AbstractsMedical & Health Science

Purpose: The study sought to address the disparity of sexual assault service delivery in emergency departments using a two part sequential mixed methods study with physicians and nurses. Methods: The first part of the study employed retrospective medical chart review (n = 112) at two ED sites within an Akron, Ohio health system. The second part of the study employed semi-structured open-ended interviewing with 13 ED providers who treated at least two sexual assault patients during the chart review year. Results: The highest offered service is the sexual assault forensic examination (92.7% of patients). The lowest offered service is HIV PEP (0 patients). On average, few providers offered STD testing, pregnancy testing, and HIV testing more than 50% of the time. Providers believed they offered services more often than chart review reported. Reasons for not offering HIV PEP include the cost of HIV PEP to the patient, the lack of patient adherence to the medication due to side effects, and the low risk of contracting HIV. A major sub-theme focused on the perceived impact of the loss of the SANE program two years prior. Generally there is little pattern among themes by service delivery performance. Conclusion: Compared to other studies, compliance with suggested treatment guidelines is lower in some service delivery behaviors. There are perceived multiple levels of impact in service delivery for SA patients. Many providers perceive the loss of the SANE program as detrimentally impactful to service delivery quality. Recommendations for future research and improvements to the current system of treatment are discussed.