THE OFFICE VISIT
During an Interpersonal Violence (IPV) patient encounter, it is recommended that a provider follow these guidelines:
- De-stigmatize IPV by framing the interview questions
- Screen for IPV and Document encounter in patient chart
- Acknowledge patient concerns and offer support
- Conduct a Safety Assessment
- Refer and offer Resources
Create an environment that indicates the healthcare office is a safe place to discuss IPV. Display posters and have brochures and wallet-sized safety cards available in both public and private areas, such as waiting rooms, exam rooms, and bathrooms.
- Asking about IPV or DV routinely during the patient assessment.
- When screening questions are asked of all patients, IPV and DV becomes a general health concern and contributes to the community’s knowledge.
“Violence is common in many people’s lives. I ask all my patients about it.”
“Violence in relationships is an important health issue because it affects people’s physical and mental health. So I ask everyone these questions...”
- Linking your IPV or DV questions to another part of the patient interview, such as risk factors, or the depression screening or the social history.
“Do you smoke?"
"How much alcohol do you drink?"
"Any drug use?"
"Do you wear seatbelts?"
"Have you ever been emotionally or physically abused by a partner?"
"Within the past year, have you been hit, slapped or otherwise physically hurt?"
"Within the past year, have you been forced to have sex against your will?"
"Are you afraid of your partner?“
Anyone could be a victim of IPV or DV. Do not assume that certain categories of patients are immune – such as those who are well-educated, wealthy, male, teenaged, or homosexual. Unfortunately, interpersonal or domestic violence touches all types of people.
[Back to Top]
ASSESSMENT AND SCREENING TOOLS
Prior to asking about IPV or DV, consider showing the video “Picking up the Pieces” or providing handouts or brochures. This may facilitate conversation about IPV or DV during your screening and assessment.
See Patient Support, Information, & Education
The following tools can be used during the patient encounter to screen and assess for interpersonal or domestic violence:
4 Questions - Abuse Assessment > (Screen / to determine if patient needs to be assessed)
Abuse Assessment > (English / Spanish)
Safety Assessment > (English Only)
- IPV may be more readily identified in the Latino population by indirect lines of questioning
- "Have you ever been in a relationship where you felt lonely?"
- "Have you ever been in a relationship where you have felt controlled by your partner?"
- Latina women are more likely to respond to family and child welfare rather than personal welfare concerns
- Educate mothers in a nonjudgmental manner about the negative impact of IPV on children's welfare
- For additional information see:
- Amerson, R., Whittington, R., & Duggan, L. (2014). Intimate Partner Violence Affecting Latina Women and Their Children. Journal of Emergency Nursing. doi: 10.1016/j.jen.2013.12.003
Additional tools may be found at the link below, which is a collection of various assessment tools compiled by the CDC for the screening of intimate partner violence. Of these tools, we have identified several we consider useful in the healthcare setting.
Intimate Partner Violence and Sexual Violence Victimization Assessment Instruments for Use in Healthcare Settings
- Domestic Violence Initiative Screening Questions - pg. 33
- Falmouth Pediatric Associates Violence Handout - pg. 39
- Personalized Safety Plan - pg. 40-41
- Secondary Survey - pg. 46-47
- Woman Abuse Screening Tool (WAST) - pg. 72
- Pruebas de la Violencia Contra la Mujer (WAST español)– pg.75
[Back to Top]
DOCUMENTATION GUIDELINES AND FORMS
The following checklists and forms can be used to ensure adequate documentation of the Interpersonal Violence (IPV) or Domestic Violence (DV) event. All forms should be placed in the patient chart.
Adequate documentation can provide concrete evidence of violence and abuse, and may be crucial to the outcome of a legal case. If the medical record and trial testimony are in conflict, the medical record may be considered more credible.
Documentation > Checklist
Photography > Guidelines
Consent to Photograph > (English / Spanish)
IPV Physical Assessment > Guidelines
Head > Guidelines
Body > (Male)
Body > (Female)
[Back to Top]