Domestic Violence Protocol: Report

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Objective: For this assignment, you will create a Domestic Violence Protocol for a Community Health Center that you will be able to choose (Any Health Care Facility).The Domestic Violence Protocol is designed to provide guidelines and establishes standards for public safety call takers, dispatchers, first responders and investigators in handling domestic violence incidents. The Protocol seeks to interpret and apply statutory and case law relating to domestic violence incident response and investigation. Particular attention is given to protecting victims of domestic violence, including children, other members of the household and pets, through enforcement of restraining orders, medical care, and working with support agencies to provide alternate shelter, relocation services, counseling and Legal services.You are encouraged to choose (Any Health Care Facility: Hospital, Doctor Office, Emergency Care Center, etc.).The paper will be 8-10 pages long.


Students will create a Domestic Violence Protocol for the Institution of your choosing.The purpose of this protocol is to set a standard to improve both the quality of the care given by individual health care providers and the overall CPHS response to domestic violence.This protocol outlines the elements of an effective response.

You need to read the article (in the additional weekly reading resources localize in the Syllabus and also in the Lectures link) assigned for this week and develop a 8-10-page paper reflecting your understanding and ability to apply the readings to your Health Care Setting. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA format when referring to the selected articles and include a reference page.


  • Introduction (5 points / 25%) Offer an abstract that provide a brief outlook of the protocol and explaining in your own words what is meant by a Domestic Violence Protocol for a Health care Facility.

2. Your Domestic Violence Protocol (10 points 50%)

a. Presentation Page:









b. Definition and Guiding Principles:

What is Domestic Violence, sings of violence, and mention the principles of this protocol.

c. Screening:

In all primary care clinics, family planning clinics, prenatal clinics, mental health clinics, social work intakes, PHN intakes:

Screen all women and adolescent girls.Also, screen men and boys presenting with symptoms or signs of domestic violence

d. Assessment:

Obtain history of present complaint.Physical examination:Request that patient disrobe for a more thorough exam.Provider should examine for evidence of further injuries or scars.

e. Intervention

f. Documentation:

Health care providers should complete a legible medical record for each known or suspected victim of domestic violence.This record should include the following:• A description of domestic violence history, including present complaints or injuries, past experiences of physical/sexual abuse and frequency of abuse.Include date, time and location of domestic violence incidents.• Whenever appropriate use the patient’s own words in quotation marks.• A description of patient’s injuries, including type, location, size, color and age.Document injuries on a body map (See Appendix E for sample Body Map). • Alleged perpetrator’s name, address, and relationship to patient (and children, if any), if patient is willing to provide this information.• A description of other health problems, physical or mental, which may be related to the abuse

g. Mandatory Report of Injury

h. Continuity of Care

3. Conclusion (3 points / 15%)

Briefly recapitulate your thoughts & conclusion to you Domestic Violence Protocol. How did this plan impact your thoughts on Health Care Administrator and Human Resource Department?

Evaluation will be based on how clearly you respond to the above, in particular:

a) The clarity with which you associate, relates, stablish and apply your knowledge to generate the Domestic Violence Protocol;

b) The Complexity, depth, scope, Profundity and organization of your paper; and,

c) Your conclusions, including a description of the impact of the Domestic Violence Protocol on any Health Care Setting.

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