We are all aware that sexual assault and intimate partner violence will more than likely increase due to the current COVID-19 pandemic. However, the capacity of hospitals is likely to vary across the state as illness and hospitalizations continue to rise. Local programs should check in remotely with their SARTs and hospital partners to discuss modifying protocols for providing hospital advocacy and sexual assault forensic exams during this pandemic. Please note, many hospitals around the state are limiting the number of support persons and visitors who can accompany patients and advocates may need to plan to provide support via a telemedicine portal or via phone.

COVID-19 has forced us to completely change the way we approach both our advocacy and prevention efforts. However, we are all aware that sexual violence does not stop, even as it seems our world has to some degree. To ensure we are still connecting to survivors with a trauma-informed lens, OAESV has created a hospital advocacy video that Sexual Assault Nurse Examiners and other medical professionals can show survivors when they present at the ED, since most of our advocacy programs are currently offering tele-advocacy services. We want to be very clear; this video is in no way meant to replace advocates, or hospital advocacy, but instead will provide a more personable look into advocacy by detailing what programs can offer survivors. We want survivors to see a friendly face, the face of advocates in Ohio. Please feel free to share with your local hospital partners, or even use this as a template to create your own videos.

West Virginia Foundation for Rape and Information Services also ran and evaluated a mobile SANE unit pilot project. Their final report may offer some tips and guidance for communities looking to implement something similar.

In conversation with a representative from the International Association of Forensic Nurses (IAFN), they shared the following tips as well:

Please encourage your advocates to connect with their SART members to ensure coordination of services and to modify current protocol responses. Some information for them to discuss includes:

• Is the hospital restricting access to “non-essential” visitors, and what does that mean for advocates responding to the hospital?

• Has the advocacy program modified its services in any way (e.g. telephone services only?)
• Do advocates feel comfortable and safe responding to hospitals in-person right now? And if not, can they provide hospital advocacy via phone?
• If an advocate is unable to provide in-person hospital response, work the hospital to create a plan that allows them to provide hospital advocacy to the survivor via phone.
• If a survivor has an opportunity to speak with an advocate via phone, please ensure the survivor is able to talk with the advocate in a private location at the hospital that promotes confidentiality.
• If a survivor does not have access to a phone at the hospital, please coordinate with your local hospital and SANEs to have the survivor complete the “ED Consent for Sexual Assault Advocacy” form to be faxed over to your advocacy program to ensure coordination of follow-up services.

Please also encourage your advocates to take guidance directly from local health officials.  However, if needed, please support them in advocating on behalf of survivors that medical care following sexual violence is to be considered a medical emergency and not an elective procedure.  We all must be creative and flexible so that access to patient care is not compromised or delayed.

Some resources that may be helpful:

IAFN’s COVID page: https://www.forensicnurses.org/page/covid

The Emergency Nurses Association https://www.ena.org/practice-resources/COVID-19

Please find below some updated guidance from the International Association of Forensic Nurses

• Video from IAFN discussing collaborating with advocacy during the COVID-19 pandemic
• Video from IAFN discussing medical forensic care options during the COVID-19 pandemic

Dangers of DIY Kits

IAFN also posted an update recently saying that nurses are receiving renewed marketing for do-it-yourself evidence collection kits. They released a video explaining why these kits are not best practices in the interest of survivors. Their statement includes the following simple explanation that may be useful for coalitions continuing to field questions about these kits as well:

“We know some forensic nurse examiner programs have received updated marketing information regarding at-home evidence collection kits. We first addressed this issue in August of 2019 when they were being marketed to college campuses and individuals.

Despite our current circumstances and challenges, do-it-yourself evidence collection kits continue to be a poor practice that provide no healthcare benefit to the patient.

These kits provide no option for pregnancy or sexually transmitted disease prevention, no opportunity for the clinician to assess related short- and long-term health issues, and no opportunity to connect patients with available community resources. Additionally, they raise serious questions about the admissibility of evidence and the chain of custody.”

The full video state and additional materials can be found on IAFN’s Addressing DIY Sexual Assault Evidence Collection Kits page.

Read Ohio Alliance to End Sexual Violence and Ohio’s IAFN Chapter Letter on DIY Kits During COVID

Recorded Webinars and Resources for TeleAdvocacy

Shifting Hospital Advocacy During COVID-19 - OAESV

• ED Consent for Sexual Assault Advocacy

• Hospital Letter for Survivors
• ED Letter to Survivors
• Temporary Hospital Response Protocol
• Message for SANE or ER Nurse

Digital/Phone HIV Resources

• Order a free home HIV test kit from OHIV.org. (Restrictions apply, limited quantities available.)
• Chat with HIV/STI experts at 1-800-332-2437 or OHIV.org about sexual health concerns.
• Make a TelePrEP appointment and talk to a provider about the daily medication that can prevent HIV.

Law Enforcement Safety Guidelines

If you have any questions or concerns about shifting hospital advocacy during COVID-19, please feel free to reach out to our Director of Coordinated Community Responses, Shandra Witherspoon at switherspoon@oaesv.org or 216.308.1501 as she is in constant communication with IAFN and is staying up to date on national and state policies and best practices.