Author Affiliations: Pritzker School of Medicine, University of Chicago.
Emergency Medicine Residency, Icahn School of Medicine at Mount Sinai.
J Forensic Nurs. 2020 Apr/Jun;16(2):73-82. doi: 10.1097/JFN.0000000000000290.
Emergency department (ED) providers serve as the primary point-of-contact for many survivors of sexual assault but are often ill-prepared to address their unique treatment needs. Sexual assault nurse examiners (SANEs) are therefore an important resource for training other ED providers. The objective of this project was to create a SANE-led educational intervention addressing this training gap. We achieved this objective by (a) conducting a needs assessment of ED providers' self-reported knowledge of, and comfort with, sexual assault patient care at an urban academic adult ED and, (b) using these results to create and implement a SANE-led educational intervention to improve emergency medicine residents' ability to provide sexual assault patient care. From the needs assessment survey, ED providers reported confidence in medical management but not in providing trauma-informed care, conducting forensic examinations, or understanding hospital policies or state laws. Less than half of the respondents felt confident in their ability to avoid retraumatizing sexual assault patients, and only 29% felt comfortable conducting a forensic examination. On the basis of these results, a SANE-led educational intervention was developed for emergency medicine residents, consisting of a didactic lecture, two standardized patient cases, and a forensic pelvic examination simulation. Preintervention and postintervention surveys showed an increase in respondents' self-perceived ability to avoid retraumatizing patients, comfort with conducting forensic examinations, and understanding of laws and policies. These results show the value of an interprofessional collaboration between physicians and SANEs to train ED providers on sexual assault patient care.
急诊科（ED）医护人员是许多性侵犯幸存者的主要接触点，但他们通常准备不足，无法满足其独特的治疗需求。性侵犯护士检查人员（SANEs）因此是培训其他 ED 医护人员的重要资源。本项目的目的是创建一个由 SANEs 领导的教育干预措施，以解决这一培训差距。我们通过以下方式实现了这一目标：(a) 对城市学术成人 ED 的 ED 医护人员自我报告的性侵犯患者护理知识和舒适度进行需求评估，以及 (b) 使用这些结果创建和实施由 SANEs 领导的教育干预措施，以提高急诊医学住院医师提供性侵犯患者护理的能力。从需求评估调查中，ED 医护人员报告对医疗管理有信心，但对提供创伤知情护理、进行法医检查或理解医院政策或州法律缺乏信心。不到一半的受访者对自己避免再次创伤性侵犯患者的能力有信心，只有 29%的人对进行法医检查感到舒适。基于这些结果，为急诊医学住院医师开发了由 SANEs 领导的教育干预措施，包括一个讲座、两个标准化患者案例和法医骨盆检查模拟。干预前和干预后的调查显示，受访者自我评估避免使患者再次受到创伤的能力、进行法医检查的舒适度以及对法律和政策的理解有所提高。这些结果表明，医生和 SANEs 之间的专业合作在培训 ED 医护人员进行性侵犯患者护理方面具有价值。
