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Sexual Assault Service Resources

Manual

Sexual Assault Service Protocols and Tools

The Sexual Assault Service Protocols and Procedures Manual is a guide to responding to sexual assault in a health care setting. Protocols are shared as a reference for use in other settings.

The following materials have been developed for use within BC Women's Hospital and Health Centre. There are support systems at BC Women's Hospital and Health Centre that may not exist in other clinical settings; therefore adoption of materials by outside agencies are not the responsibility of BC Women's Hospital and Health Centre. Information is provided for reference only. All materials are the property of BC Women's Hospital and Health Centre and may only be reprinted in whole or in part with our express permission.

 If you would like more information about any of our resources, please contact (604) 875-2881.

For Health Care Providers:

SAS pamphlet Oct 2017

Information for patients about what to do after a sexual assault, care at Vancouver General Hospital or the UBC Urgent Care Centre, and common feelings after a sexual assault.  A list of local resources is included. This pamphlet is available in multiple languages.

SAS booklet for Survivors of Sexual Assault 2017

A patient aftercare booklet that includes information about medical care, the legal system, and common feelings after a sexual assault. A list of resources across BC is included. Available here in pdf, or can be ordered ready-to-read, from our service.

Additional Resources:
Guidelines

The following guidelines have been developed for use within BC Women's Hospital and Health Centre. There are support systems at BC Women's Hospital and Health Centre that may not exist in other clinical settings; therefore adoption of materials by outside agencies are not the responsibility of BC Women's Hospital and Health Centre. Information is provided for reference only.

Support Tools

Decision Support Tools (DST) for Sexual Assault Nurse Examiners (SANE) 

The following decision support tools (DST), competencies and other documents have been developed to assist RN working as sexual assault nurse examiners (SANE) to assess risk of exposure to sexually transmitted infections (STI) including HIV, and safely dispense appropriate prophylactic agents to prevent infection following a sexual assault. Dispensing immunoprophylactic agents and post-exposure chemoprophylactic agents for the purpose of preventing infection is a Section 6 restricted activity with limits and conditions as set out in the Nurses (Registered) and Nurse Practitioners Regulation under the Health Professions Act.

CRNBC Limit and Condition

Registered nurses who compound, dispense or administer immunoprophylactic or chemoprophylactic agents to prevent infection following sexual assault must either:

  • possess the competencies established by the BC Women's Sexual Assault Service (BCW SAS) and follow decision support tools established by BCW SAS [Note: This applies to sexual assault nurse examiners] or
  •  possess the competencies established by the BC Centre for Disease Control (BCCDC) and follow DST established by BCCDC. [Note: This will apply to registered nurses who hold CRNBC certification in STI management]
The competencies and DST that follow are those established by BCW SAS for use by SANE.

Application Parameters

DST and other documents have been developed for SANE working in hospital-based emergency departments with access to an emergency physician, attending patients age 13 and over who have been sexually assaulted within the previous seven days. RN must have employer support to use these DST.

SANE refer to the emergency physician for patient-specific medication orders when the patient is pregnant or breastfeeding. It is recommended that RN utilizing the DST and other related documents follow established criteria for referral and transfer of care to the emergency department physician.

While every effort has been made to assure accuracy of the information, data, or material contained in these documents, the developers assume no legal liability or responsibility for the completeness or accuracy of any of the information.

Context for the Use of These Documents
Assessment of risk of exposure to STI including HIV, and safely dispensing appropriate prophylactic agents is one aspect of sexual assault patient care. Other prophylactic medications to be considered following a sexual assault may include the progesterone-only emergency contraceptive pill (ECP). Dispensing ECP is not covered in this DST.

Comprehensive sexual assault care is much broader than offering prophylactic medication and includes both general competencies and core competencies. General competencies include:

  • Providing sexual assault crisis counselling, advocacy and support
  • Performing sexual assault health assessment and examination
  • Explaining sexual assault medical-forensic options
  • Offering preventative health care options
  • Offering appropriate community referrals
  • Collecting and managing forensic samples
  • Providing credible court testimony
  • Interacting appropriately with other sexual assault related services
These general competencies are to be understood and applied in a manner that reflects foundational concepts central to best practice in sexual assault. These foundational concepts are reflected in the following core competencies:

  • Understanding the social context of sexual assault
  • Understanding and applying principles of women-centred-care

Instruction in comprehensive sexual assault care reflecting all of these competencies is beyond the scope of the following DST and accompanying documents.

DST are evidence-based documents used to guide the assessment, diagnosis and treatment of client-specific clinical problems or potential problems. When decision support tools are used to direct practice, they are used in conjunction with clinical judgment, available evidence, and possible discussion with colleagues. Nurses also consider individual patient needs and choice when using DSs to make clinical decisions. 

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