By Jennifer A. Korkosz, DNP, WHNP-BC
Across the United States, women who seek immediate care following sexual assault can expect to receive thorough and uniform care in a variety of clinical settings. This approach to the acute care of sexual assault survivors comes as a result of the evolving and growing role of sexual assault nurse examiners (SANEs)—nurses who are educated and prepared to follow standardized guidelines and criteria. However, the follow-up care that sexual assault survivors receive from their regular healthcare providers (HCPs) can vary greatly. Many women receive inadequate post-assault care, which may compromise their recovery and even exacerbate the aftereffects of an already harrowing experience. Ensuring that follow-up examinations are every bit as thorough and uniform as the initial care should be a priority for HCPs.
Incomplete or inadequate care in the weeks and months following a sexual assault can lead to long-term physical and mental sequelae. To limit these sequelae, clear-cut standardized clinical guidelines are needed. Using current national recommendations and reports from experts in the field,1-12 together with her own clinical experience and input and advice of 17 community-based advanced practice nursing colleagues who comprised a focus group, the author developed and copyrighted a clinical practice guideline tool that can be used in primary care practices. This tool—a Clinical Flow Sheet Post Sexual Assault©—incorporates all aspects of a patient’s recovery and well-being to support a holistic recuperation.
Jennifer A. Korkosz is Assistant Professor at the Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, in Bethesda, Maryland. The views expressed in this project are those of the author and do not reflect the official policy or position of the United States Air Force, Department of Defense, or the U.S. government.
References
1. Ackerman DR, Sugar NF, Fine DN, Eckert LO. Sexual assault victims: factors associated with follow-up care. Am J Obstet Gynecol. 2006;194(6):1653-1659.
2. Bates CK. Patient Information: Care After Sexual Assault (Beyond the Basics). 2012. http://www.uptodate.com/contents/care-after-sexual-assault-beyond-the-basics
3. Coker AL, Davis KE, Arias I, et al. Physical and mental health effects of intimate partner violence for men and women. Am J Prev Med. 2002;23(4):260-268.
4. Kapur NA, Windish DM. Health care utilization and unhealthy behaviors among victims of sexual assault in Connecticut: results from a population-based sample. J Gen Intern Med. 2011;26(5):524-530.
5. Linden JA. Clinical practice: care of the adult patient after sexual assault. N Engl J Med. 2011;365(9):834-841.
6. McCall-Hosenfeld JS, Freund KM, Liebschutz JM. Factors associated with sexual assault and time to presentation. Prev Med. 2009;48(6):593-595.
7. Mishel MH. Theories of uncertainty in illness. In: Smith MJ, Liehr PR, eds. Middle Range Theory for Nursing. 3rd ed. New York, NY: Springer Publishing Company; 2014:53-86.
8. Wadsworth P, Van Order P. Care of the sexually assaulted woman. J Nurse Pract. 2012;8(6):433-440.
9. Zinzow HM, Resnick HS, Barr SC, et al. Receipt of post-rape medical care in a national sample of female victims. Am J Prev Med. 2012;43(2):183-187.
10. Prins A, Ouimette P, Kimerling R. Primary Care PTSD Screen (PC-PTSD). 2003. http://www.ptsd.va.gov/professional/assessment/screens/pc-ptsd.asp
11. Maurer DM. Screening for depression. Am Fam Physician. 2012;85(2):139-144.
12. Spitzer RL, Kroenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety disorder. Arch Intern Med. 2006;166:1092-1097.