b'| AWARENESS GUIDEUnderstandably, many patients may beto staff, consult on policies and protocols andthey should put protocols in place now to hesitant to discuss this type of sensitivereceive referrals if patients do disclose.screen everyone.ninformation upon first meeting a provider,Its important that everyone in the clin-says Sweeney, who recommends reviewingical setting be aware of the health impactREFERENCESthis part of a patients history over timeof domestic violence, what the process isCenters for Disease Control and and in many ways, especially if a bruise orfor talking with patients about relationshipPrevention, 2019. Accessed September 13, multiple bruises and the description of thesafety, and how to make a referral to domes- 2020. [https://www.cdc.gov/violencepre-patients injury doesnt fit. tic violence or other support services, shevention/intimatepartnerviolence/fastfact.continues, pointing healthcare profession- html] GETTING SERIOUS ABOUT RESPONDING als toward FWVs online toolkit designedU.S. News & World Report, 2020. Screening is a good start, but more is requiredto foster partnerships between healthcareAccessed September 17, 2020. [https://to effectively identify and intervene in domes- providers and domestic violence advocates.www.usnews.com/news/health-news/tic violence cases, says Virginia Duplessis,Ultimately, the healthcare teams responsearticles/2020-08-18/radiology-study-sug-MSW, a program director on the health teamto domestic violence differs based on thegests-horrifying-rise-in-domestic-vio-at Futures Without Violence,practice setting, says Sweeney.lence-during-pandemic]a San Francisco-based non-profit orga- In a small, private, one-to-two personOffice on Womens Health, 2019. Accessed nization dedicated to ending domestic andpractice, the amount of time and expertiseSeptember 13, 2020. [https://www.wom-sexual violence, and home to the Healthneeded to assist a patient who is the victimenshealth.gov/relationships-and-safety/Resource Center on Domestic Violence.of domestic violence is daunting, she says.effects-violence-against-women]The approach to addressing domes- In a federally qualified health center or hos- San Diego County District Attorney, 2016. tic violence in healthcare settings haspital, there are usually social workers to han- Accessed September 17, 2020. [http://really evolved over the past 20 years, saysdle these situations. www.sdcda.org/helping/dvtraining/Duplessis. Initially, we focused on screen- Whatever the practice setting, all patientsstory_content/external_files/Sample%20ing questions to identify victims. But whatneed to know that their information is con- Screening%20and%20Framing%20we found over time is that screening is notfidential, expect on a need-to-know basis,Questions%20for%20Domestic%20enough. Many patients dont feel ready orwith the goal of providing assistance, saysViolence.pdf]safe enough to disclose domestic violence. Sweeney, adding that healthcare providersFutures Without Violence, 2020. Accessed All these patients answering no tomust be familiar with the confidentialitySeptember 16, 2020. [https://www.future-screening questions were not getting theand reporting laws in their area and stateswithoutviolence.org/wp-content/uploads/needed support, she adds.of practice.CUES-graphic-Final.pdf] Since we know that one in four womenNew York state and New York City, forFutures Without Violence, 2018. Accessed will experience domestic violence over herexample, have domestic violence hotlines,September 16, 2020. [https://ipvhealth.org/]lifetime, we can assume all patients can ben- she points out, noting that providers should efit from conversations about relationshiphave such numbers readily available.RESOURCESquality and safety, says Duplessis.The office should know and have contact1. Emedicinehealth.com Symptoms and Even if they are not experiencing vio- information for local resources in their com- signs of domestic violence. Cunha, lence themselves, they probably know some- munities, says Sweeney, and how they areJ., Medically reviewed 3-11-2019, one who is, and [they] might be in a positionfunctioning during the pandemic.eMedicineHealth.to help. So, we are advocating a universalIndeed, COVID-19 has created a variety2. Helpguide.org Domestic violence and approachtalking to every patient aboutof factors that figure to contribute to the rise healthy relationships, and telling themin domestic violence cases that the afore- abuse. Smith, M. and Segal, J., last updated about support services available for thosementioned Brigham and Womens HospitalJune 2019, helpguide.org international.who are experiencing violence.research revealed. Providers at your facil- 3. Mayoclinic.org Domestic violence against (Futures Without Violence offers an evi- ity must be aware of these factors and actwomen: recognize patterns, seek help. dence-based intervention called CUES,accordingly, says Sweeney.Mayo Clinic Staff, February 25, 2020, designed to improve and health and safetyWith all thats going on, substance abuseMayo Foundation for Medical Education outcomes for domestic violence survivors.)has increased, for example. Those in treat- and Research (MFMER).Of course, healthcare providers cannotment programs often no longer have access,4. Ncadv.org National Statistics Domestic address domestic violence in a vacuum, saysshe says. [The pandemic is contributing to]Violence Fact Sheet (National Coalition Duplessis, urging healthcare providers and sys- increased joblessness, increased financialAgainst Domestic Violence/NCADV.tems to forge relationships with local domesticstrain, and increased depression. For facil- org) 303-839-1852: resources, printed fact violence programs, who can provide trainingities that think their clientele is immune,sheets, events, support.www.elitecme.com |2020| AWARENESS GUIDE 15'