Factors Affecting Telemedicine Implementation in Emergency Departments and Nurses' Perceptions of Virtual Sexual Assault Nurse Examiner Consultation for Sexual Assault Survivors.
M Kathryn Allison, Geoffrey M Curran, Wendy A Walsh, Emily R Dworkin, Melissa J Zielinski
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Abstract
Introduction: Emergency department (ED) nurses play a critical role in caring for sexual assault patients, but many have not received training on how to conduct a proper sexual assault forensic medical examination. Live or real-time sexual assault nurse examiner (SANE) consultation provided via telemedicine (known as "teleSANE") during sexual assault examinations is a promising new practice to address this issue.
Purpose: The purpose of this study was to assess ED nurses' perceptions of influences on telemedicine use, as well as the utility and feasibility of teleSANE, and identify potential influences on teleSANE implementation in EDs.
Methods: Guided by the Consolidated Framework for Implementation Research, this developmental evaluation involved semistructured qualitative interviews with 15 ED nurses from 13 EDs.
Results: Interviews revealed facilitators and barriers to current telemedicine use across Consolidated Framework for Implementation Research levels. Facilitators included state-level grant funding and technical assistance. Barriers included clinician discomfort being on video and access to ongoing training. Participants believed teleSANE consultation would improve patient care and forensic evidence collection but had concerns for patient privacy and acceptability. Most participants worked in EDs that have the information technology support and telemedicine equipment needed to support teleSANE implementation, although many requested ongoing education and trainings on teleSANE and sexual assault care to improve clinician confidence and account for high staff turnover.
Discussion: Findings highlight the unique needs of sexual assault survivors receiving telemedicine services in EDs, particularly those in rural communities with heightened privacy concerns and limited access to specialty care.
期刊介绍：
The Journal of Forensic Nursing (JFN) the official journal of the International Association of Forensic Nurses, is a groundbreaking publication that addresses health care issues that transcend health and legal systems by articulating nursing’s response to violence. The journal features empirical studies, review and theoretical articles, methodological and concept papers, and case reports that address the provision of care to victims and perpetrators of violence, trauma, and abuse. Topics include interpersonal violence (sexual assault, abuse, intimate partner violence); death investigation; legal and ethical issues; forensic mental health nursing; correctional nursing; and emergency and trauma nursing.
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