Domestic Violence Report and Referral

How to use the iPad or computer to complete the DV mandatory report AHS

DV mandatory report checklist

ü  Identify a DV Patient ü  Notify SW ü  Notify Police ü  Find the I-Pad ü  Take pictures (start and end pictures with the patient’s

sticker) ü  Sign in with Username and Password ü  Complete the form ü  Upload pictures ü  Send the form

Find the iPad

Lock box Password iPad Password Username and Password

AHS Web Apps

https://medreportguard.com/dvrr/

DVRR Splash Page

Referral to the FJC

•  Non mandated report

DV mandated report

•  Pt being treated for DV injury

DVRR Login Each provider will have a unique Username and Password

Review the reports that you have already entered

Create a new report

1)  From the Pt 2)  From the Officer 3)  From Dispatcher

DVRR Police Report Number

DVRR Summary of injuries

Assailant info

Page 4 Assailant Info

Identify the relationship of the assailant

In custody or out of custody?

Danger assessment

Validated Scale developed at Johns Hopkins University By Jacqueline Campbell

Page 5 Danger Assessment

Ask questions as they are written.

Spanish version is

available.

Danger assessment score

Page 5 Danger Assessment

Self calculating Score

Discharge Safety

Page 6 Discharge Safety

Ask the pt for the best contact

number

Patient Consent

Page 6 Discharge Safety

Pt consents to have FJC staff contact them

Submission Confirmation

Page 7 Submission confirmation

X’s indicate that information still needs

to be completed

Most important elements of report

þ The patient identifying information þ The police report number þ Body map and photos of the injury/summary of injury þ Both patient consents signed þ Phone number to contact patient

Domestic Violence Fatality 1 in 5 women killed by their intimate partner received emergency department care in the year prior to their murder for injuries inflicted by the same partner

For every one femicide, there are approximately 9 attempted femicides

(Sharps, Koziol-Mclain, Campbell et al 2001)