This collaboration is somewhat unusual because St Vincent Mercy Medical Center and The Toledo Hospital are the two largest, competing acute care facilities in the Toledo area. A 40-hour SART course was developed on the basis of existing programs in Tulsa, Okla, Amarillo, Tex, and Akron, Ohio. When SANEs are on duty in the emergency department they provide primary care for sexually assaulted patients. The nurse, patient advocate, and police are notified by telephone or pager system if they are not at the hospital. The SANE obtains a basic history and assessment before consulting the attending physician for prophylactic antibiotics, pregnancy prevention, or other orders and develops a specific patient plan of care.
All patients meet with the physician at some time before, during, or after the examination.
The program requires that a physician examine the patient for specific injuries or when pre-existing histories such as genital bleeding, pregnancy, insertion of a foreign object, difficulty breathing, or loss of consciousness are present, or when the patient is younger than 14 years. Nurses may request that a physician examine the patient or perform pelvic examinations as needed. The nurse-physician relationship was extremely important to the inception of the program. January, March, July, and August were the busiest months, with 14 to 17 patients examined each month. The increase in sexual assault during the summer months was expected.