Quality Improvement: Increasing SANE Utilization of Evidence-Based Practice

Background: Varying protocols among sexual assault nurse examiner (SANE) programs lead to inconsistent patient care and indicate that evidence-based recommendations are not being utilized. To address this problem, an evidence-based treatment protocol designed to improve care provided to patients who have experienced sexual assault was implemented at an outpatient rape crisis center (RCC). In addition to implementing the new protocol, a SANE education program was provided. Methods: Retrospective chart reviews were conducted. A total of 21 protocol components were examined pre- and post-implementation of the quality improvement project. Additionally, a knowledge quiz and self-efficacy tool were administered before, immediately after, and 3 months after the SANE education program. Results: Before implementation, the overall compliance with the 21 protocol components was 42.1% for RCC exams and 17.9% for hospital exams. After implementation, the overall compliance increased to 85.3% for RCC exams and 56% for hospital exams. When examining protocol components individually, compliance varied dramatically. There was an improvement in SANE knowledge and self-efficacy when comparing pre- and post-scores; however, the results were not statistically significant and were found to have unequal variances. Conclusion: Nurses are ideally positioned to instigate protocol changes that will positively impact patient outcomes. Other nursing professionals can utilize the quality improvement project content, steps, lessons learned, and results to create similar evidence-based practice quality improvement projects to address gaps in practice.