Enhancing the Accessibility of SANEs Using Telehealth Services Jillian Chapman, RN, BSN Xavier University MSN Poster, April, 2021

PURPOSE PROBLEM/ BACKGROUND METHODS

• Due to time constraints and the ongoing pandemic, To propose the intervention of telehealth services to • 1 in 6 women and 1 in 33 men have been victims of Case Presentation this intervention was only proposed, not carried out increase the accessibility of trained nurse sexual assault in their lifetime (RAINN, 2021). • Each nurse is provided a device secured with the HIPPA • The setting is a Forensics Department at a large examiners (SANEs) • Each year, there are roughly 300,000 reported cases of compliant TruTeleHealth Platform hospital system in north eastern Ohio sexual assault across the nation (RAINN, 2021) • When a case presents, a consult is made, following a • Patient population consists of adult sexual assault • Telehealth services offer a feasible and practical • Care for the sexual assault victim is a timely three-step process victims consenting to services alternative to in-person care that allows for the delivery circumstance that requires specialized care • Implementation of the intervention is done over a of proper and prompt care • Of the estimated 5,000 emergency departments, only three-phase process • Via telehealth, SANEs will directly see the patient and 900 have established SANE programs (Meunier-Sham • Phase One: walk the healthcare professional through the entire et al., 2019) • Establish technology at all locations interview and exam process • Train staff ▪ Telehealth offers the potential to: Barriers to the expansion of SANE programs • Phase two: (Clowers, 2018) • Define ethical, legal requirements • Ongoing national shortage, including the lack of • Apply for funding and grants specialty nurses such as SANES • Uphold Joint Commission and other • Delayed specialty recognition and acceptance • Success is to be measured by : regulatory requirements • Majority of patient consent to services • Difficult and pricey certification process • Gain stakeholder support • Lack of key stakeholder support • Phase three: • Increased Personnel satisfaction • SANE retention rates are exponentially low • Expand partnerships • Decreased exam length • Evaluate outcomes, make alternations FRAMEWORK OUTCOMES CONCLUSIONS RELEVANCE TO NURSING

Joanne Duffy’s Quality Caring Model Predictions made by the current staff The development and expansion of SANE programs are challenged by the nationwide , as well as • 100% of SANES were open to the implementation of the delayed acceptance of forensic nursing telehealth services • More than half believed telehealth would enhance • Sexual assault cases continue to rise nationwide caregiver satisfaction • The care of the sexual assault victim is a time sensitive • More than half believed telehealth would have a issue that requires access to trained professionals positive impact on staff turnover and burnout • SANES offer specialized, evidence- based training that • 75% of the SANEs stated telehealth would potentially supports the patient’s recovery process decrease overall exam length • The profession of nursing is ever evolving and so is the • 75% believed the service would decrease patient wait way in which healthcare is delivered to patients time • Telehealth offers a way to deliver proper and prompt real- time care Concerns of the current staff References Duffy et al., 2003. Clowers, N. (2018, December). Information on the Availability of Forensic Examiners. United States • Government Accountability Office. https://www.gao.gov/assets/700/695914.pdf. A middle-range theory that highlights the importance • 1/3 of SANEs expressed concerns over patient Duffy, J. R., & Hoskins, L. M. (2003). The Quality-Caring Model©: Blending Dual Paradigms. ANS. of relationships compliance and consent to services Advances in nursing science, 26(1), 77. Meunier-Sham, J., Preiss, R., Petricone, R., Re, C., & Gillen, L. (2019). Laying the Foundation for the • Telehealth focuses on relationship-centered patient • All SANEs reported concern regarding the effect National Center: Integration of the Quality-Caring Model Into TeleSANE Practice. Journal of Forensic Nursing, 15(3), 143–151. https://doi.org/10.1097/JFN.0000000000000252 and professional encounters telehealth would have on the overall court process and Miyamoto, S., Thiede, E., Dorn, L., Perkins, D., Bittner, C., & Scanlon, D. (2020). The Sexual Assault • Strong relationship development is essential in the prosecution rates Forensic Examination Telehealth Center: A Comprehensive, Nurse-led Telehealth Model to Address Disparities in Sexual Assault Care. The Journal of Rural Health, 1–22. care of the sexual assault victim • All SANEs expressed concerns for use with pediatric https://doi.org/10.111/jrh.12474 , Abuse, & Incest National Network (RAINN). (2020). Scope of the Problem: Statistics. patients Retrieved from https://www.rainn.org/statistics/scope-problem Walsh, W., Meuiner-Sham, J., & Re, C. (2019). Using Telehealth for Sexual Assault Forensic Examinations: A Process Evaluation of a National Pilot Project. Journal of Forensic Nursing, 15(3), 152–162. https://doi.org/10.1097/JFN.0000000000000254