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A suite approach to healing

SANE and SAFE: Texas Health Dallas makes changes and history

Monday November 7, 2011
A forensic and medical exam room and private bathroom with a shower at the new Center for SAFE Healing at Texas Health Dallas.
A forensic and medical exam room and private bathroom with a shower at the new Center for SAFE Healing at Texas Health Dallas.
(Photos courtesy of Texas Health Dallas)
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Loren Larkin, RN, BSN, MA, CEN, CPEN, CA-SANE, right, clinical educator for the ED and sexual assault nurse examiner coordinator for Texas Health Dallas, and another nurse during SAFE training
Sept. 20 marked a first in Dallas County when Texas Health Presbyterian Hospital Dallas opened the W.W. Caruth Jr. Center for SAFE Healing, a 3,000-square-foot, multi-room suite located in the facility’s ED. The new center is a unique healing environment for sexual assault victims and their family members.

Nationally, fewer than 18% of sexual assault cases are reported to law enforcement, according to the Bureau of Justice Statistics. In the nation’s ninth largest city, the Dallas County District Attorney’s Office reported 459 sexual assault cases in 2008 with a population of more than two million. “The inference here is that there have been many unreported cases of sexual assault,” said Loren Larkin, RN, BSN, MA, CEN, CPEN, CA-SANE, clinical educator for the ED and sexual assault nurse examiner coordinator for Texas Health Dallas. “We are hoping to help change that.”

According to Larkin, before March 2010, Dallas was one of the largest cities in the U.S. without a certified SANE program. Today, Dallas County not only is making necessary changes, but making history.

On Nov. 18, 2010, the W.W. Caruth Jr. Foundation Fund of Communities Foundation of Texas presented a $2 million grant to Texas Health Dallas to fund the county’s first independent rape crisis center, Dallas Area Rape Crisis Center. The grant also funded the implementation of Dallas’ first certified SANE program to train Texas nurses to conduct sexual assault forensic exams and collect court-admissible forensic evidence.


Renee Donald, RN, BSN, SANE, left, and social worker Jacquelyn Bowen, LCSW, center, work as part of a team at the Center for SAFE Healing.
The same grant propelled the opening of the Center for SAFE Healing. The center’s design is described as the ‘Suite Approach,’” Larkin said. “The victims of sexual assault enter into a well-defined area that provides a safe, quiet, healing environment.”

The center features two medical exam rooms with advanced forensic equipment; law enforcement and social service advocacy rooms; private bathrooms with showers; secured access to evidence collection; an education center for nurse training and a private family waiting area.

Within the walls of the center, the patient is cared for by SANEs and other team members, such as a physician, social worker and possibly a volunteer advocate from the Dallas Area Rape Crisis Center or Victim’s Outreach. The advocate often will stay with the patient from start to finish to see to his or her needs. The teamwork revolves around ensuring the patient is medically cared for, evidence is properly collected and also that the patient is returning to a safe environment upon discharge.


Cole Edmonson, RN
The center offers an environment in which to hone the art of SANE nursing, said Cole Edmonson, RN, DNP, FACHE, NEA-BC, CNO and vice president of patient care, Texas Health Dallas. “There is a clear relationship between practitioners, the environment and the patient that can advance the healing process in space design that focuses on empathy, trust, safety and comfort,” he added.

The center also is equipped with the Secure Digital Forensic Imaging system. “It is much more than a camera,” Larkin said. “It’s a system that allows for high security encryption of images and highly-controlled sharing of those images among law enforcement.”

Larkin said the SDFI system, designed in direct consultation with SANEs, allows even small injuries, unseen by the naked eye, to be discovered and documented.

The SDFI system has more capabilities for SANEs to learn and explore, Larkin continued, including a technique that allows “the early identification of bleeding beneath the skin, even prior to the visual presence of such injury to the surface of the skin — in cases of bites and even strangulation marks. This is an advanced technique that we are excited to master and utilize.”

In the past, Dallas County law enforcement organizations referred all sexual assault victims to one local hospital where forensic evidence was collected, Larkin said. “The victim does not want to be sent to a second facility to tell someone else what happened a second time,” Larkin explained. “This limited the number of victims who pursued the legal steps of reporting and testifying, ultimately delaying or preventing the healing process.”

A 2009 Department of Justice report revealed there is a 95% increase in successful prosecution of cases when evidence is collected by a SANE certified nurse. “Since we began providing sexual assault services in March 2010, we have treated over 148 victims,” Larkin explained. But, he said, there is still work to be done.


Amy McGuire is a freelance writer. Post a comment below or email editorSouth@nurse.com.