A victim of physical abuse by her domestic partner is being treated for a broken humerus. Which indicator for the outcome of Abuse protection is most important to achieve before the patient leaves the emergency department?
a. The patient has completed and reviewed a workable safety plan.
b. She agrees to seek a restraining order limiting contact by the perpetrator.
c. The patient demonstrates insight into the abusive nature of the relationship.
d. She has been referred to counseling and battered-person support groups.
A
Completion of a safety plan empowers the patient and enables her to act to protect herself and her children if another episode of abuse occurs. It is best that the patient review and then repeat the name, contact number, and purpose of each resource cited in the plan (rather than simply giving the patient literature with this information). Development of insight into the abusive relationship will require time. Securing a restraining order is a complicated decision and does not necessarily protect the patient from abuse—in fact, it can become a provocation for further abuse. The decision to seek such an order is an individual one, and release from the emergency department cannot be predicated upon it. Referrals for secondary and tertiary prevention are important and should be made in the emergency room, but they are not as critical to the patient's basic safety as the safety plan.
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