Intimate Partner Violence — Community Response

Intimate partner violence (IPV) affects approximately 1 in 4 women and 1 in 10 men in the United States. The community health nurse encounters IPV across all settings — prenatal clinics, emergency departments, pediatric visits (witnessing violence harms children), home health, and primary care. The USPSTF recommends screening all women of reproductive age for IPV and providing or referring to intervention services. Validated screening tools include the HITS (Hurt, Insult, Threaten, Scream), AAS (Abuse Assessment Screen used in pregnancy), and STAT (Slapped, Threatened, And Thrown). The nurse screens in private — NEVER with the partner present. If the client discloses abuse, the nurse's priorities are: assess immediate safety (does the client have a safe place to go tonight?), document injuries objectively using a body map and the client's own words in quotation marks, provide information about community resources (National Domestic Violence Hotline, local shelters, legal advocacy), develop a safety plan (packed bag with essentials, copies of important documents, emergency contacts, escape route), and respect the client's autonomy — leaving an abusive relationship is a process, not a single event. The nurse does NOT pressure the client to leave, call police without the client's consent (unless mandatory reporting applies), or express judgment. Mandatory reporting laws for IPV in adults vary by state — some states require reporting only if a weapon caused injury. When children are present in an IPV household, the nurse assesses child safety and reports to CPS when abuse, neglect, injury, threat, or state-mandated exposure criteria are met. During pregnancy, IPV often escalates. The nurse screens at the first prenatal visit, at least once per trimester, and postpartum.