Name
Capella University
NURS-FPX 4050 Coord Patient-Centered Care
Prof. Name
Date
Care coordination has become a need of the healthcare system due to the interrelation of different factors affecting the well-being of the patient and the community. This paper is the final care coordination plan for the preliminary issue discussed in assessment one, about Domestic Abuse and Violence (DAV), through evidence-based literature, best practices, and community resources. It concerns 10 million people every year in the U.S. (Huecker et al., 2023). DAV can harm a person’s physical, psychological, mental, sexual, and financial stability of any age: child, adult, or elder. This paper focuses on DAV targeted toward adults; a study highlights one in four women and one in nine men are targets of domestic violence every year (Huecker et al., 2023).
A Patient-Centered Plan (PCP) aims to address health issues for domestic violence victims. It will consider multiple factors, including their beliefs, values, reasons, and severity of the problem. Developing patient-centered interventions and timelines is crucial for practical and value-based care. Healthcare personnel play a pivotal role in identifying, treating, and managing victims through holistic care. They ensure preventive measures to avoid recurring incidents and support in consideration of their needs and preferences (Hegarty et al., 2020).
Physical abuse associated with DAV can manifest in various ways, including bruises, cuts, burns, sprains, internal pain, or head injuries. These signs should be taken seriously and must be addressed as a priority. The medical staff must perform screenings for any physical signs of abuse and provide community resources for protection and treatment (Huecker et al., 2023). Neglecting physical signs will not only impact mental and emotional well-being but can also produce life-threatening situations. DAV victims are prone to eating and sleeping disorders. The abuse is usually associated with low educational and income households, beliefs in domination, and alcohol/drug abuse (Bo & Yating, 2023). Some Community resources that can be used for physiological assistance are the North Carolina Coalition Against Domestic Violence (NCCADV) and the Rape, Abuse & Incest National Network (RAINN). These resources provide immediate help, safety planning, shelter, counseling, and physical and emotional support by providing references to safe environments (Berkowitz, 2023; NCCADV, 2023).
As soon as a DAV victim approaches, the first responsibility of healthcare personnel is to observe any physical signs of harm. It should be done within the first couple of hours. Healthcare faculty, depending upon the need and severity, will perform several duties after treating the injury. They will report to authorities and involve required services like psychologists for post-traumatic impact. They will also assist patients in referral to protective services if the victim cannot return home, including community references to dietary or physical therapies to recover rapidly from physical injuries. Lastly, interventions for follow-up and rehabilitation will be ensured in the next three months (Adigun et al., 2020).
Domestic violence can have a profound negative impact on the psychological health of victims. DAV is related to depression and post-traumatic disorder, leading to isolation, antisocial personality, and low self-esteem. It needs to be addressed to improve quality of life through therapies and counseling to develop confidence and trust in others and improve well-being. Healthcare professionals should consider the psychological impact on people and integrate efforts in care coordination for psychological rehabilitation (Mazza et al., 2021). For Psychological interventions, the following community resources can prove beneficial: Safe Harbor, Helpmate, and YMCA (Young Men’s Christian Association). These resources assist with advocacy and raising awareness, providing long-term support essential for holistic well-being through counseling and community activities (Harbor, n.d.; Helpmate, n.d.; YCMA, n.d.).
The healthcare personnel should work on psychological intervention for anxiety, depression, and post-traumatic disorder within the first week. Healthcare must be based on individual needs and preferences, including counseling and therapies. For instance, Cognitive Behavioral Therapy (CBT), mindfulness-based therapies, and trauma-focused therapies are used. These therapies work on thought patterns. Present-moment awareness and reduced stress create a sense of safety and control (Baker et al., 2021).
Emotional instability means mood swings, uncontrolled anger, severe sadness, anxiety attacks, and negative perception of the surroundings. Healthcare professionals incorporate the emotional aspects of victims in their care-coordinated plan. Emotions directly impact psychological and physical well-being, so it must be addressed (Menefee et al., 2022). DAV victims struggle to communicate and cooperate with healthcare personnel and others openly due to emotional scars. It causes denial and refusal to seek help and worsens the situation. Healthcare professionals empathetically should conduct a comprehensive assessment of the survivor’s emotional well-being and safety needs.
The assessment should include an evaluation of emotional regulation difficulties, triggers for emotional distress, and coping mechanisms (Olivier et al., 2020). The emotional stability efforts are supported by various community resources such as Safe Alliance and The Five N Two Food Pantry. These resources provide emotional support through the provision of sustenance in times of crisis, like food, transportation, shelter, and counseling (Safe Alliance, n.d; Fiventwo, n.d.).
Emotional well-being intervention should be a long-term plan with periodic follow-up sessions, depending upon the individual needs and preferences of the DAV victims. Ideally, a 4-6 months educational and supportive program for emotional regulation must be planned in care coordination. The plan should involve strategies to manage emotional reactions and ensure the survivor’s physical safety. There are several strategies for emotional regulation (Olivier et al., 2020). Mindfulness practices and relaxation techniques, such as breathing exercises and muscle relaxation. These help with emotion regulation by promoting relaxation and reducing stress. Self-management initiatives through behavioral change are effective (Flaubert et al., 2021).
The healthcare personnel, while providing care coordination to domestic violence and abuse victims, must consider four principles of ethics: beneficence, non-maleficence, autonomy, and justice (Varkey, 2020). These principles provide guidelines to put victims at the center of the plan by protecting them, benefiting them, giving control, and serving justice. Healthcare professionals should involve patients in decision-making and respect their beliefs and choices, as cultural, ethnic, and racial factors influence the well-being of individuals (Free et al., 2021).
Additionally, abuse and violence deteriorate an individual’s confidence and trust. DAV victims also experience guilt and shame, and thus, the interventions made must be kept private and secure (Heron & Eisma, 2021). Any case details should not be shared with irrelevant staff, community members, or on social media. DAV victims must be provided with easy access to all community resources for maximum benefit and an effective care plan. All of these factors are essential for patients’ autonomy, their benefit, protection from harm, and the provision of long-term support for physical, emotional, and psychological well-being (Varkey, 2020).
Various policies govern domestic violence and abuse issues. These policies provide immediate support and long-term assistance for rehabilitation. They support in multiple ways, including financial and legal backing. Some of the significant policies are as follows:
Healthcare professionals must educate their patients and community about the applicability of FVPSA law in all states and the helpline. Reporting is the first step, and it must be communicated by primary care professionals in daily practice so no case of domestic abuse goes unreported. It provides services like crisis intervention, support through education, planning for safety measures, referring directly to safe shelters, and services for any support. This allows victims to get attended immediately when they feel they are threatened. This service keeps the matter extremely confidential and respects the victim’s dignity (U.S. HHS., 2019).
This policy encourages healthcare professionals to integrate mental health initiatives and acknowledge related physical illnesses or injuries. In the case of domestic abuse, healthcare professionals must go beyond attending physical injuries. It should address emotional trauma and provide psychological support for the well-being of DAV victims (CMS, 2023).
This law enforces the protection of patient’s sensitive information by healthcare facilities and community services (CDC, 2022). This lifts the burden of being judged by healthcare professionals or community members due to physical, emotional, or psychological instability. It must be integrated for continued and coordinated care through trust and respect (CDC, 2022).
DAV victims require careful and considerable measures based on evidence-based strategies. It becomes a healthcare professional’s responsibility to make decisions skillfully and ethically in such dire situations. Consequently, healthcare professionals must prioritize a few aspects while discussing the treatment plan with victims:
The top priority during care coordination while interacting with the victim is ensuring their safety and needs. It can be a referral strategy to ensure the victim is at a safe place away from potential harm, for instance, referring to Safe Horizon in New York and My Sister’s Place. These are emergency shelters, counseling, and legal advocacy shelters. They can also reach out to helplines and community resources for immediate safety (Victorian Government, 2020).
DAV victims should consider patients’ needs and preferences. Cultural, economic, and social backgrounds should be considered, and healthcare professionals should integrate strategies that are most effective through evidence. The one-size-fits-all solution can prove ineffective, so a personalized care plan should be essential and a priority of healthcare personnel while addressing DAV victims in a care-coordinated plan (Free et al., 2021).
As discussed earlier, DAV can have physical, psychological, and emotional instability, which needs to be addressed in the long run. Tools like Patient-Reported outcome measures (PROMs) can help involve patients and find the effectiveness of the plan for victims in a care coordination initiative (Churruca et al., 2021). This will allow modification and intervention as per requirements and ethical principles.
Educating patients is essential to empower and build confidence in DAV patients. Healthcare providers must inform victims and their close ones, if involved, about the implications, symptoms, and consequences of the incident, strategies, and make lifestyle choices best suited to the individual’s well-being (Doran & Mortel, 2022). This priority aligns with the goals of Futures Without Violence, which demonstrates systematic efforts through awareness, training to healthcare personnel, and preventive and supportive efforts (Futures Without Violence, 2022).
While discussing DAV patients or their families, healthcare providers might make changes to the plan to prioritize evidence-based interventions. This allows for optimal outcomes. It aligns with the latest research and ensures that the most effective strategies are implemented. The care coordinator enhances the plan’s efficacy and promotes patient safety and health outcomes in a care-coordinated setting. Most importantly, it communicates the plan’s currency, relevance, and patient-centeredness through discussion with DAV patients (Sheehan et al., 2021).
The evaluation of the learning session content through feedback and surveys to align objectives or activities with current literature or Healthy People 2030 goals is essential. The DAV literature must be relevant, recent, and reliable to have an effective outcome. The findings should be taken into consideration for modifying teaching practices (Mash & Edwards, 2020). So, healthcare personnel and nurses must consider the following tactics.
Keep current research on DAV and continued evaluation on domestic abuse for advancement in addressing the issue. Next, the learning strategies should be based on exercises that provide critical thinking and hands-on experience, such as simulation exercises for awareness and a holistic approach to care coordination. Updating content and activities in educational sessions should be modified or replaced for innovative interventions, so they align with evidence-based literature and Healthy People 2030 goals, which make an effort to reduce violence of all kinds, including domestic. It clearly takes the healthcare institution’s role in the effective reduction of violence through screenings and intensive case management (Health, 2020).
The need to revise learning sessions regarding DAV is to equip healthcare professionals with knowledge and skills that will result in better outcomes. Revising and aligning the learning session will remove ambiguities, provide evidence about interventions, and provide appraisal, application, and evaluation for the long-term effectiveness of the learned session. Evaluation will allow for a coordinated approach addressing DAV with current and national goals of reducing the violence of all kinds and improving health outcomes (Cardoso et al., 2021).
Addressing DAV requires a patient-centered approach that prioritizes safety, individual needs, and evidence-based interventions. By implementing strategies such as patient-centered care, regular evaluation, and alignment with Healthy People 2030 goals, healthcare professionals can effectively support victims and promote their physical, psychological, and emotional well-being. Continued adaptation of educational practices is essential to ensure ongoing improvement and responsiveness to the needs of domestic abuse and violence victims.
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