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Expanding Your Program To Include Intimate Partner Violence

Since hospitals are required to screen patients for intimate partner violence (IPV), facilities with SANE programs may choose to use their forensically trained nurses to evaluate patients once they are identified by other nursing or medical staff. When considering adding IPV, it is important to be familiar with all local resources. Programs expanding to serve this population will want to ensure collaborative working relationships with local IPV crisis centers and shelters in an effort to meet all of the patient's needs.

Challenges to this type of expansion—

  1. Protocols will need to be in place to determine when program staff will be called to evaluate a patient. Will all assaults be evaluated? For example, a bar fight between two strangers, or only assaults where there is ongoing contact between a victim and a suspect, such as with an adult child and elder parent? 
  2. Nurses will need to understand that many patients who identify as victims of IPV may chose not to accept services that would allow them to leave an abusive situation.
  3. Program staff will require education in history-taking surrounding the patient’s IPV experience, not just as a one-time incident, but rather any violence that occurred across the life of the relationship and its impact on the patient’s health. 
  4. Program staff will need training in formal safety planning. Verifying that safety planning can be accomplished with community-based advocacy or social work is critical. Programs functioning outside the hospital setting may be required to travel to sites such as shelters or police stations in order to serve the patient. 
  5. Testimony in IPV frequently involves civil as well as criminal court proceedings, and, as a result, program staff may be involved in order of protection or restraining order hearings. These cases can and do occur rapidly following the incident of care, unlike testimony following a sexual assault. This may create issues with staff coverage to be able to respond to the needs of the criminal justice system while maintaining services at the hospital.
  6. Program staff will need to be familiar with the mandatory reporting requirements surrounding IPV-specific issues. These requirements may be specific to types of injury sustained, or even involve reporting when animal abuse is part of the overall IPV. Although animal abuse is not normally a mandatory report, being familiar with your local resources for animals living within violent homes will give program staff the ability to provide more information to the victim.
  7. Programs will need to be aware that providing information to IPV patients may increase their risk for continued abuse. Documentation tools, referrals, and safety planning information to give to a patient should be in a format that can be hidden (such as information contained in a lipstick tube).
  8. Coordination with law enforcement and hospital security is important to assure that perpetrators of IPV do not pose a safety risk to staff or patients.