| Description |
Sexual assault has been linked to many long-term health consequences, such as depression, anxiety, post-traumatic stress disorder (PTSD), pain, injuries, sexually transmitted infections (STIs), pregnancy, increased inflammation, hypertension, and poorer overall health. Despite these health concerns, only 35-40 % of survivors attend the recommended follow-up care after an initial exam done by a sexual assault nurse examiner (SANE). Local Problem: In response to this challenge, a sexual assault nurse practitioner in the Salt Lake Area initiated a dedicated clinic day in 2022 to provide follow-up care for sexual assault survivors. However, despite establishing this clinic and allocated funding, fewer than five percent of survivors utilized the clinic for follow-up care, indicating a significant gap between the availability of services and survivors' utilization of recommended post-assault care. Method: A DNP midwifery student conducted a quality improvement project to help. This project aimed to improve follow-up care for individuals who have experienced sexual assault in Salt Lake, Utah, Wasatch, and Summit counties, specifically those who underwent an initial sexual assault examination with Wasatch Forensic Nurses, by implementing a standardized approach to follow-up care (during the initial examination) based on available local resources. Intervention: The creation of the new follow-up approach consisted of several stages. Initially, research on the topic was conducted, and meetings with key community stakeholders were held. Following this, a chart review and pre-survey were carried out to identify gaps in care and knowledge regarding follow-up (Phase I). With this data, a tailored follow-up approach for sexual assault survivors was developed (Phase II) and presented during comprehensive training delivered across multiple monthly staff meetings (Phase III). The final stage (Phase IV) consisted of conducting a post-intervention chart review and administering a post-intervention survey to evaluate feasibility, usability, and satisfaction. Results: Pre- and post-survey used. Thirteen participants were matched for each person who completed both surveys. Results indicated that 92% (n=12) were "very likely" to discuss the purpose of follow-up care post-intervention, which increased by 30% (n=8) pre-intervention. One hundred percent (n=13) reported believing follow-up care was "very important," up from 61% (n=8) pre-survey, and 86% (n=13) "strongly agreed" or "agreed" that the new approach would change how they discuss follow-up moving forward. Furthermore, chart reviews revealed a slight increase in documentation regarding follow-up care. Moreover, there was a notable statistical rise in the documentation related to STI testing specifically as a crucial indication for follow-up care (x2 (1) = 6.08, p < .05). Conclusion: Implementing a standardized approach to follow-up care for sexual assault victims based on available resources proved to be a valuable intervention. From this project, SANE nurses increased their knowledge of potential post-sexual assault complications and committed to changing how they approach follow-up care with their patients. This project can be sustainable for future use, as feedback indicated it was both "informative" and "helpful to practice." |
