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APPENDIX H 327 Appendix H Core Competencies for Family Violence COMPETENCIES NECESSARY FOR NURSES TO PROVIDE HIGH-QUALITY CARE TO VICTIMS OF DOMESTIC VIOLENCE Competencies related to acknowledging the scope of the problem: 1. Recognize prevalence of domestic violence in all its forms. 2. Recognize risk factors for both victimization and perpetration of domestic violence. 3. Recognize the significant physical and mental health effects of both ongoing and prior domestic violence. 4. Recognize the effects of violence across the lifespan, including the long- term effects for children who are either victims or witnesses of domestic violence. 5. Recognize oneâs own attitudes about domestic violence, including possibil- ity of own friendsâ or family membersâ victimization and the need to ad- dress ongoing issues arising from such experiences. Competencies related to identification and documentation of abuse and its health effects: 1. Know developmentally appropriate questions to be used in screening in various settings (for example, McFarlane and Parkerâs (1994) âAbuse As- sessment Screenâ). 327
328 APPENDIX H 2. If physical violence, assess particularly for forced sex, mental health status, old undiagnosed head injuries, risk of suicide and/or homicide (for example, Campbellâs (1986) âDanger Assessmentâ). 3. Assess for possibility of child abuse in the home and the effects of violence on children. 4. Assess for possibility of elder abuse in the home. 5. Document extent of current and prior injuries using body map and photo- graphs if possible. Competencies related to interventions to reduce vulnerability and increase safety, especially of women, children, and elders: 1. Know local, state, and national domestic violence referral resources, includ- ing abuse shelters and safe houses. 2. Communicate nonjudgmentally and compassionately with the victim. 3. Conduct safety planning with the victim. 4. Refer to social worker, shelter, and legal counsel as appropriate. Competencies related to ethical, legal, and cultural issues of reporting and treatment: 1. Know state and national legal mandates regarding domestic violence, in- cluding mandatory reporting responsibilities. 2. Know appropriate methods for collection and documentation of data so that both the patient and the provider are protected. 3. Know the ethical principles that apply to patient confidentiality for victims. 4. Recognize that ethical dilemmas often arise from culture differences. 5. Recognize that cultural factors are important in influencing the occurrence and patterns of and responses to domestic violence in individuals, families, and communities. 6. Provide culturally competent assessment and intervention while maintain- ing human rights. Competencies related to prevention activities: 1. Increase public awareness of domestic violence. 2. Promote activities to address prevention with populations at risk (e.g., child witnesses, pregnant women, and dependent-frail elderly). 3. Promote activities to assist with behavioral changes in battering and battered individuals. 4. Recognize the need to establish programs to support victims, their fam- ily members, and the abuser.
APPENDIX H 329 Source: American Association of Colleges of Nursing, âAppendix A: Compe- tencies Necessary for Nurses to Provide High Quality Care to Victims of Domestic Violence,â In âPosition Statement: Violence as a Public Health Prob- lem,â http://www.aacn.nche.edu/Publications/positions/violence.htm [28 August 2000], Reprinted with permission.