All hospital staff who interact with patients who are victims of sexual assault should practice trauma-informed principles of care. This means being able to provide nonjudgmental and compassionate care immediately while providing options to the patient about what services are available. Staff who are in a position to receive a disclosure from a victim of sexual violence (emergency department triage personnel and nurses, labor and delivery nurses, and other nursing staff) should be aware of local reporting policies and the procedures for activation of the SANE, advocacy, and other team members as directed by local protocols. This process may be more complex for minors who have experienced sexual victimization by not only peers or strangers, but also, more commonly, by relatives or caregivers. As a result, the response may include not only the SANE or forensic medical providers and law enforcement, but also child welfare. Because of this additional complexity, establishing intra-organizational collaboration within a hospital system is imperative. The collaboration may include clinical pathways that provide direction to the frontline emergency department staff, with specific instructions for who to contact under what circumstances, and clinical care sets that delineate routine labs and medications needed for victims of sexual violence. Patients should be able to wait in a safe, comfortable space. Patients should not be denied the opportunity to void or eat pending the forensic kit. Instead, the appropriate staff should assist the victim with urine collection and store it in a forensically sound manner.
Screening for Interpersonal Violence: Requirements of the Joint Commission
The Joint Commission, an accrediting organization that oversees health care organizations and programs in the United States, includes a standard (Standard PC.3.10) for the identification of victims of abuse who may present to any area of the facility. If your hospital is accredited by the Joint Commission, the hospital should have a copy of the complete standards. There should already be a facility-wide policy or criteria developed/in use for identifying these victims. SANE program managers may be instrumental in developing, instituting, and educating staff on the policy and the implications of trauma on patients who are treated in the facility. There are seven elements identified in Standard PC.3.10:
All cases of abuse or neglect must be reported immediately within the hospital.