August 03, 2017

August Meeting Minutes

• Special thank you to Det. Hearitt for a job well done
• Introductions
• Speaker: Holly Franz, Coordinator for the Crisis Services Sexual Assault Forensic Nurse Examiner Program (SANE)
   o The SANE Program is in 8 hospitals in the Kaleida and Catholic Health System
   o Last year the SANEs got called to the hospitals 135 times and preformed 110 sexual assault forensic kits
      6 of the referrals were for individuals over 60
        • 3 of the 6 referrals had kits completed
           o The other 3 referrals did not because they were beyond the 96 hour post-assault window for evidence to be collected
        • 3 of the 6 referrals were from facilities
   o How the referral process works:
      A patient presents to the hospital, usually in the Emergency Department (ED) and during the triage process the patient says they have been sexually assaulted
      The patient will be immediately taken back to a private room
      The triage nurse calls Crisis Services to get a SANE to come out to the hospital
        • A SANE will not go if the 96 hour post-assault window has passed or if the patient says no to evidence collection
      Usually a SANE and an Advocate will meet at the hospital
      The SANE will get their own consent from the patient for the exam before starting and a patient can stop at any time
        • A Health Care Proxy (HCP) may or may not be able to give consent for someone with diminished capacity. Even if the HCP consents on the patient’s behalf, if the patient says no the exam, it will not be completed
        • This whole process is about giving power and control back to the patient
      The ED doctor assesses the patient prior to them meeting with the SANE
      The SANE will meet with the patient without any hospital staff or family present in the beginning to contract with the patient about who they want and do not want in the room
        • The SANE and the Advocate are typically in the room with a patient, unless the patient requests the Advocate to wait outside
      The SANE is only a visitor in the hospital so they cannot treat the patient. They can only make suggestions and recommendations to ED staff based on the patient’s feedback about what they want
      The SANE conducts a forensic interview, a forensic exam, and then does evidence collection
        • There are 15 steps to the evidence collection procedure and each step has its own envelope to store the evidence to avoid contamination
        • The evidence cannot be left unattended
        • A patient can say what they want and do not want to have collected
      The SANE and Advocate are with a patient for an average of 4.5-5 hours
      The Advocate can advocate for the patient in and out of the hospital room
      It is important to use the patient’s language when referring to anatomy and events, especially with older clients so they feel comfortable
        • Can use pointing if that is easier or more comfortable for the patient
 Discussion about whether or not there are any safeguards to keep registered sex-offenders away from all vulnerable populations
 Discussion about quality of care in nursing homes and Medicaid bed holds
o Next meeting is Tuesday, September 5, 2017 at 100 James E. Casey, Buffalo