STATE OF NEW HAMPSHIRE



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STATE OF NEW HAMPSHIRE OFFICE OF THE ATTORNEY GENERAL Sexual Assault Nurse Examiner Rules and Regulations for Currency of Practice Created 12/8/00 Revised 7/02, 7/05, 9/07, 1/09, 3/15

Definitions Adult: shall be defined per the International Association of Forensic Nurses (IAFN) SANE Education Guidelines for the adult/adolescent patient population. Certification: The IAFN offers national board certification for Registered Nurses in both Adult/Adolescent and Pediatric SANE practice. Full information regarding certification can be found at the following link https://iafn.site-ym.com/?page=certification. It is important to understand that practice as a SANE is the foundation upon which certification is built, so nurses should expect to practice for at least a year prior to sitting for board certification. Certification is not necessary to practice. Currency of Practice: is the formal process outlining the training (didactic and clinical) received by the examiner, as well as documentation of practice. IAFN: The International Association of Forensic Nurses. IAFN SANE Education Guidelines: set forth the minimum level of instruction for each key target competency in the adult/adolescent and/or pediatric/adolescent populations, while allowing for flexibility to meet the educational needs of registered nurses in diverse practice settings and communities. 1 Medical/Forensic Examination: A medical evaluation of the sexually assaulted patient that includes a history, physical examination, injury identification, documentation, risk assessment and treatment as well as resources and referrals. This examination may occur with or without evidence collection. Pediatric/Child: shall be defined as per the IAFN SANE Education Guidelines for the pediatric/adolescent patient population. SANE-A Certification: represents the earned credentials designated to a recipient by achieving a passing score on the adolescent/adult board certification examination, offered through the Commission for Forensic Nursing Certification at the International Association of Forensic Nurses. SANE-P Certification: represents the earned credentials designated to a recipient by achieving a passing score on the pediatric board certification examination, offered through the Commission for Forensic Nursing Certification at the International Association of Forensic Nurses. SANE-Prepared: A RN who has successfully completed the comprehensive SANE training course and required clinical hours, but who has not passed the IAFN adolescent/adult SANE certification written examination. Sexual Assault Nurse Examiner (SANE): A Registered Nurse (including advanced practice nurses) who has been specially trained to provide comprehensive sexual assault care, including evidence collection and testimony, in keeping with the IAFN SANE Education Guidelines (2013). 1 International Association of Forensic Nurses (2013) Sexual Assault Nurse Examiner Education Guidelines. Elkridge, MD https://c.ymcdn.com/sites/iafn.siteym.com/resource/resmgr/education/sexual_assault_nurse_educati.pdf 2

Education Requirements Nurses wishing to practice as a SANE in New Hampshire must: Have a minimum of two years experience as an RN; Be licensed and in good standing as a Registered Nurse (RN) through the New Hampshire Board of Nursing (NHBON) or a COMPACT state; Successfully complete the New Hampshire Office of the Attorney General s (OAG) approved 40 hour didactic SANE training course on the Pediatric and/or Adult/Adolescent Population and additional 8 hour clinical skills lab (48 total hours); OR Show proof of completion of a 40 hour didactic Adult/Adolescent and/or Pediatric/Adolescent SANE didactic training that meets the most current IAFN Education Guidelines with proof of clinical competency on the population served; OR Show proof of current IAFN board certification as a SANE-A or SANE-P, which qualifies you as having met the education requirement to practice in New Hampshire on the patient population for whom certification was achieved. Attendance at the New Hampshire Evidence Collection specific training as outlined by the NH SANE Director. The adolescent/adult course is not a prerequisite for the pediatric/adolescent course. The courses may be taken in any order. There is no requirement to complete both courses, unless it is a requirement imposed by the nurse s employer. Clinical Requirements The goal of the clinical requirements is for nurses to achieve competency in clinical practice. Since competency is unique to every nurse based on their practice, experience, and comfort level, competency is determined by the evaluating clinician and the facility utilizing the SANE or by the NH SANE Director or designee in a skills lab session. All NH SANE Programs and hospitals utilizing SANEs should be familiar with the specific minimal clinical requirements found in the IAFN SANE Education Guidelines as the NH SANE Program follows these standards. The Adult/Adolescent and Pediatric/Adolescent Clinical Preceptorship Content can be found on page 31 and page 58 of the IAFN SANE Education Guidelines respectively. Appropriate preceptors include physicians, physician assistants, advanced practice nurses, or forensically experienced registered nurses. All SANEs must submit a letter to the NH SANE Program from their preceptor and/or nurse manager, on facility letterhead, attesting to their competency at the local program level based on the clinical objectives outlined in the IAFN SANE Education Guidelines. The letter must indicate which patient population they have served and how the manager can be reached for verification. See Appendix B for a sample letter. 3

Maintaining Currency of Practice Requirements There are two forms of currency of practice accepted in New Hampshire: 1. Current (not expired) SANE Certification through the Commission for Forensic Nursing Certification at the IAFN for the patient population being served (SANE-A /SANE-P ); OR 2. Successful completion of the Biannual NH SANE Currency of Practice Application. 4

Applications for Currency of Practice I. All SANE files will be housed by the NH SANE Program at the New Hampshire Coalition Against Domestic and Sexual Violence (NHCADSV). Nurses are responsible for providing the following information and updating the NH SANE Director or a designee with any updates or changes. The information that must be current in the file includes: A. SANE Identification Form (see Appendix C); B. Copy of current RN license number with validation through Board of Nursing web site demonstrating that the SANE has an unencumbered Registered Nursing License in the State of New Hampshire or a COMPACT State; 2 C. Copy of classroom certificate for 40 hour adolescent/adult or pediatric/adolescent SANE training; D. Copy of classroom certificate for 8 hour clinical skills lab program. E. Copy of completed documentation of clinical hours (see Appendix D); F. Biannual verification of relevant Continuing Education, totaling thirty (30) hours; AND G. Biannual verification of currency of practice by a. Submitting a signed letter by their nurse manager, on facility letterhead, indicating they have been practicing in the role of Sexual Assault Nurse Examiner, which patient population they have served, and how the manager may be reached for verification 3 ; OR b. Successfully completing a simulated, precepted sexual assault examination through the New Hampshire SANE Program and receiving a letter validating their competency. Completion of a simulated, precepted sexual assault examination through the New Hampshire SANE Program does not guarantee a letter validating competency. H. Up-to-date, signed Currency of Practice Statement of Understanding/ I. Up-to-date data entry for all Medical Examinations on Sexual Assault patients in the SANE database. II. It is the responsibility of the SANE to submit the Currency of Practice Application (see Appendix A) to the NH SANE Program or proof of SANE-A or SANE-P Certificates every two years. Files will be reviewed by the NH SANE Program Director or designee. A. RNs current in their practice and regulatory requirements will be issued a Currency of Practice card. B. RNs not current in their practice will receive written instructions on additional information needed to meet the Currency of Practice requirements. An amended Currency of Practice application must be received within 60 days of the notice for correction. If the packet is incomplete upon submission, the RN will be asked to resubmit. 2 NURSYS online license verification system at https://www.nursys.com/ 3 see example/template at the end of this document. 5

a. The amended packet and/or corrections may only be resubmitted once. b. Extensions beyond 60 days will be granted for extenuating circumstances only and at the discretion of the NH SANE Program. C. Nurses who fail to submit appropriate documentation will no longer be considered practicing SANEs, and the following will occur: a. A letter indicating the RNs failure to meet the necessary requirements for practice will be sent to the RN and the RNs nurse manager; and b. The RN will be expected to reapply for the SANE didactic and clinical portions of the training. 6

NH SANE Program Currency of Practice Statement of Understanding I hereby attest that I have read and understand the State of New Hampshire, Office of the Attorney General, Sexual Assault Nurse Examiner Currency of Practice Guidelines, and have been given a copy of these guidelines. I also agree to the following provisions: a. I will assume responsibility for submitting my license number so that the program may verify my nursing license as active, and unencumbered; b. I will comply with all currency of practice requirements as stated in the guidelines. c. I will assume responsibility for maintaining my currency of practice by providing the NH SANE Program at NHCADSV with the appropriate information every two years, as appropriate. I understand that if my currency of practice is not up-to-date, the SANE Program may be obligated to share that with other parties (ie: my employer, prosecutors and defense counsel). Signature: Date: Print Name: Please return to: State of New Hampshire SANE PROGRAM NHCADSV PO Box 353 Concord, NH 030 7

Appendix A NH SANE Program: Currency of Practice Application Please provide the following to the NH SANE Program biannually by April 30 th starting in the year 2016. From Initial SANE Training: Copy of classroom certificate for 40 hour adolescent/adult and/or pediatric/adolescent SANE training Copy of classroom certificate for 8 hour clinical skills lab program To be Updated: Updated SANE Identification Form (see Appendix C) Copy of current RN license number with validation through Board of Nursing web site demonstrating that the SANE has an unencumbered Registered Nursing License in the State of New Hampshire or a COMPACT State Demonstration of ongoing Commitment to Currency: Copy of completed documentation of clinical hours (see Appendix D) Up-to-date data entry for all Medical Examinations on Sexual Assault patients in the SANE database. Biannual verification of relevant Continuing Education, totaling thirty (30) hours Biannual verification of currency of practice by: Submit a signed letter by your nurse manager, on facility letterhead, indicating that you have been practicing in the role of Sexual Assault Nurse Examiner, which patient population you have served, and how the manager may be reached for verification (see Appendix B) OR Submit a letter validating your competency received from the New Hampshire SANE Program after successful completion of a simulated, precepted sexual assault examination. 8

Appendix B Sample Competency Letter from Nurse Manager FACILITY LETTERHEAD NH SANE Program NHCADSV PO Box 353 Concord, NH 03301-0353 Name of Manager Address Phone Number Email Address Date Dear SANE Program Director, I am the manager currently supervising (insert the name of the practicing SANE here) in her/his practice as a Sexual Assault Nurse Examiner. (Name of SANE) practices on the (PEDIATRIC AND/OR ADULT-please specify) sexual assault populations. (Name of SANE) has been deemed competent by our facility in the practice of sexual assault exams as a SANE, including but not limited to performing speculum examinations on the appropriate patients. Additionally s/he collaborates with other medical providers in the facility when necessary, and multidisciplinary partners outside the facility where appropriate. I understand the importance of quality improvement mechanisms within SANE practice, and that the NH SANE Program offers continuing education opportunities and even competency testing should we need to utilize that service. Please feel free to contact me if you have further questions. Sincerely, (Typed name of Manager below signature) 9

Appendix C NH Sexual Assault Nurse Examiner Identification Form Name Address * City * State * Zip Code * Phone * Fax Email* State of Nursing License * Nursing License Number * Other Professional Licensure Year of Original Training * Hospital Affiliation* Department* Supervisor's Name* Supervisor's Phone Number* Supervisor s Email* ED Nurse Manager* ED Nurse Manager Email* Population Served *Denotes a Required Field -If you work at multiple hospitals please include the above information for those hospitals. 10

Appendix D NH SANE Program: Currency of Practice Completion Record Name: Program/Hospital Name: Adult or Pediatric Exam Month & Year Seen Hours to Complete Exam Age of Patient Kit Completed? Signature of Supervisor/Manager 12