Preliminary Care Coordination Infographic

Domestic violence is also known as domestic abuse or intimate partner violence. Domestic violence is an ongoing pattern of behavior in any relationship that is used to obtain and to sustain power and control over a person’s intimate partner. It is when someone engages in or threatens to engage in physical or sexual, emotional, economic, or psychological actions against another person. Domestic violence in a physical environment is the intentional use of force by one person on another person with the intent of causing bodily injury, pain, or injury to an intimate partner/family member (Wathen & Mantler, 2022). This can involve harmful behaviors, including hitting, kicking, slapping, strangling, or any other systematic behaviors that are intended to remove the survivor’s autonomy and leave them completely controlled. Recent research found that trauma-informed care practices enable clinicians to screen for physical abuse and to coordinate multi-agency safety plans safely and without re-traumatizing survivors (Wathen & Mantler, 2022). This assessment aims to: review evidence-based approaches to managing physical abuse, set goals (Specific, Measurable, Achievable, Relevant, and Time-bound), and identify community resources that can support the delivery of safe, continuous care to all people impacted by physical abuse.

Analyzing the Selected Health Concern and the Associated Best Practices for Health Improvement

The U.S. has a serious public health problem of physical domestic abuse. Violent acts such as punching, kicking, shoving, and other dangerous assaults against an adult or minor by a person who is well acquainted with the victim are examples of physical abuse that affects thousands of people every year. Statistics for domestic abuse demonstrate how widespread the problem of domestic abuse is. There is a significant number of adult females (around 22.5%) and adult males (around 13.7%) who have been physically abused by an intimate partner in their lifetime, and many more cases are reported every year ( Zhang Kudon,2026). Besides being physically hurt, the survivors also face tremendous psychological trauma. Many of the negative consequences of physical abuse include traumatic brain injury, chronic pain syndrome, depression, and heightened addiction susceptibility.

While the issues stemming from this form of abuse seem widespread, domestic physical abuse is a relatively unseen problem in the general public. Several actors stand in the way of reporting domestic physical abuse. Others have shame arising from the experience, worry about being retaliated against for reporting abuse, and do not know where to turn for help if they want to leave the abuse (Gilbert et al., 2022). As a result, because of the large number of potential victims of hidden crises, medical providers need to take active steps to identify and address the issue of domestic physical abuse in their clinics.

Evidence-based practice guidelines encourage healthcare providers to be proactive in identifying individuals who could be victims of domestic physical abuse and to offer them assistance and services. Universal, private screening for indicators of domestic physical abuse could be done either in primary care or reproductive health settings, as suggested. The screenings should be aimed at determining both whether their patients are at risk for domestic physical abuse and at building collaborative plans for improving their patients’ sense of safety. The aim is to activate an immediate response to the resources of the emergency (Berring et al., 2024). Along with evidence-based screening, healthcare providers need to find a way to deliver patient-centered care. All healthcare professionals need to employ trauma-informed care techniques during clinical assessment of patients with histories of abuse. In summary, an integrated treatment plan that integrates medical treatment with counseling, outreach, and advocacy for legal rights, and referral to crisis programs is the best and safest way to ensure that patients achieve long-term wellness and recovery.

Physical and Psychosocial Considerations

Physical domestic abuse can result in serious bodily injuries to victims, as well as to their children. However, it may also cause serious psychological injuries, which can result in severe depression, post-traumatic stress disorder, and substance dependency. Victims do not often go to the doctor because they have grown accustomed to emotionally depending on their abusers, and fear that if they do seek help, they will be retaliated against (White et al., 2024). As a result, several health providers, such as doctors, will conduct a physical examination to make sure there are no other health issues and will also perform a comprehensive assessment of the survivor’s mental well-being. This is to try to find out the survivor’s needs and come up with a plan to address those needs to allow the survivor to be as healthy as possible. This process needs to be supported by peer-led support groups, which will give the survivor the emotional strength needed, along with trauma-informed psychiatric care. The first action to take with a victim of physical domestic abuse is to make sure that they are physically safe. Beyond that, healthcare professionals need to collaborate with other organizations to provide any resources that may be needed for the patient to heal and move forward with their life (Miller et al., 2021).

Cultural Considerations

Healthcare providers serving victims of physical domestic abuse must be aware that each victim has their own culture. Thus, culturally competent interventions based on an individual’s experiences are essential for healthcare providers. Patients are much more likely to report and disclose physical abuse if they are comfortable with disclosing private information. Healthcare providers need to be aware of how aspects of a victim’s culture make it less likely for them to speak up about their abuse, such as stigma in their community, the fear that their family may isolate them, or mistrust of the justice system (Peddigrew et al., 2026). Healthcare providers can establish trust between themselves and the patient by collaborating with community leaders and advocates who are specifically trained to serve people of the same culture as the victim. After establishing a trust relationship between the medical team and patient, it is easier for the patient to recognize and deal with any unfinished risks of an abusive relationship.

SMART Goals

An important part of effectively addressing intimate partner violence is creating and using formalized, outcome-specific SMART goals. The following list of SMART goals has been created to enhance early detection, improve psychosocial support, and improve the provision of coordinated care to survivors, addressing physical, psychological, and cultural needs.

Goal 1: Universal Physical Abuse Screening via Clinical Protocols (Oliynyk, 2025)

Specific (S): Develop a consistent (standardized) screening method for evaluating possible physical trauma/abuse using a valid screening instrument like the E-HITS Physical Violence Scale to identify hidden signs of physical trauma/abuse or previous history of physical violence/bodily assault. The screening can only be done by nurses or mental health professionals with training in the assessment, in a private area.

Measurable (M): Audits are recorded in electronic medical records. We aim to obtain a completion rate of at least 76.5% on all outpatient clinic sessions where we have verified patient confidentiality.

Achievable (A): By implementing TIC structured education programs for the clinicians, increase the clinicians’ confidence in recognizing signs of physical abuse, and require the clinician to document suspicions of abuse in the EHR.

Relevant (R): This intervention is directed toward addressing the often overlooked issue of physical abuse from domestic partners. Through proactive clinical screenings, it helps patients overcome the barriers of fear/shame to report, increasing provider clinical confidence by more than 52%.

Time-bound (T): Develop, review, and test our new protocol using a PDSA quality improvement cycle over three months.

Goal 2: Multidisciplinary Safety Interventions for Physical Trauma (Sun et al., 2024)

Specific (S): All patients who present as having disclosed an acute episode of physical domestic abuse will receive immediate mapping of safety. In addition, all of these patients will be given specially designed behavioral health interventions to treat the serious physical and neurocognitive consequences of acute trauma.

Measurable (M): Patient safety plans are signed and completed, and emergency shelters and/or other patient support groups are confirmed before patient discharge from the clinic by matching indicators of physical abuse in the EHR.

Achievable (A): This will be done by directly connecting our hospital’s clinical environment with a network of crisis shelters and local law enforcement through the use of clinical social workers or designated participant navigators.

Relevant (R): There are several reasons why it is relevant to integrate safety planning and counseling into treatment for individuals who have experienced recurrent episodes of physical abuse. These are not exhaustive, but include, but are not limited to: Traumatic Brain Injuries (TBI), Complex Post-Traumatic Stress Disorder (PTSD), and Chronic Pain. The integrated safety planning and counselling have been shown to improve the individual’s ability to resist future physical abuse and thus prevent further neurocognitive decline.

Time Bound (T): Immediate safety mapping is required for the first visit, and subsequent visits are performed biweekly, for a time period of 90 days after the intervention.

Community Resources

Safe Horizon is the largest victim service provider in the U.S., and hospitals can work together to provide direct access to specific help services. Safe Horizon has an extensive network of emergency shelter facilities as well as a 24/7 hotline allowing hospital staff to make a “warm transfer” or seamlessly connect the victim with an advocate (Safe Horizon, 2025). Therefore, in using this process, medical staff take the victim to a safe place before the victim is released from the hospital, thereby limiting potential future hazards and the amount of acute stress for the victim. In addition, advocates at Safe Horizon offer timely crisis counseling services to the medical team. They can be instrumental in designing immediate safety plans that help complete the continuum of care from medical to community protective services. Working with Safe Horizon, the transition of a victim from an emergency room to a safer place is compassionate and expedited.

Rapidly developing an action plan is necessary in the hospital to respond to the immediate effects of physical abuse and/or acute physical injury, in conjunction with a dedicated physical violence response program. Hospitals may also partner with the National Coalition against Domestic Violence (NCADV), providing a cohesive response to significant trauma. Together, these two agencies will enable hospitals to act quickly and specifically to treat the physical trauma and/or traumatic brain injuries and other safety issues that may be present with the survivor’s physical and medical condition, and reduce further physical harm (NCADV 2024).

One agency that offers culturally competent advocacy and safety planning for survivors who are Asian, Native Hawaiian, or Pacific Islander (Apigbv, 2025) is the Asian Pacific Institute on Gender Based Violence Network. Bilingual advocates serve in collaboration with hospitals that offer important cultural and linguistic services, removing barriers due to language (Apigbv, 202). However, hospitals need to establish positive partnerships with community-based agencies to meet both short- and long-term needs of survivors (Evans et al., 2024). These community-based agencies are important partners in providing survivors with the social resources they will need that hospitals cannot provide, such as crisis shelter placement, dedicated legal advocacy, and trauma-focused support groups.

Conclusion

Healthcare systems can effectively manage physical domestic abuse by having a system of care coordination that is comprehensive and integrated, extending beyond the provision of medical treatment. Integrated care coordination system: Using trauma-informed clinical screenings alongside structured SMART goals, cultural sensitivity, and rapid warm transference to external community resources, such as emergency housing, legal aid, and psychiatric support, can help providers break the cycle of violence, create a safe environment for patients, and promote long-term healing and independence.

For the 1st or 3rd assessment of this class visit: NURS FPX 4065 Assessment 1 or NURS FPX 4065 Assessment 3