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Domestic violence and abuse (DVA) has long-lasting consequences on the physical, mental, emotional and psychological health of adults, children and young people affected by it. Recognising and responding to DVA in healthcare services is both a professional duty and a public health priority. Evidence-based guidance and frameworks outline how healthcare professionals including nurses should act when working with people affected by, or at risk of, DVA. In this article, the authors present a whole-systems public health leadership approach for strengthening nurses' recognition of DVA and their response to it. The authors describe frameworks, tools and resources that nurse managers and leaders can implement to support nurses in their safeguarding role. They stress the importance of embedding enquiry about DVA in routine care; implementing frameworks for training and clinical use; providing staff with training and clinical supervision; multi-agency partnership working; and continuous service evaluation and data monitoring.