Domestic Violence – Kentucky

About this course

In the United States, it is estimated that as much as 25% of women and 11% of men are victims of family and domestic violence. Domestic and family violence, including child abuse, intimate partner violence, and elder abuse often starts when a caretaker, parent, or partner feels the need to dominate or control another person. Many victims of domestic violence present to healthcare settings for treatment, however often times, the healthcare provider misses the signs of domestic violence, or when signs are present, is unable to sufficiently interview, assess, document, or provide resources for the victim of domestic violence. This learning independent study course seeks to provide an overview of domestic violence and the responsibilities of the healthcare provider as it relates to Kentucky law.

Learning objectives

• Identify the risk factors, signs, and symptoms of domestic and family violence
• Describe the characteristics that define domestic and family violence
• Identify available resources to help the healthcare provider assist the victim of domestic or family violence
• Identify the Kentucky Statutes that relate to domestic violence
• Describe the ethical and legal reporting requirements in the State of Kentucky

Course outline

35 sections · finish in any order across devices

1. 1

   Introduction

   Family and Domestic violence are a common problem in the United States and affects approximately 10 million people every year. They are abusive behaviors in which one individual gains power over another individual. In the United States, it is estimated that as much as 25% of women and 11% of men are

   4 min

2. 2

   Causes of Domestic and Family Violence

   Domestic and family violence, including child abuse, intimate partner violence, and elder abuse often starts when a caretaker, parent, or partner feels the need to dominate or control another person. This can occur because of several reasons, such as:

   4 min

3. 3

   Statistical Data

   Domestic violence is a serious and challenging public health problem. Approximately 33% of women and 10% of men 18 years of age or older experience domestic violence.

   4 min

4. 4

   National Statutes

   Federal Child Abuse Prevention and Treatment Act (CAPTA):

   4 min

5. 5

   Kentucky Statutes

   Domestic violence in Kentucky falls under the Kentucky Cabinet for Health and Family Services and the Division of Protection and Permanency. Domestic violence under KRS 403.715 to 403.785 is defined as "physical injury, serious physical injury, sexual abuse, assault, or the infliction of fear of imm

   5 min

6. 6

   Legal Implications

   It is important to be aware of federal and state statutes governing domestic and family abuse. Reporting domestic and family violence to law enforcement does not obviate detailed documentation in the medical record.

   4 min

7. 7

   Child Abuse

   Each year there are over three million referrals submitted to child protective services nationally. Maltreatment of children is found in every race, culture, ethnicity, and socioeconomic status. Age, family income, and ethnicity are all risk factors for both sexual abuse and physical abuse. Gender i

   4 min

8. 8

   Types of Abuse Seen in Children

   Abusive Head Trauma:

   6 min

9. 9

   Laboratory Testing for Suspected Abuse

   Laboratory studies are often important for forensic evaluation and criminal prosecution. On occasion, certain diseases may mimic findings that are like child abuse, and therefore, they must be ruled out.

   4 min

10. 10

    Diagnostic Imaging for Suspected Abuse

    The evaluation of the pediatric skeleton can prove challenging for a non-specialist as there are subtle differences from adults and children, such as cranial sutures and incomplete bone growth. As a result, a fracture can be misinterpreted. When child abuse is suspected, a radiologist should be cons

    4 min

11. 11

    Treatment

    Initial management of an abused child involves stabilization, including assessing the patient’s airway, breathing, and circulation. Once ensured that the patient is stable, a complete history and physical examination is required. Child protective services must be informed of any suspicion of child a

    4 min

12. 12

    Child Abuse Resources

    American Professional Society on the Abuse of Children

    4 min

13. 13

    Special Considerations

    When feasible, and without delaying care to the child, photographs of injuries should be taken prior to initiating treatment of suspected injuries of child abuse.

    4 min

14. 14

    Outcomes

    Child abuse is a public health problem that leads to lifelong health consequences, both physically and psychologically. Physically, children who are victims of abusive head trauma may have neurologic deficits, developmental delays, cerebral palsy, and other forms of disability. Psychologically, vict

    4 min

15. 15

    Intimate Partner Violence Statistical Data

    According to the Center for Disease Control, 25% of women and 14% of men will experience physical violence by their intimate partner, and about 33% of women and nearly 16% of men will experience some form of sexual violence at some point during their lifetimes. The occurrences of intimate partner vi

    4 min

16. 16

    Pregnant Women

    The American College of Obstetricians and Gynecologists (ACOG) recommends that all women be assessed for signs and symptoms of domestic violence during regular and prenatal visits. Healthcare providers should offer support and referral information if domestic violence is suspected or verbalized. ²²

    4 min

17. 17

    Lesbian, Gay, Bisexual, Transgender, Queer and/or Questioning

    Domestic violence occurs in lesbian, gay, bisexual, transgender, queer and/or questioning (LGBTQ) couples, and the rates are thought to be like a heterosexual woman at approximately 25%. Although the rates of domestic violence are thought to be similar, the following instances show variations in the

    4 min

18. 18

    Intimate Partner Abuse

    Approximately 33% of women and 20% of men will be victims of abuse. Usually domestic violence is perpetrated by men against women; however, females may exhibit violent behavior against their male partners.

    4 min

19. 19

    Elder Abuse

    There is no universally accepted definition of when old age begins. As a result, statistics on elder abuse are highly variable. All racial, socioeconomic, and religious backgrounds are affected by elder abuse.

    4 min

20. 20

    Intimate Partner Domestic Violence and Elder Abuse Assessments

    A detailed assessment of the victim should occur after they disclose that abuse has occurred. Assessing safety is the priority. A list of standard prepared questions can help alleviate the uncertainty in the patient's evaluation. If there are signs of immediate danger, refer to advocate support, she

    4 min

21. 21

    Testing

    The healthcare provider should evaluate for evidence of dehydration, electrolyte abnormalities, infection, substance abuse, improper medication administration, malnutrition, physical abuse, and sexual abuse. Tests to consider include:

    4 min

22. 22

    Evidence Collection

    Domestic and family violence commonly results in legal prosecution of the perpetrator. It is important to avoid destroying evidence. Preferably, a team specializing in domestic violence should aid with evidence collection. Evidence includes tissue specimens, blood, urine, saliva, and vaginal and rec

    4 min

23. 23

    Documentation

    The medical record is often evidence used to convict an abuser. A poorly documented chart may result in an abuser not being prosecuted.

    4 min

24. 24

    Domestic Violence and Abuse Resources

    In cases of acute injury or emergency, contact local law enforcement.

    4 min

25. 25

    Discharge Considerations

    Prior to discharge, the healthcare provider should evaluate the victim of domestic violence to determine if the patient will be in danger if returning home. Questions to consider before discharging a victim include:

    4 min

26. 26

    Special Considerations in Screening for Family and Domestic Violence

    Healthcare providers play a crucial role in screening, identification, and reporting domestic violence. Using screening tools in clinical practice can increase the chances that domestic violence will be identified.

    4 min

27. 27

    Tools

    The physical examination is still the most significant diagnostic tool to detect abuse. A child or adult with suspected abuse should be undressed, and a comprehensive physical exam should be performed. The skin should be examined for bruises, bites, burns, and injuries in different stages of healing

    4 min

28. 28

    Child Abuse

    Healthcare providers must take responsibility to identify child abuse to prevent recurrent injuries. While it has not been established that routine child abuse screening is necessary, clinicians should screen for abuse if it is suspected. Multiple missed appointments and delays in seeking medical tr

    4 min

29. 29

    Intimate Partner Violence

    Some experts believe screening should only occur when signs and symptoms are present. Routine screening may, in fact, be problematic because it can stigmatize victims and result in anxiety. Further, in cases of domestic violence, victims are often unwilling to use available resources to end abuse.

    4 min

30. 30

    Elder Abuse

    The elderly is at risk of abuse in the home environment as well as in institutional settings. Risk factors for elder abuse both at home and in institutions include increased age, dementia, abnormal behaviors, cognitive decline, physical dependency, and daily living activities impairment. Screening f

    4 min

31. 31

    Screening Challenges

    While screening is crucial to identify domestic and family, several barriers exist. Despite the prevalence of domestic violence, many healthcare providers do take the time to screen patients who could be victims. Unfortunately, no universal approach has been established to assess for domestic violen

    4 min

32. 32

    Screening Recommendations

    The following provides recommendations for screening abuse:

    4 min

33. 33

    Conclusion

    Domestic violence may be difficult to uncover when the victim is frightened, especially when they present to a hospital or healthcare practitioner's office. The key is to establish an assessment protocol and maintain an awareness of the possibility that domestic and family violence may be the cause

    4 min

34. 34

    Domestic Violence Posttest

    Domestic and family violence occurs in all ages, races, and sexes.

    4 min

35. 35

    Domestic Violence Posttest Answers

    Emotional or psychologic domestic violence includes verbal and non-verbal communication which inflicts emotional or mental harm. Emotional or psychologic violence may be subtle, but it is often very harmful to the victim, resulting in depression and suicide. abuse may involve convincing the victim t

    6 min

This course satisfies

Requirement summaries come from our state requirement records. Always confirm details with your board before you renew.

References and resources

• Coker, A. L., Banyard, V. L., & Recktenwald, E. A. (2017). Primary intimate partner violence prevention programs for adolescents and young adults. Preventing Intimate Partner Violence. https://doi.org/10.1332/policypress/9781447333050.003.0003
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• Jordan, K. S., Steelman, S. H., Leary, M., Varela-Gonzalez, L., Lassiter, S. L., Montminy, L., & Bellow, E. F. (2019). Pediatric sexual abuse. Journal of Forensic Nursing, 15(1), 18-25. https://doi.org/10.1097/jfn.0000000000000232
• Lifflander, A. L. (2019). Hard times and hard stops. JAMA, 321(9), 837. https://doi.org/10.1001/jama.2019.1208
• Logan, J. E., Ertl, A., & Bossarte, R. (2019). Correlates of intimate partner homicide among male suicide decedents with known intimate partner problems. Suicide and Life-Threatening Behavior, 49(6), 1693-1706. https://doi.org/10.1111/sltb.12567
• Marie Boltz, G., Capezuti, E., Fulmer, T. T., & DeAnne Zwicker, D. (2016). Evidence-based geriatric nursing protocols for best practice (5th ed.). Springer Publishing Company.
• Marvin, A. F., & Volino Robinson, R. (2018). Implementing trauma-informed care at a non-profit human service agency in Alaska: Assessing knowledge, attitudes, and readiness for change. Journal of Evidence-Informed Social Work, 15(5), 550-563. https://doi.org/10.1080/23761407.2018.1489324
• Murphy, L., Read, D., Brennan, M., Ward, L., & McDermott, K. (2019). Burn injury because of interpersonal violence in the Northern Territory Top End. Burns, 45(5), 1199-1204. https://doi.org/10.1016/j.burns.2019.01.013
• Newland, X., Boller, M., & Boller, E. (2019). Considering the relationship between domestic violence and pet abuse and its significance in the veterinary clinical and educational contexts. New Zealand Veterinary Journal, 67(2), 55-65. https://doi.org/10.1080/00480169.2018.1559108
• Oliver, C. L., & Jaffe, P. G. (2018). Comorbid depression and substance abuse in domestic homicide: Missed opportunities in the assessment and management of mental illness in perpetrators. Journal of Interpersonal Violence, 088626051881514. https://doi.org/10.1177/0886260518815140
• Ragavan, M. I., Thomas, K. A., Fulambarker, A., Zaricor, J., Goodman, L. A., & Bair-Merritt, M. H. (2018). Exploring the needs and lived experiences of racial and ethnic minority domestic violence survivors through community-based participatory research: A systematic review. Trauma, Violence, & Abuse, 152483801881320. https://doi.org/10.1177/1524838018813204
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• Sarkar, R., Ozanne-Smith, J., & Bassed, R. (2019). Systematic review of the patterns of Orofacial injuries in physically abused children and adolescents. Trauma, Violence, & Abuse, 152483801982761. https://doi.org/10.1177/1524838019827617
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