College of Nursing, Pennsylvania State University, University Park, Pennsylvania.
J Rural Health. 2021 Jan;37(1):81-91. doi: 10.1111/jrh.12544. Epub 2020 Dec 6.
Sexual assault care provided by sexual assault nurse examiners (SANEs) is associated with improved health and prosecutorial outcomes. Upon completion of SANE training, nurses can demonstrate their experience and expertise by obtaining SANE certification. Availability of nurses with SANE training or certification is often limited in rural areas, and no studies of rural certified SANEs exist. The purpose of this study is to describe rural SANE availability.
We analyze both county-level and hospital-level data to comprehensively examine SANE availability. We first describe the geographic distribution of certified SANEs across rural and nonrural (ie, urban or suburban) Pennsylvania counties. We then analyze hospital-level data from semistructured interviews with rural hospital emergency department administrators using qualitative content analysis.
We identified 49 certified SANEs across Pennsylvania, with 24.5% (n = 12) located in 8 (16.7%) of Pennsylvania's 48 rural counties. The remaining 37 certified SANEs (75.5%) were located in 13 (68.4%) of Pennsylvania's 19 nonrural counties. Interview data were collected from 63.9% of all eligible rural Pennsylvania hospitals (n = 63) and show that 72.5% (n = 29) have SANEs. Of these, 20.7% (n = 6) have any certified SANE availability. A minority of hospitals (42.5%; n = 17) have continuous SANE coverage.
Very few SANEs in rural Pennsylvania have certification, suggesting barriers to certification may exist for rural SANEs. Though a majority of hospitals have SANEs, availability of SANEs was limited by inconsistent coverage. A lack of certified SANEs and inconsistent SANE coverage may place rural sexual assault victims at risk of receiving lower quality sexual assault care.
性侵犯护士检查师（SANEs）提供的性侵犯护理与改善健康和检控结果有关。完成 SANE 培训后，护士可以通过获得 SANE 认证来展示他们的经验和专业知识。在农村地区，通常缺乏接受过 SANE 培训或认证的护士，而且没有关于农村认证 SANEs 的研究。本研究的目的是描述农村 SANE 的可用性。
我们分析了县级和医院级别的数据，以全面检查 SANE 的可用性。我们首先描述了经过认证的 SANEs 在宾夕法尼亚州农村和非农村（即城市或郊区）县的地理分布。然后，我们使用半结构化访谈对农村医院急诊部管理人员进行了医院级别的数据分析，并进行了定性内容分析。
我们在宾夕法尼亚州发现了 49 名经过认证的 SANEs，其中 24.5%（n=12）位于宾夕法尼亚州 48 个农村县中的 8 个（16.7%）。其余 37 名经过认证的 SANEs（75.5%）位于宾夕法尼亚州 19 个非农村县中的 13 个（68.4%）。从所有符合条件的宾夕法尼亚州农村医院（n=63）中收集了 63.9%的访谈数据，显示其中 72.5%（n=29）有 SANEs。其中，20.7%（n=6）有任何认证的 SANE 可用性。少数医院（42.5%；n=17）有连续的 SANE 覆盖。
宾夕法尼亚州农村地区很少有 SANEs 获得认证，这表明农村 SANEs 可能存在认证障碍。尽管大多数医院都有 SANEs，但 SANEs 的可用性受到覆盖范围不一致的限制。缺乏经过认证的 SANEs 和不一致的 SANE 覆盖可能使农村性侵犯受害者面临接受低质量性侵犯护理的风险。
