Committee writes the ABCs on domestic violence

Requirement reveals unmet need

To create a staff training program on domestic violence, Baptist Health Systems of South Florida in Miami created a curriculum committee. It consisted of staff from many disciplines, some who frequently interact with victims of domestic violence, such as emergency department physicians and nurses, and those who don’t, such as representatives from the education department.

The committee was assembled in response to a mandate by the Florida State Legislature, which requires all licensed health care professionals to have one hour of domestic violence education annually. "We created the curriculum in response to the requirement, but as we wrote it, we realized that there was a great need. We heard a lot of stories as we researched the topic that sensitized a lot of people on the committee," says Helen Slaven, MS, corporate director of organization development at Baptist Health Systems of South Florida. She worked in the education department when she participated on the committee six years ago.

The legislature provided an outline of the information that needed to be included in the curriculum and the committee used it as a framework. Each committee member took a section of the outline to research and write. For example, one person researched statistics to provide facts and figures on the prevalence of domestic violence.

"My input was to coordinate committee members and make sure the pieces fit together," says Slaven. The committee had to take the narrative pages created by its members and compile a training manual, so a lot of editing was done as the project progressed. There was 20 times more material accumulated than could be covered in an hour class so choices had to be made.

What concerned the committee was how to effectively address everyone. It was easy for the legislature to mandate an hour of education, but trainers couldn’t assume that everyone was at the same level of understanding. "We decided to include lots of information so that trainers would be able to use the materials as they saw fit based on the group they were going to deliver the information to," says Slaven.

Once the curriculum began to take shape, the committee gathered as a group and looked at the copy projected on a wall for the final editing. "It was a wonderful experience because everyone taught everyone else along the way," says Slaven.

Curriculum covers many aspects

The curriculum, titled Domestic Violence: Breaking the Cycle, covers the forms of domestic violence and provides a profile of the victim and the abuser. The training guide states: "In the health care setting, victims of domestic violence are most often identified by the injuries, signs, and symptoms for which they seek treatment. Acute signs and symptoms sustained by victims of domestic violence may include bruises, lacerations, concussions, and fractures. Chronic signs and symptoms include joint damage, partial loss of hearing or vision, scars from burns, bites, or knife wounds."

Also the curriculum provides guidelines for health care providers to routinely screen for domestic violence and assess suspected victims. These guidelines cover interview questions. For example, to uncover violence a health care professional may ask:

• Did someone cause these injuries? Who? Has it ever happened before?

• What do you fear the most?

To evaluate the extent of violence, the professional might ask:

• Have you ever been hit, punched, kicked, or hurt in any way before?

• Are you afraid it will happen again? Were you afraid to come here today?

To determine safety, the health care worker might ask:

• Have you wished you could leave? What has prevented it?

• Do you have a safe way to get home from here and a safe place to stay?

Details on documenting, intervening, and reporting domestic violence are covered as well as providing information about making referrals for a victim of domestic violence. The material is available as a self-study guide or as a training manual to be used to conduct a class. Currently, Baptist Health Systems of South Florida uses the self-study guide.

To enhance both formats, a video was created as an introduction. On the videotape, physicians, nurses, and a psychologist discuss their experiences in working with and living with domestic violence.

"The purpose of the videotape is to help people understand that victims of domestic violence may be working and walking right beside them. The video is not laden with content, its intent is to engage the observer emotionally to want to learn how to keep this from happening," says Leah Kinnard, EdD, RN, a consultant with Creative HealthCare Management in Minneapolis and formerly the director of education at Baptist.

The project was a well thought-out comprehensive approach, says Kinnard.

 

[Editor’s Note: The video and curriculum, Domestic Violence: Breaking the Cycles, created by the Baptist Health Systems of South Florida is available from the Florida Hospital Association for $259 for members and $525 for nonmembers. To order, contact their Orlando office: Florida Hospital Association, Orlando Office, 307 Park Lake Circle, Orlando, FL 32803. P.O. Box 531107, Orlando, FL 32853-1107. Telephone: (407) 841-6230. Fax: (407) 422-5948.] n

For more information about creating a staff training program on domestic violence contact:

Leah Kinnard, EdD, RN, Consultant, Creative HealthCare Management, Minneapolis. Telephone: (800) 728-7766. E-mail: leahjo@aol.com.

Education Department, Baptist Health Systems of South Florida, 6200 S.W. 73 St., Miami, FL 33143-4989. Telephone: (305) 662-8139.