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Emergency Department Preparedness to Care for Sexual Assault Survivors: A Nationwide Study.
- Source :
- Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health; May2023, Vol. 24 Issue 3, p629-636, 8p
- Publication Year :
- 2023
-
Abstract
- Introduction: Emergency departments (ED) provide trauma-informed care to sexual assault (SA) survivors and connect them with comprehensive services. Through surveying SA survivor advocates, we aimed to 1) document updated trends in the quality of care and resources offered to SA survivors and 2) identify potential disparities according to geographic regions in the US, urban vs rural clinic locations, and the availability of sexual assault nurse examiners (SANE). Methods: We conducted a cross-sectional study between June-August 2021, surveying SA advocates who were dispatched from rape crisis centers to support survivors during ED care. Survey questions addressed two major themes in quality of care: staff preparedness to provide traumaresponse care; and available resources. Staff preparedness to provide trauma-informed care was assessed through observations of staff behaviors. We used Wilcoxon rank-sum and Kruskal-Wallis tests to analyze differences in responses according to geographic regions and SANE presence. Results: A total of 315 advocates from 99 crisis centers completed the survey. The survey had a participation rate of 88.7% and a completion rate of 87.9%. Advocates who indicated that a higher proportion of their cases were attended by SANEs were more likely to report higher rates of traumainformed staff behaviors. For example, the recalled rate of staff asking patients for consent at every step of the exam was significantly associated with SANE presence (P < 0.001). With respect to access to resources, 66.7% of advocates reported that hospitals often or always have evidence collection kits available; 30.6% reported that resources such as transportation and housing are often or always available, and 55.3% reported that SANEs are often or always part of the care team. The SANEs were reported to be more frequently available in the Southwest than in other US regions (P < 0.001) and in urban as opposed to rural areas (P < 0.001). Conclusion: Our study indicates that support from sexual assault nurse examiners is highly associated with trauma-informed staff behaviors and comprehensive resources. Urban-rural and regional disparities exist regarding access to SANEs, suggesting that elevating nationwide quality and equity in care of survivors of sexual assault requires increased investments in SANE training and coverage. [ABSTRACT FROM AUTHOR]
- Subjects :
- KRUSKAL-Wallis Test
DIVERSITY & inclusion policies
HOSPITAL emergency services
HEALTH services accessibility
PATIENT advocacy
ACADEMIC medical centers
RURAL conditions
CROSS-sectional method
SEXUAL assault nurse examiners
MANN Whitney U Test
SURVEYS
MEDICAL care use
SEX crimes
QUALITY of life
QUESTIONNAIRES
DESCRIPTIVE statistics
HEALTH equity
METROPOLITAN areas
THEMATIC analysis
HOUSING
TRANSPORTATION
Subjects
Details
- Language :
- English
- ISSN :
- 1936900X
- Volume :
- 24
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
- Publication Type :
- Academic Journal
- Accession number :
- 163771715
- Full Text :
- https://doi.org/10.5811/westjem.59257