Sexual Assault Nurse Examiners: Developing Clinical Excellence in Emergency Services

2.50
Hdl Handle:
http://hdl.handle.net/10755/162614
Type:
Presentation
Title:
Sexual Assault Nurse Examiners: Developing Clinical Excellence in Emergency Services
Abstract:
Sexual Assault Nurse Examiners: Developing Clinical Excellence in Emergency Services
Conference Sponsor:Emergency Nurses Association
Conference Year:1999
Author:Darlene, , Bradley
Contact Address:Loma Linda University Medical Center, 11234 Anderson Street, Loma Linda, CA, 92811
Clinical Topic: The intent of this clinical project was to develop and implement a sexual assault emergency nurse examiner team. Team development was essential to meet the needs of the medical community, the survivors of sexual assault, and law enforcement. Community hospitals and law enforcement were faced with prolonged delays in having sexual assault exams completed. Substandard documentation and evidence collection led to a less than optimal perpetrator conviction rate. Survivors of the assault were fearful of their continued safety.

Implementation: A multidisciplinary team was formed to strategize, implement and develop essential program components. The membership included adult and pediatric trauma clinicians, social services, law enforcement, rape crisis counselors, emergency nursing experts, educators, and physicians.
Education is essential to the development of sexual assault nurse examiners (S.A.N.E.). Forty hours of coursework was presented in accordance with the Office of Criminal Justice's suggested curriculum. Additionally, clinical training and competency verification was provided for pelvic examinations, photo-documentation, evidence collection and chain of custody procedures, precept adult and pediatric examinations, perpetrator exams, and forensic documentation procedures.
An advanced practice protocol allowed the S.A.N.E. to practice independently, although provisions for consultation with the emergency department physician were included. Medical collaboration is required in cases where substantial injury has occurred such as with strangulation, significant extremity or genital injury which requires surgical intervention or wound repair.
Integration of the quality improvement program provided for the continued development of the nurse examiner. Peer review improved the performance of both the examiner and the evaluator. The review includes an examination of the documentation, photography, descriptions of injury, and findings. Comments are provided to the examiners; a return response is expected on all reviews.
Law Enforcement contracts were obtained to financially support the program. These provisions funded examinations at no cost to the individual.

Outcomes: The formation of the S.A.N.E. has been a positive improvement organizationally. Medical center policies and procedures have been rewritten to accommodate the work the team has done. Consults are provided on related inpatient and outpatient cases requiring a forensic evaluation. The sophistication of the evidence collection and procedures has strengthened the cases for law enforcement.

Recommendations: A natural outgrowth of the Sexual Assault program is a focus on family violence. The team will develop a program that is inclusive of prevention, recognition, and treatment for family violence. Social service and counseling disciplines continue skill development in forensic, photography, and law enforcement practices related to violent crimes. The medical staff has become more attuned to forensic procedures. Excellence results when forensics is applied to emergency medicine practice in cases of trauma, abuse, or other violent crimes. [Clinical Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSexual Assault Nurse Examiners: Developing Clinical Excellence in Emergency Servicesen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162614-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Sexual Assault Nurse Examiners: Developing Clinical Excellence in Emergency Services</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1999</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Darlene, , Bradley</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Loma Linda University Medical Center, 11234 Anderson Street, Loma Linda, CA, 92811</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: The intent of this clinical project was to develop and implement a sexual assault emergency nurse examiner team. Team development was essential to meet the needs of the medical community, the survivors of sexual assault, and law enforcement. Community hospitals and law enforcement were faced with prolonged delays in having sexual assault exams completed. Substandard documentation and evidence collection led to a less than optimal perpetrator conviction rate. Survivors of the assault were fearful of their continued safety.<br/><br/>Implementation: A multidisciplinary team was formed to strategize, implement and develop essential program components. The membership included adult and pediatric trauma clinicians, social services, law enforcement, rape crisis counselors, emergency nursing experts, educators, and physicians. <br/>Education is essential to the development of sexual assault nurse examiners (S.A.N.E.). Forty hours of coursework was presented in accordance with the Office of Criminal Justice's suggested curriculum. Additionally, clinical training and competency verification was provided for pelvic examinations, photo-documentation, evidence collection and chain of custody procedures, precept adult and pediatric examinations, perpetrator exams, and forensic documentation procedures.<br/>An advanced practice protocol allowed the S.A.N.E. to practice independently, although provisions for consultation with the emergency department physician were included. Medical collaboration is required in cases where substantial injury has occurred such as with strangulation, significant extremity or genital injury which requires surgical intervention or wound repair.<br/>Integration of the quality improvement program provided for the continued development of the nurse examiner. Peer review improved the performance of both the examiner and the evaluator. The review includes an examination of the documentation, photography, descriptions of injury, and findings. Comments are provided to the examiners; a return response is expected on all reviews.<br/>Law Enforcement contracts were obtained to financially support the program. These provisions funded examinations at no cost to the individual.<br/><br/>Outcomes: The formation of the S.A.N.E. has been a positive improvement organizationally. Medical center policies and procedures have been rewritten to accommodate the work the team has done. Consults are provided on related inpatient and outpatient cases requiring a forensic evaluation. The sophistication of the evidence collection and procedures has strengthened the cases for law enforcement.<br/><br/>Recommendations: A natural outgrowth of the Sexual Assault program is a focus on family violence. The team will develop a program that is inclusive of prevention, recognition, and treatment for family violence. Social service and counseling disciplines continue skill development in forensic, photography, and law enforcement practices related to violent crimes. The medical staff has become more attuned to forensic procedures. Excellence results when forensics is applied to emergency medicine practice in cases of trauma, abuse, or other violent crimes. [Clinical Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:31:09Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:31:09Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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