The Implementation of the Sexual Assault Forensic Examination Telehealth Center: A Program Evaluation.
Sheridan Miyamoto, Elizabeth Thiede, Elizabeth N Wright and 5 others
PMID 34132652WHAT IT FOUND
Local nurses delivered sexual assault exams with remote expert support in three rural hospitals.
Three eligible patients declined telehealth; nurse confidence rose, and hospitals made system changes, but there was no comparison group.
Key findings
01Among the 8 local nurses who completed follow-up, confidence significantly increased for compassionate support (p < .0001), complete forensic examination (p = .027), and quality images (p = .016).
02Patients rated the telehealth-supported exam positively: 78% agreed or strongly agreed it improved care, 74% agreed or strongly agreed it helped them feel better, and 83% rated care excellent or very good.
03Partner hospitals reported an average of 34 system-level changes per site, including paid on-call systems and recruitment of at least 4 local nurses.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study had no concurrent control group, so changes cannot be compared with hospitals that did not use telehealth. Only 3 rural hospitals were included, and they were chosen because they already wanted to improve sexual assault care and had administrative support, so results may not apply elsewhere. The patient sample was small: 23 eligible patients were analysed, and rural sites generated few cases in the first year. Only 8 local nurses completed the year-one confidence survey, and 3 nurses left early, so confidence findings rest on a small follow-up group. Surveys were developed for the project and used self-reported Likert ratings; missing answers were dropped rather than modelled. The paper reports preliminary first-year trends and says more cases and future comparison sites are needed.
Declared interests
The SAFE-T Center was created with funding from the Department of Justice, Office for Victims of Crime. The supplied text does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not conclude that telehealth consultation improves sexual assault exam quality or patient recovery. The study had no comparison group, only 23 patients were analysed, only 8 nurses completed follow-up, and the main positive results were self-rated confidence and satisfaction.