INJURY indicating AN ACT OF VIOLENCE, or receiving a request for such treatment, SHALL REPORT THE SAME immediately to the sheriff's department. ANY PERSON WILLFULLY FAILING TO REPORT SUCH TREATMENT OR REQUEST THEREFOR IS GUILTY OF A MISDEMEANOR OF THE FIRST DEGREE"

All of them

(Select all that apply) Which of these acts constitutes as sexual violence? 1.Rape or penetration of victim 2.Victim made to penetrate someone else 3.Non-physically wanted penetration 4. Unwanted sexual contact 5. Non-contact unwanted sexual experiences

1. Disabilities/Mental retardation that may increase caregiver burden 2. Social isolation of family 3. Parent lack of understanding of child's needs and development 4. Parent history of abuse 5. Poverty/Unemployment 6. Substance abuse 7. Young, single, nonbiological families 8. Parental stress or distress 9. Community violence

9 risk factors that may contribute to child maltreatment?

Low birth weight and increased risk of child abuse

Abuse during pregnancy can have serious results for both the mother and infant such as

cardiac complications

Assault, or stress leading up to or following assault in the elderly can contribute to

Unintenional physical neglect

During a home visit, the nurse notices that an elderly woman is caring for her bedridden husband. The woman states that this is her duty, she does the best she can, and her children help her when they are in town. Her husband is unable to care for himself, and she appears thin, weak, and exhausted. The nurse notices that several of his prescription medication bottles are empty. Situation is best described as

reproductive

Forced sex that accompanies physical abuse contributes to a host of health problems in what system?

IPV

Gynecological problems (esp. sti's), pelvic pain, complaints of sexual dysfunction, IBS, back pain, depression, PTSD, insomnia, panic attacks or nerves are all conditions associated with

NO

If the child is verbal, should history be obtained in the parents present when there is suspicion of child abuse?

Use that word.

If the patient describes their abuse with curse words, do you use that word or sanitize it?

Woman's Experience with Battering (WEB) scale

If the pt says no to Abuse Assessment Screen (AAS) but there are other indicators associated with IPV, what instrument should you use?

Florida Statute 415.1034

Mandatory of any hospital personnel engaged in the admission, examination, care or treatment of vulnerable adults

May not report domestic violence (IPV) without informed consent from the adult, even on admission of violence.

One exception to the mandatory reporting of abuse concerns for victims of domestic violence. In Florida, what is that?

True

T/F We screen every patient, especially if there is a high suspicion.

FALSE; can lead to all or one of those things

T/F child maltreatment doesn't have any long term effects on physical, psychological, emotional, social and cognitive development

elderly

These are the health effects of? Complications from injuries or bleeding; infections that can progress to generalized sepsis, and then death if immunocompromised

Child

These are the health effects of? immediate: bruises, fractures, and lacerations; severe: death or long-term disability such as mental retardation, blindness, and physical disability

Intimate partner violence (IPV), child abuse and elder abuse

What 3 things are included in the category of domestic violence?

Florida Statute 790.24, 415.1034 and 39.201

What Florida statutes are we legally held to as health care providers?

The joint commission (TJC)

What entity requires all health care settings to address domestic violence?

the health care system

What is an extremely important early point of contact with violence?

Medical history (previous visits; meds that may cause bruising)

What is an important part of child abuse and neglect evaluation?

Detailed, nonbiased progress notes; injury maps; photographic doc in health record

What three things should we use when documenting IPV, child/elder abuse?

self-neglect

When caring for others, especially elderly, that person may begin to have

Child's own words

When documenting child's history, should you use your own perception of what they said or the child's own words?

exceptionally poignant

Write down "_____________________ __________________" statements that specify the perpetrator and the threat.

Danger Assessment (DA)

a 19-item yes/no instrument used extensively by nurses in health care system that is an excellent assessment of frequency/severity of violence. More yes answers, more serious the danger

Intimate partner

a person with whom one has a close personal relationship an can be characterized by the following: Emotional connectedness Regular contact Ongoing physical contact and/or sexual behavior Identify as a couple Familiarity and knowledge of each others lives

universal screening

defined as a clinician screening every male and female patient through age 64 for domestic violence, as opposed to only screening certain patients because of risk factors or warning signs.

elder neglect

failure by a caregiver to satisfy the elder's basic needs or to protect the elder from harm

neglect

failure to provide for a child's basic needs (physical, educational, medical and emotional)

Screening

few short, open-ended questions asked by a clinician to the patient

elder abuse

intentional actions that cause harm or to create a serious risk of harm to a vulnerable elder by a caregiver person who stands in a trust relationship to the elder

Counseling

may include provision of basic information, including how a patient's health concerns may relate to violence, and referrals for additional assistance when patient's disclose abuse

self-neglect

neglect of one's own physical and mental well-being

Physical abuse

physical injury due to punching, beating, kicking, biting, burning, shaking, or otherwise harming a child (even when harm is unintended)

Has anyone: 1. Ever touched you inappropriately 2. Made you do things you didn't want to do? 3. Taken things that were yours without asking? 4. Physically hurt, scolded, or threatened you? 5. Failed to help you take care of yourself? 6. Have you signed documents you didn't understand? 7. Are you afraid of anyone at home? 8. Are you alone a lot?

questions you ask during elder abuse screen?

true

t/f suspected self-neglect is also a mandatory reportable activity to adult protective services

child emotional abuse

this includes any pattern of behavior that harms a child's emotional development of sense of self-worth (e.g. frequent belittling, rejection, threats, and withholding love and support)

child sexual abuse

this includes fondling a child's genitals, incest, penetration, rape, sodomy, indecent expose, and commercial exploitation through prostitution or the production of pornographic materials

Pregnancy

when are women very susceptible to violence?

husband, boyfriend, or ex-husband

women are more often killed by _______________, _________________, and ____________________________ than by anyone else