Seminal Literature

The following materials have been collected to provide critical information relevant to Sexual Assault Nurse Examiner (SANE) program sustainability. For information on how to obtain print copies of these documents, submit a request to the NSVRC team.

A National Protocol for Sexual Assault Forensic Medical Exams
U.S. Department of Justice, Office on Violence Against Women. (2004).
This first National Protocol for Sexual Assault Medical Forensic Examinations provides detailed guidelines for criminal justice and health care practitioners in responding to the immediate needs of sexual assault victims.

Evaluation and Management of the Sexually Assaulted or Sexually Abused Patient
American College Of Emergency Physicians. (1999).
Provides a set of useful and practical recommendations to standardize the evaluation and management of sexual assault patients.

Excellence in Forensic Practice: A Clinical Ladder Model For Recruiting and Retaining Sexual Assault Nurse Examiners (SANEs)
Sievers, V., & Stinson, S. (2002). Journal of Emergency Nursing, 28(2), 172-175.
The clinical ladder model provides five levels of an assigned salary scale aimed at dealing with the challenging frequently discussed problem of retaining experienced forensic nurses in programs.

Guidelines for Medico-Legal Care for Victims of Sexual Violence
World Health Organization. (2004).
These guidelines will be of interest to a wide range of health care professionals who come into contact with victims of sexual violence or have the opportunity to train health care providers that will attend victims of sexual violence. These guidelines can be used as a day-to-day service document and/or as a tool to guide the development of health services for victims of sexual violence. Additionally, this resource can be used to prepare in-service training courses on sexual violence for health care practitioners and other members of multidisciplinary teams.

Organizational Characteristics of Sexual Assault Nurse Examiner Programs: Results from the National Survey Project
Campbell, R., Townsend, S. M., Long, S. M., Kinnison, K. E., Pullet, E. M., Adames, S. B., & Wasco, S. M. (2005). Journal of Forensic Nursing, 1(2), 57-64.
Sexual Assault Nurse Examiner (SANE) programs throughout the United States were contacted to participate in in-depth telephone interviews about program operations and services for sexual assault patients. Programs that had been in operation 5 years or less at the time of this study are compared to older programs to examine trends.

Report on the National Needs Assessment of Sexual Assault Response Teams National Sexual Violence Resource Center. (2006).
This report provides results from a national survey developed to assess how local, state, territory and tribal communities respond to victims of sexual violence, particularly in the development of SART teams.

Responding to Sexual Assault Victims’ Medical and Emotional Needs: A National Study of the Services Provided by SANE Programs
Campbell, R., Townsend, S. M., Long, S. M., Kinnison, K. E., Pulley,E. M., Adames, S. B., & Wasco, S. M. (2006). Research in Nursing and Health, 29(5), 384-398.
This article measured the consistency with which a national random sample of 110 Sexual Assault Nurse Examiner (SANE) programs provided 17 services to sexual assault victims. SANE programs consistently offered forensic evidence collection, sexually transmitted infection (STI) prophylaxis, information on HIV, information on pregnancy risk, and referrals to community resources. Reasons programs did not routinely offer particular services (e.g., STI cultures, HIV testing/prophylaxis, emergency contraception (EC)) included financial constraints, difficulties balancing medical care with legal prosecution, and affiliations with Catholic hospitals.

The Adverse Childhood Experiences (ACE) Study
The ACE Study is an ongoing collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente. Led by Co-principal Investigators Robert F. Anda, MD, MS, and Vincent J. Felitti, MD, the ACE Study is perhaps the largest scientific research study of its kind, analyzing the relationship between multiple categories of childhood trauma (ACEs), and health and behavioral outcomes later in life.

The Effectiveness Of Sexual Assault Nurse Examiner (Sane) Programs: A Review of Psychological, Medical, Legal, and Community Outcomes
Campbell, R., Patterson, D., & Lichty, L. F. (2005). Trauma, Violence, & Abuse, 6(4). 313-329.
This article reviews the empirical literature regarding the effectiveness of SANE programs in five domains: (a) promoting the psychological recovery of survivors, (b) providing comprehensive and consistent postrape medical care (e.g., emergency contraception, sexually transmitted disease [STD] prophylaxis), (c) documenting the forensic evidence of the crime completely and accurately, (d) improving the prosecution of sexual assault cases by providing better forensics and expert testimony, and (e) creating community change by bringing multiple service providers together to provide comprehensive care to rape survivors. Preliminary evidence suggests that SANE programs are effective in all domains, but such conclusions are tentative because most published studies have not included adequate methodological controls to rigorously test the effectiveness of SANE programs. Implications for practice and future research are discussed.

Sexual Assault Nurse Examiner (SANE) Program Goals and Patient Care Practices
Patterson, D., Campbell, R., & Townsend, S. M. (2006). Journal of Nursing Scholarship, 38(2), 180-186.
The purpose of the study was to examine Sexual Assault Nurse Examiners (SANE) programs’ goals and guiding philosophies and how they influence patient care practices for sexual assault victims.

Sexual Assault Nurse Examiner (SANE) Programs: Alternative Systems for Service Delivery for Sexual Assault Victims
Ahrens, C. E., Campbell, R., Wasco, S. M., Aponte, G., Grubstein, L., & Davidson, W. S. (2000). Journal Of Interpersonal Violence, 15(9), 921-943.
In this article, two recently established SANE programs are studied in depth to reveal how rape crisis centers in different communities created these services. Factors associated with the successful implementation of these SANE programs included (a) strong organizational history, (b) use of sexual assault councils and task forces, (c) affiliation with larger organizations, (d) positive relationships with hospitals, (e) engaging in training and collaboration with community systems, and (f) strategies for resolving differences. Implications for the health care of sexual assault victims are discussed.

This project was supported by Grant No. 2006-WT-AX-K052 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women.