ADMIN/NON MEDICINE
DOMESTIC VIOLENCE
PromptClinical indicators of domestic violence
ResponsePhysical
- Unexplained bruising
- Bruises various ages
- Head/neck/facial injuries
- Hidden injuries (breast/abdo/genitals)
- ‘accidents’ occurring during pregnancy
- Miscarriage/preg complications
- Injury ≠ History
- Bite marks, weird burns
- Multiple presentations, often after hours
- Partner does the talking, won’t leave alone
- Anxious with partner present
- Evasive/ashamed of injuries
- Reluctance to follow advice
PromptMandatory report to police for DV (Even if against patients wishes)
ResponseSerious injuries have been inflicted e.g broken bones, stab/gunshot wounds
The perpetrator has access to a weapon and has threatened any person or caused a reasonable person to fear for their personal safety
An immediate risk to any individual/s or the public exists
An offence has occurred on Health Service premises
Health staff have been threatened
The perpetrator has access to a weapon and has threatened any person or caused a reasonable person to fear for their personal safety
An immediate risk to any individual/s or the public exists
An offence has occurred on Health Service premises
Health staff have been threatened
PromptManagement of DV victim
ResponseConfidentiality
No patient information to be provided at triage/over phone
Documentation
Offer social work/allied health supports
Ensure safe discharge disposition or SSW if no safe discharge option for now
Non-judgemental approach
Provide information such that can access police/legal if changes mind
No patient information to be provided at triage/over phone
Documentation
Offer social work/allied health supports
Ensure safe discharge disposition or SSW if no safe discharge option for now
Non-judgemental approach
Provide information such that can access police/legal if changes mind
PromptBattered woman management discharge requirements
ResponseSafety of patient + children addressed
Careful documentation of injuries in case of future legal issues
Conceal patient identity in ED
Referral to SW or other expert services for counselling
Offer to assist with police contact
antenatal/medical care
Analgesia
Return precautions
DV reporting
Careful documentation of injuries in case of future legal issues
Conceal patient identity in ED
Referral to SW or other expert services for counselling
Offer to assist with police contact
antenatal/medical care
Analgesia
Return precautions
DV reporting
PromptMANAGEMENT PLAN (REGULAR PATIENTS)
Response
PromptManagement plan benefits
ResponseReduce variation in care
Assist in prompt decision making
Reduce over investigation
Assist managing patient expectations
Assist in prompt decision making
Reduce over investigation
Assist managing patient expectations
PromptGoals of management plan
ResponseDetect serious illness
Help patient in long term
Improve patient care
Minimise ED stay
Improve engatement with community support
Reduce disruption to staff
Help patient in long term
Improve patient care
Minimise ED stay
Improve engatement with community support
Reduce disruption to staff
PromptStakeholders in management plan
ResponsePatient
GP
Emergency staff/physician
Nursing
Medical
Directors/exec
**Disease** specialty (Eg cardio, resp, psych)
GP
Emergency staff/physician
Nursing
Medical
Directors/exec
**Disease** specialty (Eg cardio, resp, psych)