Once it is recognized that a client (and their children) are experiencing (or exposed) to intimate partner violence, a public health nurse will assess the risk of immediate danger, and then in partnership with the client, discuss and identify responses (or interventions) that will address the client’s needs, including needs for safety.
Organizational Decision Required: Risk Assessment
Conducting a risk assessment provides both the client and the health professional with important information to determine level and risk of danger (including femicide) and to assist with developing a safety plan tailored to this level of danger. There are different validated tools to assess for this type of risk, including the Danger Assessment or the Ontario Domestic Assault Risk Assessment (ODARA).
It will be an important discussion for an organization to determine what type of risk assessment (and any associated training) will be endorsed within their organization. This decision might be informed by:
- Evidence-base underpinning tool validity
- Common risk assessment tool used by community partners to promote consistency in assessment, communication and response across agencies
- The knowledge/skills of the health care professional to administer, score, and interpret the findings of the risk assessment (and then any additional resources required for training or certification)
- The time available within the professional-client encounter e.g., for some programs/encounters, it might be the role of the provider to briefly assess risk of immediate danger and then as part of the safety plan, immediately refer to another professional/agency where a formal risk assessment and additional safety planning can be completed OR if the provider has the knowledge, skill, confidence and time within a program (e.g., long-term home visitation program), then it may be appropriate for the provider to conduct a more formal assessment such as the Danger Assessment.
Learning Goals (examples)
Teaching and Learning Activities
Assess risk of immediate danger
Discuss safety strategies
Make appropriate referrals
Understand when and how to complete a brief risk assessment
- Review the PHN-PREP guidance document “Intimate Partner Violence: Brief Risk Assessment”
- With a peer or team, practice asking the Danger Assessment-5 tool questions and discuss how to score the tool, and then identify what nursing actions would follow each response on the tool.
Complete, score and interpret the Danger Assessment to determine the level of danger an individual who is experiencing intimate partner violence has of being killed by their intimate partner
- Depending on the need/resources available/type of home visitation program, some health units might invest in nurses completing the Danger Assessment training and certification
Explain strangulation as a risk factor for serious harm and lethality
- Complete the module “High Risk IPV + Safety Planning” (Responding to Domestic Violence in Clinical Settings)
Be knowledgeable of the services available in your community to support individuals who have experienced intimate partner violence
Use warm referrals to support clients to access, navigate, and engage with community supports and services
- Arrange for site visits to various local agencies (e.g., domestic violence shelter, child protection agency, law enforcement) to learn who from their agency provides supports to people experiencing violence, how your clients can access these supports, and what it is like for a client to engage with their services.
- Review the PHN-PREP guidance document “Trauma-and Violence Informed Care: Making Warm Referrals”
- With a peer/team, review “Safety Planning for People Who Experience Domestic Violence” and discuss what types of safety strategies could be discussed with clients a) choosing to remain with their partner; b) planning to leave; c) in the process of leaving; or d) after leaving.
LEARNING OUTCOMES (EXAMPLES)
Assess risk of immediate danger
Discuss safety strategies
Make appropriate referrals
LEARNING OUTCOMES (EXAMPLES)
Understand when and how to complete a brief risk assessment
TEACHING AND LEARNING ACTIVITIES
- Review the PHN-PREP guidance document “Intimate Partner Violence: Brief Risk Assessment”
- With a peer or team, practice asking the Danger Assessment-5 tool questions and discuss how to score the tool, and then identify what nursing actions would follow each response on the tool.
LEARNING OUTCOMES (EXAMPLES)
Complete, score and interpret the Danger Assessment to determine the level of danger an individual who is experiencing intimate partner violence has of being killed by their intimate partner
TEACHING AND LEARNING ACTIVITIES
- Depending on the need/resources available/type of home visitation program, some health units might invest in nurses completing the Danger Assessment training and certification
LEARNING OUTCOMES (EXAMPLES)
Explain strangulation as a risk factor for serious harm and lethality
TEACHING AND LEARNING ACTIVITIES
- Complete the module “High Risk IPV + Safety Planning” (Responding to Domestic Violence in Clinical Settings)
LEARNING OUTCOMES (EXAMPLES)
Be knowledgeable of the services available in your community to support individuals who have experienced intimate partner violence
Use warm referrals to support clients to access, navigate, and engage with community supports and services
TEACHING AND LEARNING ACTIVITIES
- Arrange for site visits to various local agencies (e.g., domestic violence shelter, child protection agency, law enforcement) to learn who from their agency provides supports to people experiencing violence, how your clients can access these supports, and what it is like for a client to engage with their services.
- Review the PHN-PREP guidance document “Trauma-and Violence Informed Care: Making Warm Referrals”
LEARNING OUTCOMES (EXAMPLES)
TEACHING AND LEARNING ACTIVITIES
- With a peer/team, review “Safety Planning for People Who Experience Domestic Violence” and discuss what types of safety strategies could be discussed with clients a) choosing to remain with their partner; b) planning to leave; c) in the process of leaving; or d) after leaving.