The number of nurses experienced in providing care to sexual assault victims has wavered over the years at Penn State Health Holy Spirit Medical Center.
Liz Knauss, nurse manager of the emergency department at Holy Spirit, said there were two good programs over the years with effective staffing, but recently, the hospital had only two Sexual Assault Nurse Examiners, or SANEs. With hospital leadership estimating that Holy Spirit sees about 45 sexual assault patients a year, Knauss said nurses felt afraid that any mistake could affect a criminal case.
“They felt very frustrated up until now,” she said. “It was so nerve-wracking [performing sexual assault exams]. They need specialized care. … We had two SANE nurses who worked here, so they weren’t here full-time.”
It’s not an uncommon scenario, especially at rural hospitals that may not have even one nurse with sexual assault training. With limited staffing, sexual assault survivors may end up having to wait hours for a trained nurse to see them or even get transferred to another hospital, something that is against state Department of Health regulations but happens when staff believe they have no other options.
It’s these kinds of obstacles to an already difficult time for patients that local health officials want to solve.
Penn State Health on Wednesday announced that Holy Spirit Medical Center and Hampden Medical Center are the latest in the health system’s partnership with Penn State’s Ross and Carol Nese College of Nursing to incorporate telehealth technology into sexual assault services that officials branded as the “new standard of care.”
The college offers SANE training to nurses at its Hershey campus, as well as its own experienced staff to help with exams via video through the college’s Sexual Assault Forensic Examination Telehealth (SAFE-T) Systems.
On Wednesday, Hampden Medical Center highlighted 11 trained nurses and Holy Spirit Medical Center honored nine trained nurses who officials hope will be retained and aided through this new program.
Telehealth service
Dr. Sheridan Miyamoto, an associated professor at the nursing college and director of SAFE-T, said they have a staff of 11 trained nurses who are available via rotation 24/7 to all partnering hospitals. Hampden and Holy Spirit medical centers along with two more Penn State Health hospitals later this year will round out the current partnerships to eight hospitals in the state.
These nurses via a cart equipped with secure technology will be able to talk to patients, view photographs of the exam immediately upon them being taken by the local nurse and guide a nurse during the exam to make sure all possible evidence is collected and noted.
Miyamoto said the extra help is a boon for a process that can be very complicated.
“They’ll see the patient’s body in real time … and make sure they don’t miss an opportunity to collect evidence. Because we don’t get another moment to get that,” she said.
Miyamoto said an on-site nurse conducting an exam is usually tasked with following a rape kit that involves a lot of documentation — nearly 20 pages worth. With examination and interviews, an exam can take three to five hours.
With as much data as they’re collecting, Miyamoto said a second pair of eyes doesn’t just help with the exam and with the criminal forensic investigation, it also helps give more attention to a patient while the in-person nurse may be working on documentation.
She said that in surveys of the first 76 patients who experienced the telehealth program, 95% felt better after the exam, 92% felt telehealth improved their quality of care, and 91% rated local care as either “very good” or “excellent.”
That kind of support is what Miyamoto hopes the local community will see at partnering rural hospitals, and with the recent launch at the two local Penn State Health hospitals. Hampden Medical Center nursing staff went through a course in less than 30 days to make sure the telehealth service was operational by the time it opened on Oct. 1. Holy Spirit launched its telehealth program on Wednesday with a celebration.
Technology and expansion
Even though the SAFE-T System is relatively new, the technology has grown since its first equipment was built in 2017.
Jon Essick, IT manager for SAFE-T Systems, said the college moved to create its own technology and device because of the lack of options in the field. Building off of cameras and colposcopes used for sexual assault investigations for decades, Essick said they were looking for something easier for staff to use and that didn’t pose a security issue with transferring photographs or data.
The first telehealth cart developed in 2017 was a start in improving some features, but Essick said the carts being used now by partnering hospitals are much easier to use, are secure and far more capable of taking magnified photos.
As the technology improves, the staff are also looking forward to expanding these kinds of services.
Miyamoto said the first hospitals that employed the SAFE-T Systems were rural hospitals. Those like Hampden and Holy Spirit medical centers coming on now are more suburban and are entering a contract to help alleviate costs not covered by grants.
The program was initially funded through the Department of Justice’s Office for Victims of Crime, and U.S. Health Resources & Services provides funding to offset the costs of SANE training for nurses. The college is using hospital contracts to help cover costs not covered by grants.
Miyamoto said, however, that hospital contracts wouldn’t be of interest to rural hospitals that don’t have the sexual assault patient load as other more urban hospitals, so she hopes other funding, such as those proposed in state Senate Bill 1172, will be made available to make sure any hospital has the opportunity to partner with the program.
“Everyone should have access to this level of care, no matter where they live,” Miyamoto said. “I think telehealth is going to be the answer.”
SAFE-T Systems currently helps sexual assault survivors 12 and older, though Miyamoto said they are looking at creating a pediatric program, as well. Currently, Hampden and Holy Spirit medical centers partner with Penn State Health Milton S. Hershey Medical Center to offer pediatric sexual assault services. Hershey Medical Center itself became a partner with SAFE-T Systems in 2019.
