Development and Evaluation of an Evidence-Based Clinical Practice Guideline of Sexual Assault Forensic Examination for Female Victims

Background: Sexual assault is a crime, and causes devastating impacts on victims. The number of reported cases of female sexual assault victims is steadily increased for the last 5 years in Taiwan. The current guideline from the Ministry of Health and Welfare, Taiwan provides limited information focusing on the process of forensic evidence collection. No evidence-based clinical guideline with state of art is available for forensic examiners to provide better and competent care to female victims of sexual assault. 

Purpose: This study aims to develop and evaluate an evidence-based clinical practice guideline of forensic examination of sexual assault for female victims. 

Methods: The seven steps by Bowker et al. (2008; 2010) were used for the development phase of the evidence-based clinical practice guideline: (1) establishing a guideline development team in the emergency department of a southern Taiwan medical center; (2) analyzing the existing guidelines on sexual assault forensic examination; (3) forming PICO (population, intervention, comparison, outcome) questions; (4) undertaking systemic reviews for clinical questions, and critically appraising published articles using Critical Appraisal Skill Program (CASP) (5) drafting a guideline; (6) conducting a 3-round Delphi study 30-50 experts in health care, social welfare, and jurisdiction; (7) inviting 3 methodology experts to evaluate the newly developed guideline according to Appraisal of Guideline for Research and Evaluation II (AGREE II). For the implementation and evaluation phase, 10 clinical nurses in emergency department will be invited to evaluate the clinical applicability and feasibility of the guideline, and 10 victims of sexual assault will be invited to rate their satisfaction of the care by the newly developed guideline.

Results: The guideline provides forensic examiners including nurses and physicians with up-to-date, evidence-based strategies and consistent methods to provide optimal, sensitive and competent care to female victims of sexual assault.The process of developing and evaluating an evidence-based clinical guideline can also provide an example for clinicians to use scientific strategies to provide evidence-based practice.

Conclusion:  This guideline will  forensic examiners in their efforts to respond to sexual assault victims in the most  competent ,compassionate and understanding manner possible.