Similarly, the video educates patients on the path of the sexual
assault kit, should they pursue a subsequent criminal charge.
With a nationwide backlog of rape kits, only those with an
attached crime report are reviewed.
Offering Financial Assurance
Patients also worry about paying for the sexual assault exam or
ED visit. This increasingly enters the equation as outreach about
sexual assault on college campuses has yielded more reports
from undergraduates. College and high school students
frequently question clinicians on the rules about informing
parents or express reluctance to undergo a sexual assault exam,
lest parents discover the incident by receiving an insurance bill.
With patients’ financial burdens so often discussed, nurses
insisted the video include information about Pennsylvania’s
Victims Compensation Assistance Program.
“Because of this law, all aspects of the sexual assault exam are
fully compensated and no patient ever receives a bill,” said
Tammy Bimber, MSN, RN, CEN, SANE-A/P. “It covers any evidence
collection and prophylactic medication for sexually transmitted
As the program covers only the exam and minor injuries that
don’t require X-ray testing, some related procedures – such as
CT scans for patients who were unconscious during the assault
– are billed. Here too, it’s emphasized that patients have options
as far as how to proceed.
“Every patient decides for himself or herself whether insurance
should be billed or not,” Bimber said.
Fighting STDs and Unwanted Pregnancy
While nurses communicate throughout the film about the
patient’s right to choose, they also accentuate the importance of
getting a timely prophylactic medication.
“Statistically, we know the chances of seeing victims again is
low post-discharge,” Simonian said. “We want to give the first
dose of the prophylactic as soon as possible in the ED to prevent
gonorrhea or chlamydia. We can start the series for hepatitis B
in the ED, but it requires follow-up. If the patient has a high risk
for HIV, we start on a 30-day prophylactic, but it requires
Approximately 98 percent of patients facilitywide opt for the
morning-after pill. “If there’s one thing they’re looking for, it’s
emergency contraception,” Simonian said. Still, approximately 5
percent of patients nationwide become pregnant after a sexual
In addition to educating patients and informing the community
about UPMC resources, the video may further increase the
exposure of SANEs. “Our video has been very well-received, and
we’ve had a lot of interest from colleagues in patient advocacy,
law enforcement and academia,” Krasneski-Schreiber said. n
By Robin Hocevar
ENA Connection Contributor
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