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Child advocacy center, forensic nurse, nurse practitioner, pediatric, primary care, referrals, sexual assault



  1. Ceccucci, Janice DNP, FNP-BC, SANE-A, NYSAFE, SANE-P


Objective: The purpose of this project was to evaluate nurse practitioners' (NPs') current approach and self-reported competence in the care of the sexually abused child in the primary care setting.


Methods: A 50-question survey was distributed to 5,734 NPs who were members of a state nursing organization and nursing alumni. Inclusion criteria included NPs caring for pediatric patients in a primary care setting in New York State.


Results: A total of N = 325 responses were obtained, and 110 participants met the inclusion criteria. Very few NPs felt competent to perform a medical forensic examination on a sexually abused child (25.5%), and even fewer felt competent to render a definitive opinion on sexual abuse (17.3%) or to testify in court (12.7%). Most NPs felt the need for more training on child sexual abuse (78.2%). Most would prefer to refer children who are suspected of sexual abuse to an expert (77.3%), but very few (19.1%) are being referred to a local resource, like a Child Advocacy Center when a parent calls the office with a concern.


Conclusion: More research is needed to evaluate clinical practices regarding child sexual abuse. NPs see value in pursuing specialist referrals for child sexual abuse but do not have access to the appropriate resources or are unaware of the availability within their community.


Practice Implications: NPs should be aware of their own limitations and seek out education to improve their knowledge and skills. Forensic nurses are ideally situated to provide education on the available resources and the recommended clinical guidelines for referral.