Rationale:

• Sexual assault exams traditionally have been the responsibility of physicians, but nurses or nurse practitioners have been doing them more commonly since the early 1990s.
• Sexual assault nurse examiners are specifically dedicated to treating the patient who has experienced a sexual assualt, not tending to multiple patients in a busy practice.
• Designated practitioners may do a more comprehensive exam, provide more complete treatment, and consider the emotional needs of the patient more fully due to their extra time and training.

Evidence:

• Using sexual assault nurse examiners increases clinical interaction and leads to significant improvements in quality indicators, such as completeness of evaluation and information gathered relevant to medical-legal issues (54).
• Evidence collection kits prepared by sexual assault nurse examiners are more accurate and complete when compared with evidence collection kits prepared by nurses who are not sexual assault nurse examiners and physicians (55).
• Average assessment times are shorter for patients seen by sexual assault nurse examiners than for patients seen by physicians (approximately 3.25 hours vs. 4 hours). Physicians had more interruptions (25.1%) than did sexual assault nurse examiners (20.0%) (56).
• An analysis of the National Hospital Ambulatory Medical Care Survey found that sexual assault patients who received care in emergency departments rather than by expert sexual assault nurse examiners failed to receive prophylactic antibiotics most of the time (57). Additionally, the same data set showed that only 20% of patients seen in the emergency department received emergency contraception. Because most patients are likely to qualify, this implies substandard care compared to treatment by sexual assault nurse examiners programs (58).

Comments:

• None.