Last updated March 14, 2022

Intimate Partner Violence (IPV) Screening and Intervention

Recommendations

ACPM recommendations

1) Medical education and training: All physicians receive standardized evidence – based education and training on IPV screening, identification, diagnosis and intervention during medical school and residency.
2) National medical associations: National medical associations provide continuing medical education including education on billing, coding, documentation, and reporting, to build on the foundation developed during training.
3) State medical boards: State medical boards require initial CME training on reporting requirements as this can vary from state to state.
4) Local and regional health systems: Local and regional health systems provide an infrastructure that enables providers to screen, identify, diagnose and intervene effectively in all healthcare settings where victims of IPV may present.
a. Develop patient messaging and education materials, and provide private and safe environments for screening and caring for victims of IPV
b. Develop internal expertise of select staff and general training for all staff; collaborate with community organizations, identify resources and develop referral patterns
c. Develop written procedures/protocols and quality improvement strategies, with support and oversight from leadership to ensure capacity building.
5) Healthcare Providers: Within a supportive system, healthcare providers routinely screen for IPV in a private and safe environment using a nonjudgmental manner. Providers are knowledgeable of local reporting laws, and follow established processes to provide an intervention including assessment of safety and an effective referral process.

Screening Recommendations of other groups

Agency or organization Recommendations
USPSTF Clinicians should screen women of childbearing age for intimate partner violence (IPV), such as domestic violence, and provide or refer women who screen positive to intervention services (Grade B Recommendation). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening all elderly or vulnerable adults (physically or mentally dysfunctional) for abuse and neglect (Grade I recommendation).
ACOG Physicians should screen all women for IPV at periodic intervals, including during obstetric care (at the first prenatal visit, at least once per trimester, and at the postpartum checkup), offer ongoing support, and review available prevention and referral options. Screen for IPV in a private and safe setting with the woman alone and not with her partner, friends, family, or caregiver. Use professional language interpreters and not someone associated with the patient. At the beginning of the assessment, offer a framing statement to show that screening is done universally and not because IPV is suspected. Also, inform patients of the confidentiality of the discussion and exactly what state law mandates that a physician must disclose. Incorporate screening for IPV into the routine medical history by integrating questions into intake forms so that all patients are screened whether or not abuse is suspected. Establish and maintain relationships with community resources for women affected by IPV. Keep printed take-home resource materials such as safety procedures, hotline numbers, and referral information in privately accessible areas such as restrooms and examination rooms. Posters and other educational materials displayed in the office also can be helpful.
AAFP Physicians should discuss IPV and family violence with their patients in a routine, nonjudgmental manner. Disclose the limits of confidentiality, Inquire about violence and assess immediate safety, Offer support and harm reduction, offer supported referral. Provide primary prevention through patient education about healthy relationships.
ACEP Training in the evaluation and management of victims of domestic violence should be incorporated into the initial and continuing education of EMS personnel. This training should include the recognition of victims and their injuries, an understanding of the patterns of abuse and how this affects care, scene safety, preservation of evidence, and documentation requirements.
ACP Individual internists are encouraged to take as many of the following steps as possible to reduce for their patients the prevalence and recurrence of, as well as pain and suffering caused by, family violence:
  • become aware and knowledgeable about the diagnosis and treatment of family violence
  • become familiar with applicable abuse reporting laws and other legal requirements as well as appropriate procedures for dealing with and referring suspected cases of abuse
  • work independently or with local medical societies or other community groups to participate in violence prevention activities and/or develop resources, such as battered women shelters, in one's community
  • encourage and participate in research on family violence.
AAP Residency training programs and CME program leaders are encouraged to incorporate education on IPV and its implications for child health into the curricula of pediatricians and pediatric subspecialists. Pediatricians should remain alert to the signs and symptoms of exposure to IPV in caregivers and children and should consider attempts to identify evidence of IPV either by targeted screening of high-risk families or universal screening. When caregivers are asked about IPV, it is ideal to have a plan in place to respond to affirmative screens. Pediatricians are encouraged to intervene in a sensitive and skillful manner and attempt to maximize the safety of caretakers and child victims. Pediatricians should be cognizant of applicable IPV laws in their state, particularly as they relate to reporting abuse or concerns of children exposed to IPV. Pediatricians are encouraged to support local and national multidisciplinary efforts to recognize, treat, and prevent IPV.


Recommendation Grading

Overview

Title

Intimate Partner Violence (IPV) Screening and Intervention

Authoring Organization

Publication Month/Year

December 1, 2019

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Adolescent, Adult, Older adult

Health Care Settings

Ambulatory, Emergency care, Hospital

Intended Users

Social worker, psychologist, counselor, nurse, nurse practitioner, physician, physician assistant

Scope

Prevention, Management

Diseases/Conditions (MeSH)

D017579 - Domestic Violence, D000066511 - Intimate Partner Violence

Keywords

preventative care, Intimate Partner Violence, domestic violence, IPV