A team of nurses, doctors, social workers, and psychologists at Minneapolis Children’s Medical Center (MCMC) has offered care for victims of child sexual abuse and their families for many years. However, until the present program was developed. this care did not include an evidentiary examination; instead, these patients were referred to another hospital. In 1987, MCMC decided to develop a program in the emergency department that would include an evidentiary examination. The evidentiary examination generally is performed when a child has indications of sexual assault that has occurred during the previous 72 hours. There are three major goals of this examination: (1) to treat, or protect the child from, injuries , disease, and possible pregnancy, (2) to provide crisis intervention and emotional support for the child and family, and (3) to gather evidence to support the child’s testimony in legal proceedings. At MCMC, the sexual assault evidentiary examination program would affect three major depart ments in the hospital: emergency, laboratory, and mental health. Although each department would have a major role in caring for individual victims, administrators from each area decided that the emergency department would coordinate and maintain the program. Roles of the multidisciplinary team m the emergency department were delineated. The ED clinical nurse would coordinate care of the sexual assault victim. She or he would offer privacy and reassurance to the child and family and explain the evidentiary examination. In addition, the nurse would notify the ED physician, the on-call mental health professional, the police department, and the family physician. During the examination the nurse would assist the physician with specimen collection, physical examination, and photographs. After the examination the nurse would arrange follow-up and complete the necessary chart forms. The physician would perform the physical examination, obtain cultures and specimens, and would be accountable for maintaining the chain of evidence for legal purposes. The on-call social worker or psychologist from the mental health department would remain with the child and/or parent throughout the examination, obtain the social history and a description of the perpetrator and assault circumstances from the parent or child, and see the family in follow-up. In addition, she would notify Child Protection Services of the incident as required by our particular state law. A Planning Committee was formed to develop a protocol and to plan and implement the program. It included a clinical nurse from the emergency department, a staff pediatrician, and a clinical nurse specialist from the emergency department.
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Sep 1, 1991
Gordon R Lewthwaite 
Open Access