(This is a guest blog post by Diane Diaber, Pediatric Training Specialist, International Association of Forensic Nurses.)
I am really excited to have been asked to introduce the National Protocol for Sexual Abuse Medical Forensic Examinations: Pediatric (Pediatric SAFE Protocol), and the Pediatric Protocol Technical Assistance Project, which will be called the KIDSta Project. The new OVW funded technical assistance project includes the KIDSta.org website and targeted technical assistance around the topics covered in the Pediatric Protocol.
The need for a Pediatric SAFE Protocol became apparent to the U.S. Department of Justice, Office on Violence Against Women (OVW) during the development of the 2004 and subsequent 2013 second edition of the National Protocol for Sexual Assault Medical Forensic Examinations: Adults/Adolescent. Recognizing that the care of the prepubescent child following sexual abuse is significantly different than that of the adolescent or adult, and responding to the need for a guiding document, OVW partnered with the International Association of Forensic Nurses (IAFN) to develop the Pediatric SAFE Protocol.
The Pediatric SAFE Protocol is designed as a guide for healthcare practitioners who conduct sexual abuse examinations on prepubescent children, and other professionals and agencies involved in the initial community response to child sexual abuse. The goal of the Pediatric SAFE Protocol is that evidence based, child-centered, promising practice recommendations will be adaptable to all jurisdictions and offer guidance in practice and policy development to promote a standardized response to the prepubescent sexual abuse medical forensic examination process.
With the assistance of an advisory committee made up of child abuse pediatricians, pediatric sexual assault nurse examiners (SANE’s), children’s hospitals, hospital emergency departments, children’s advocacy centers, community sexual assault victim advocacy programs, law enforcement agencies, prosecutors and various other groups that speak on behalf of specific populations, the following background work was completed:
- Identified relevant content experts and organizations for focus groups and protocol peer review.
- Gathered and reviewed supporting documents (existing protocols, guidelines and research).
- Identified current issues, gaps and controversies in the care and response to child sexual abuse.
- Identification of the broad components of the protocol.
- Consideration as to how to optimally design the protocol to be inclusive of the needs of victims with special circumstances, those in custodial settings and members of tribal communities.
Two work group meetings were held, during a wintery week in March of 2015. One with primarily health care subject matter experts, and the other with multidisciplinary subject matter experts. The goal of these work group meetings was to harvest the knowledge and expertise from the subject experts for development of the content to include in the Pediatric SAFE Protocol. Copious notes were taken, transcribed and embedded into the content of the Pediatric SAFE Protocol. Once the first draft was complete the document underwent a three tier review process by experts and governmental partners, who offered comments, justification and resources. Additionally, there were conference calls and e-mail communications with experts to clarify or supplement information. Comments from each tiered review were analyzed, researched and integrated into the Pediatric SAFE Protocol as appropriate.
To further supplement the recommendations of the Pediatric SAFE Protocol, the IAFN’s KIDSta Project will include the KIDSta.org website and provide education and personalized technical assistance on the topics included in the Pediatric SAFE Protocol. It is the intent that this OVW-funded technical assistance project will fill the gap that has existed for those who are responding to sexual assault in children.
In response to the needs of the community, many SANE programs are considering expanding their services to include child sexual abuse. Along with the Pediatric SAFE Protocol, and KIDSta.org, the IAFN and the NSVRC’s SANE Sustainability app offers sections on program Expansion Planning and Pediatrics. The SANE Sustainability Apple app will provide up to date resources at your fingertips, and Android users can find all the materials at NSVRC.