NURS FPX 4050 Assessment 4 Final Care Coordination Plan

Patient-Centered Health Interventions and Timelines for Domestic Abuse

Domestic violence is a prevalent community issue that impacts public physical, mental, and emotional health. It poses several healthcare issues and requires prompt attention to prevent long-lasting and irreversible bodily and mental damage (Descartes et al., 2021). The three major healthcare issues raised by domestic abuse and violence include physical repercussions such as bruises, lacerations, fractures, and organ damage on the affected individuals; mental health issues: post-traumatic stress disorder, anxiety, depressive thoughts, and suicidal ideation; and substance abuse among survivors as a coping mechanism which leads to addiction and other healthcare issues (Descartes et al., 2021).

Interventions for Each Healthcare Issue and Community Resources

• To address the physical injuries concern of domestic violence, it is imperative to raise awareness and educate the community about no domestic violence and how it can deteriorate a person’s life. Moreover, comprehensive medical care and counseling must be prompted to initiate immediate access to emergency medical care for physical injuries and wounds (Boserup et al., 2020). The timelines for this intervention will comprise immediate response until the patient’s wounds start healing. Moreover, the hospital must document injuries effectively for forensic evidence (Muldoon et al., 2021). Some essential and suitable community resources for this intervention can be local emergency departments and healthcare clinics offering 24/7 care, such as hospitals like Minnesota Clinic for Health and Wellness, forensic nurse examiners programs to collect forensic evidence, legal aid, and advocacy organizations to navigate legal processes and ensure documentation is admissible in court (Gulati & Kelly, 2020). 

NURS FPX 4050 Assessment 4 Final Care Coordination Plan

• The mental health issues can be addressed adequately by ensuring the victims acquire psychotherapy and counseling from certified psychologists and psychiatrists. This will enable trauma to unfold and promote trauma-informed care, leading to improving patients’ mental well-being (Chandan et al., 2019). This will require a short-term timeline of at least 3-6 months to establish significant mental health outcomes from psychotherapy and talk therapy. The community resources can include mental health clinics such as Colorado Mental Health Institute and telemental health services from professional psychologists.
• Domestic violence survivors can be prevented from substance abuse by providing educational wisdom, social support, and practical ways to abandon addictive substances. For this purpose, healthcare professionals like nurses can play a broad role in educating patients indulged in substance abuse post-domestic violence (Bell & McCurry, 2020). They can also refer patients to mental health professionals to treat the underlying cause of this issue and improve mental and emotional health. They can also use community groups to acquire social support and keep good company to avoid using harmful products causing addiction (Bell & McCurry, 2020). The community resources included for this intervention are substance abuse treatment centers (American Addiction Centers (AAC)), Las Vegas Addiction Treatment Center), support groups (Addiction Technology Transfer Center (ATTC)), and crisis helplines such as (866) 407-6106 of AAC (American Addiction Centers, 2019). 

Ethical Decisions for Patient-Centered Health Approaches

While crafting patient-centered health approaches, it is paramount to consider ethical principles such as confidentiality, informed consent, benevolence, and cultural sensitivity. When healthcare professionals practice confidentiality and informed consent in providing trauma-informed care, they restore patient’s trust after domestic violence and assault. However, it can involve relevant stakeholders such as family members, legal enforcement, and interdisciplinary team members without obtaining the survivor’s consent (Vozmediano et al., 2021).

Implementing beneficence, meaning considering the patient’s well-being as the primary objective, will eventually result in recovering from mental health traumas, healing physical injuries, and improving the patient’s overall well-being (Isailă et al., 2021). Similarly, cultural sensitivity is an important aspect that is often neglected while tailoring health interventions for survivors of domestic violence. Healthcare professionals need to balance universal ethical principles with cultural relativism while addressing domestic violence through appropriate interventions like trauma-informed care and medical care for physical injuries (Dyar et al., 2019). The ethical questions related to decisions about ethics for developing patient-centered interventions that generate uncertainties are as follows:

• How can informed consent be procured when power dynamics may limit a survivor’s ability to make decisions freely?
• How can healthcare professionals balance the ethical principle of confidentiality and the need to involve interdisciplinary teams and relevant stakeholders to avoid potential risks and improve their health outcomes?

Implications of Health Policy Provision for Care Coordination and its Continuum

The Affordable Care Act (ACA) comprises several policies and provisions that aim to address and mitigate the impact of domestic violence. The ACA has emphasized preventive care and services, among which domestic violence screening and counseling are also included. This enables patients covered by ACA health insurance plans to access the health benefits of free screening and counseling (U.S. Department of Health and Human Services, n.d.). Furthermore, ACA has provisions that prohibit discrimination based on gender, ensuring that health insurance companies compensate people without any differential biases.

This provision is relevant as domestic violence disproportionately affects women, and the prohibition of gender-based discrimination helps ensure that survivors can access appropriate health interventions (U.S. Department of Health and Human Services, n.d.). These implications can improve access to healthcare services for survivors of domestic violence and promote a more inclusive and equitable healthcare system. Moreover, these implications encourage care coordination and its continuum for survivors of domestic violence when they receive effective healthcare interventions timely and appropriate. 

Care Coordinator’s Priorities in Discussing Plan with Affected Patient

In discussing the plan for trauma-informed care and holistic management of DV, first and foremost, the care coordinator must conduct ongoing safety assessments to ensure the physical and emotional safety of domestic violence survivors (Cabilan & Johnston, 2019). Then, the care coordinator can proceed to a thorough screening for trauma and corporeal injuries to assess the impact of domestic violence on the survivor’s body and mind. The care coordinator must coordinate with an appropriate interdisciplinary team to create tailored interventions, such as emergency care, psychotherapy, and joining support groups to address the patient’s healthcare issues (Johnson & Stylianou, 2020). 

The changes the care coordinator can make are based on the limitations that occur during discussions with affected patients. For instance, a patient’s preference for acquiring home-based psychotherapy instead of clinical-site-specific counseling will require changes in the treatment plan. This will require telemental health conferences with patients where a well-educated and experienced psychologist will be in touch with the patient and unfold trauma memories and relevant concerns (Iorfino et al., 2021). Similarly, the dynamic nature of trauma recovery can require regular assessments and adjustments, such as revising the care plan to align with the survivor’s cultural and religious preferences and incorporating culturally sensitive resources (Dheensa et al., 2020).

Learning Session Alignment with Healthy People 2030: An Evaluation

The best practices tailored for a patient who is a trauma survivor of domestic violence are compared with Healthy People 2030 goals and objectives on violence prevention. Healthy People 2030 has described some goals and objectives that align with best practices devised for DV survivors. These goals are to prevent violence and related injuries and deaths, reduce intimate partner violence, reduce emergency department visits for non-fatal intentional self-harm injuries, and increase the proportion of adolescents who deem substance abuse as risky (U.S. Department of Health and Human Services, n.d.).

The best practices involving community education on the harms of domestic violence and unveiling inner traumas that initiate domestic violence can prevent violence and related injuries, such as physical injuries and mental health dysfunction (Halliwell et al., 2019). This will ultimately reduce emergency department visitation frequency as the community increases in education, and survivors can also reduce suicidal attempts when they receive trauma-informed care timely, which recovers them from mental health issues of suicide and depression (Indu et al., 2020).

Educating the young population and survivors of DV on substance abuse, as best practice mentioned earlier, can result in a reduction in the use of addictive products. These best practices are adequately aligned with the Healthy People 2030 goals. However, there is a need for future revisions as the teaching sessions particularly need to highlight how to reduce intimate partner violence and what strategies and best practices will be required (Hardesty & Ogolsky, 2020).

Conclusion

This assessment covers domestic violence, for which a final care coordination plan is developed based on the particular healthcare issues raised by this subject. This called for suitable interventions and the need for community resources. The patients affected by DV must deliver health interventions based on ethical principles. The health policy provision by ACA promotes care coordination through free screening and counseling services among insured patients. The care coordinator must prioritize the safety of the patient throughout health interventions. The teaching session goals align with Healthy People 2030 goals requiring further revision to reduce intimate partner violence.

References

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Chandan, J. S., Thomas, T., Bradbury-Jones, C., Russell, R., Bandyopadhyay, S., Nirantharakumar, K., & Taylor, J. (2019). Female survivors of intimate partner violence and risk of depression, anxiety and serious mental illness. The British Journal of Psychiatry, 217(4), 1–6. https://doi.org/10.1192/bjp.2019.124 

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NURS FPX 4050 Assessment 4 Final Care Coordination Plan

Dheensa, S., Halliwell, G., Daw, J., Jones, S. K., & Feder, G. (2020). “From taboo to routine”: A qualitative evaluation of a hospital-based advocacy intervention for domestic violence and abuse. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-4924-1

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NURS FPX 4050 Assessment 4 Final Care Coordination Plan

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