From Members of the Texas A&M Forensic Center of Excellence:

As we continue to grapple with the significant impact COVID-19 is having across the world, we want to offer resources to our forensic nursing family to help answer some of your questions.

We have received numerous inquiries about addressing forensic nursing concerns related to providing care to patients with forensic health care needs. We encourage you to talk with your supervisor, compliance officer and risk manager to determine the best way to proceed when forensic patients present. 

Ultimately, it is our role and responsibility as forensic nurses to ensure the safety of our patients, ourselves and others. This starts with ensuring the following to the best of our ability:

• Implementation of effective screening processes for all patients, visitors and advocates for COVID-19.

• Limiting visitors. Consideration of the use of telehealth for advocate interaction with patients.

• Ensuring the use of PPE for patients that screen positive for COVID-19

• Ensuring the use of PPE for any health care worker or social worker interacting with a patient with a positive COVID-19 screen

• Consideration of guidelines that exempt health care or social workers that meet the following criteria from caring for a lab-confirmed COVID-19 patient or patient with a positive screen:

• Pregnant

• Breastfeeding

• Immunocompromised

• Over 60 years of age

Things forensic nursing teams may wish to consider:

• Should the forensic nurse call-in requirements be modified during the pandemic?

• Consider allowing forensic nurses to be on-call and “triage” patients via telephone and come in for acute examinations only.

• Consider health histories of forensic nurses (pregnancy, breastfeeding or immunocompromised status).

• Are there examinations that may be deferred to a later time?

• Can patients who report non-acute sexual assaults and who are safe, be examined at a later date?

• Should sexual assault examinations be completed in the emergency department or another area?
  
  Current CDC recommendations are as follows:

• Utilize stringent hand hygiene practices for everyone, including patients.

• Droplet precautions should be followed. These include:

• Donning gloves always.

• Donning gown & surgical mask if potential for droplet contact. 

• Masks do not need to be N-95. 

• If patient does not describe having a cough, fever or runny nose – forensic nurse should use stringent hand hygiene practices and don gloves.

• If patient is coughing, has a fever or recently had a fever, or runny nose – forensic nurse should don a surgical mask with a face shield, gown and gloves.

• Anal swabbing does not aerosolize sample. 

• Social distancing of at least six feet should occur as much as possible during the history, examination and documentation of all patient encounters. The forensic nurse should continue to utilize patient-centered, trauma-informed practices while explaining the reasons for droplet precautions.

• Housekeeping – Follow standard droplet protocol for cleaning of examination areas.  

You are invited to participate in a virtual SANE Coordinator Open Forum on July 21, 2020 from 10 AM to 12 PM CST hosted by the Texas A&M Health Center of Excellence in Forensic Nursing. All SANE Coordinators and Medical Directors are encouraged to join us in this open forum to discuss issues affecting forensic nursing practice.

Due to the impacts of COVID-19 and to support the health, safety and wellness of our participants, we have transitioned this event from a two-day, in-person forum to a series of virtual discussions to be held this summer and fall.

In our first session of the free series, we will discuss the following:

·    Track Kit update;

·    HB616 impact;

·    Educational needs impacting forensic nursing teams;

·    Forensic nursing practice issues; and

·    Open forum

Join us via zoom on July 21 from 10 AM to 12 PM CST using the link below. Please note this forum will be recorded for internal planning purposes only.

·    Meeting URL: https://tamu.zoom.us/j/94779327112?pwd=aFdNZVlUVHhiQXBPS1JCVjI0Tkk1QT09

·    Meeting ID: 947 7932 7112

·    Password: 305686