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Another intervention when considering electronic charting would be to have private and shared spaces on the record; however, this would require an agreement between the patient and the provider on ownership of the record (Drinkwater et al., 2017).

Possible solutions to these two problems could incorporate placing a code in both charts indicating “Cause for Concern.” This could be more difficult for anyone to interpret. If someone did interpret this, the provider could report cause for concern for a health issue, such as obesity or high cholesterol, not necessarily domestic violence. Development of a safety plan Clinicians often discuss safety issues with patients who have suffered from domestic violence and feel confused when the victim decides to return home instead of leaving the environment. Individuals often need time to get items together (clothes, medications, legal and banking documents) before they leave. For this reason, it is wise to discuss a safety plan with the individual to do it without harm when they decide to leave the abusive environment. Safety plans should include access to a phone with 911 on speed dial; informing family and friends of the situation when possible, making sure they do not share the information with the perpetrator; and obtaining a bag of clothing, any necessary medications, copies of bank statements, and keys to use at a later date when retrieval of these items will be complex. Laws influencing domestic and sexual violence In 1994, the Violence Against Women Act (VAWA) was created to support abused women and bring about information to promote social awareness and enact needed changes. This law was reauthorized in 2013 (now called the Violence Against Women Reauthorization Act 2013). It continues to help women who have been abused and provides enhanced funding for additional services. The following are highlights of the law: ● Allows free sexual assault exams ● Provides protection orders to women and families ● Offers prosecution and free legal services ● Strengthens penalties for criminal activities ● Set up programs to meet the needs of immigrants or women of different races and ethnicities ● Provides services for teens and children ● Affords protection for the abused who may have been evicted from their homes ● Includes support to help combat sex trafficking and assistance in giving some tribal courts jurisdiction over crimes committed by non-native perpetrators The Family Violence Prevention and Services Act (FVPSA) was created in 1984. It provides federal funding for domestic violence direct service providers, including shelters and nonresidential facilities. The FVPSA (Department of Health and Human Services Administration for Child and Family Administration on Child, Youth, & Families, n.d.) funds state and national programs to enhance the quality of life for those suffering from abuse. For additional information, go to https://www.acf.hhs.gov/fysb/resource/ fvpsa-overview-0. The Victims of Crime Act (VOCA) , established in 1984, set up funding to assist those who suffered violent crimes. The monies are obtained from donations, federal criminal fines, forfeited bonds, and special assessments. This money is then forwarded to states as grant money that can be used to compensate victims of crime (personal-psychological

Healthcare providers must instruct patients that if they feel they are in imminent danger, they should notify the police, a domestic violence shelter, or a close friend or relative. Children in the home need to know how to call 911 and give their full names to the authorities. The abused parent should teach children secret passwords that alert them to the need to leave home or an immediate situation. After a person leaves an abusive environment, they still need to remain alert. This may include telling the employer what is happening, keeping a copy of a protective order with them at all times, and changing their habits, such as not always going the same route to work (Office of Women’s Health, 2018). counseling or from lost employment), build additional shelters, or fund service providers (Office for Victims of Crime, 2013). For additional information about VOCA, go to http://www.ovc.gov/pubs/crimevictimsfundfs/index.html. Evidence-Based Practice! Electronic monitoring programs, such as those utilizing GPS technology, employ signal triangulation to track the location of individuals, along with features like inclusion/exclusion zones and curfews. However, despite their potential benefits, these programs do face certain challenges. For instance, the size of GPS devices can lead to poor signal reception, impacting the accuracy and reliability of location tracking. Additionally, issues related to battery charging can arise, affecting the continuous monitoring capabilities of these devices. Furthermore, there are various methods through which individuals can potentially violate the monitoring parameters, highlighting the need for ongoing evaluation and improvement of such technology (Hucklesby et al., 2020). The Cleary Act, established in 1990 and amended in 2013, requires greater transparency and timeliness of warning by colleges and universities regarding crimes committed on campus, including crimes of sexual violence. This law requires that colleges maintain detailed logs that the public can access. In addition, crime statistics must include all incidents that occur on, around, and off campus. Finally, the law outlines that the victim’s identity must be confidential (RAINN, 2020c). Legislation must communicate effectively with national and state agencies about the needs of those suffering from domestic and sexual violence. Likewise, healthcare clinicians must know the laws and community resources available to their patients. Only when everyone speaks up and gets actively involved will the acts of domestic and sexual violence end.

APPLYING EVIDENCE-BASED PRACTICE

The scenario that initiated this program needs a conclusion. The following information describes how Rachel dealt with Mrs. Michel, a domestic violence victim. Rachel’s interventions should begin before she encounters patients who may be victims of intimate partner violence. She must

know the federal and state laws, the state board of nursing mandates, and her employing organization’s policies and procedures that pertain to intimate partner violence. She must be prepared to adhere to mandates and to follow policies and procedures. Rachel must also know that, as a

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