S20 · Abuse or violence exposure
Risk Safety and protection
Definition
The person may be exposed to harm from others or be recovering from it.- Violence at home
- assault
- unsafe relationships
- neglect
- Unexplained injuries
- fear
- withdrawn behavior
- delays in seeking care
- partner answers for the patient
📋 Scenario
A woman attends the clinic for the third time in four months with minor injuries; her partner always stays in the room.
Subjective (S): "I am just clumsy."
Objective (O): Third visit in 4 months; healed bruise on the wrist; partner answers for her; appears anxious; no new injury today.
Assessment tools for this scenario: CP-SAFE Safety & Falls Score CP-MIND Mood & Mind Screen
Validated scales to consider: Morse Fall Scale, PHQ-9, GAD-7, C-SSRS
**CarePath diagnosis:** Abuse or violence exposure related to repeated injuries and a controlling partner (risk factors); no signs of the problem are present yet.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Ask privately and kindly. | Private, kind questions let a person speak freely without fear of the partner, and a non-judging approach makes disclosure more likely. |
| Ensure safety. | Her immediate safety comes first, because the risk of further harm can rise if the partner suspects she has spoken. |
| Document facts. | Factual, objective notes, including injuries, are accurate and may be needed later for care or legal purposes. |
| Follow local law and policy. | Laws and policies on reporting and confidentiality protect both the patient and the nurse and must be followed. |
| Offer support services. | Support services give practical help such as safe housing, advice and counselling, which she may not know about. |
| Do not blame. | Blame can cause shame and silence, so avoiding it keeps trust and makes it likelier she will seek help. |
**Expected outcomes**
- Patient assessed privately at this visit.
- Safety plan and support-service contacts offered.
- Injuries and facts documented.
- Mandatory reporting duties followed.
**Linking the data to the diagnosis**
A woman attends the clinic for the third time in four months, says, "I am just clumsy," and has a healed bruise on her wrist. Her partner stays in the room and answers for her, and she appears anxious. There is no new injury today and no abuse has been confirmed, so this is a risk diagnosis resting on repeated injuries and a controlling partner. The plan aims to assess her privately at this visit, document the facts, offer a safety plan and support contacts, and follow mandatory reporting duties, without blame.
CarePath diagnosis
Abuse or violence exposure related to repeated injuries and a controlling partner (risk factors); no signs of the problem are present yet.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Ask privately and kindly. | Private, kind questions let a person speak freely without fear of the partner, and a non-judging approach makes disclosure more likely. |
| 2. Ensure safety. | Her immediate safety comes first, because the risk of further harm can rise if the partner suspects she has spoken. |
| 3. Document facts. | Factual, objective notes, including injuries, are accurate and may be needed later for care or legal purposes. |
| 4. Follow local law and policy. | Laws and policies on reporting and confidentiality protect both the patient and the nurse and must be followed. |
| 5. Offer support services. | Support services give practical help such as safe housing, advice and counselling, which she may not know about. |
| 6. Do not blame. | Blame can cause shame and silence, so avoiding it keeps trust and makes it likelier she will seek help. |
Expected outcomes
- Patient assessed privately at this visit.
- Safety plan and support-service contacts offered.
- Injuries and facts documented.
- Mandatory reporting duties followed.
Linking the data to the diagnosis
A woman attends the clinic for the third time in four months, says, "I am just clumsy," and has a healed bruise on her wrist. Her partner stays in the room and answers for her, and she appears anxious. There is no new injury today and no abuse has been confirmed, so this is a risk diagnosis resting on repeated injuries and a controlling partner. The plan aims to assess her privately at this visit, document the facts, offer a safety plan and support contacts, and follow mandatory reporting duties, without blame.