SANE 2010-2011
Quarterly newsletter of the Colorado sane project
Colorado SANE
Since the start of the first Sexual Assault Nurse Examiner (SANE) program in 1995 at
Memorial Hospital in Colorado
Springs, SANE programs have been
spreading throughout Colorado. The
state currently has 13 programs
ranging from Fort Collins to Durango
and Grand Junction to Hugo. The Hugo
SANE program is Colorado’s newest
SANE program. Located at the Lincoln
Community Hospital and Nursing
Home in Hugo, CO, the new SANE
program will serve the counties of
Lincoln, Cheyenne, Kit Carson, and
Elbert. Read about one of Colorado’s oldest SANE programs located at the Medical Center
of the Rockies on page 2. In 2010 alone, SANE programs in Colorado conducted 2033
medical forensic exams (adult and pediatric).
To continue to meet the need for SANE nurses around Colorado, SANE education and
training was provided to 45 nurses in 2010 at locations in Colorado Springs and Denver.
The Colorado SANE Project also provided the Advanced Forensic Nurse Examiner (AFNE)
training to 13 SANEs seeking to expand their forensic nursing knowledge and practice. In
addition to educating new SANEs throughout the state, 26 nurses from Colorado traveled
to Pittsburgh, PA to attend the 18th annual Scientific Assembly of the International
Association of Forensic Nurses (IAFN) where they were educated on the latest issues
pertaining to forensic nursing practice (read more about the conference on page 5).
One of the Colorado SANE Project’s biggest accomplishments of 2010 was working with
the Colorado Department of Public Health and Environment (CDPHE) to update the drugfacilitated evidence collection kit. The standardized kit now includes specific directions for
health care professionals in the collection of specimens from patients who may have been
given drugs or alcohol. Details about kit updates can be found on page 4.
In preparation for a busy 2011, the Colorado SANE Project has already scheduled two
dates for SANE education and training in the spring and early summer, and one AFNE
training for the fall. In addition, the call for new SANE program sites will be sent out in April
2011 to hospitals and communities around the state that do not currently have SANE
programs. We look forward to another year of working with Colorado communities.
Issue 1
March 2011
In this issue:
Special points of interest:
Medical Center of the Rockies
2
Updated DFSA Kit
4
CO SANEs Publish Research
4
IAFN Conference
5
Education and Announcements
6
* CO SANE programs conducted 2033 medical
forensic exams in 2010
 Colorado DFSA kit has been updated
 Scholarly article recently published by two
Colorado Forensic Clinical Nurse Specialists
 Page 6: 2011 SANE education and training
Page 2
MEDICAL
CENTER OF THE ROCKIES
Meeting the Needs of Northern Colorado
Although the Sexual Assault Nurse Examiner
(SANE) program has only been located at the Medical
Center of the Rockies (MCR) since 2008, Susan Webster has been a practicing SANE for 14 years. Susan
was one of the founders of the MCR SANE program
that began in 1999 at the nearby Poudre Valley Hospital located in Fort Collins, CO. In 2008, the program
was moved to MCR in Loveland, CO where Susan
now coordinates and leads a team of 9 Sexual Assault Nurse Examiners. As the only SANE program located in Northern Colorado, Susan sees one of their
unique challenges as being flexible enough to travel
around to testify. Nurses may find themselves traveling to Greeley, Boulder, Fort Collins, or Longmont to
testify in a case. This is the result of the time the
MCR SANE team invested in outreach when they
moved in 2008. They took road trips to surrounding
cities to market their program and meet with law enforcement agencies that didn’t have SANE programs
in their communities. As these communities collaborated with MCR for forensic services, their patient
numbers increased by more than 300% over 3 years.
Their relationship with law enforcement agencies of
surrounding communities has also continued to grow
and Susan (continued on page 3)
www.uccs.edu/bethel/SANE.htm
Page 3
praises the “huge” support they have
demonstrated. This praise is also reciprocated by law enforcement. Steve
Wrenn, Chief Deputy District Attorney
for 19th Judicial District, commented,
“the SANE nurses at Medical Center of
the Rockies have provided invaluable
testimony on a number of high profile
sexual assault cases over the last several years. As a direct result of their
professionalism and expertise, several
dangerous sexual predators have been
convicted, making Weld County a safer
place.” This collaborative relationship
is fortified during quarterly MCR SANE
meetings where members of law enforcement from surrounding communities offer information and, in turn,
learn about new developments taking
place within the MCR SANE program
and forensic nursing practice. Community support for the MCR SANE program was also evident during the hospital’s recent (and successful) application for Magnet recognition. The Magnet Recognition Program® was developed by the American Nurses Credentialing Center (ANCC) to recognize
health care organizations that provide
nursing excellence. MCR presented
their SANE program as an example of
how nursing excellence is provided to
the communities they serve. Now that
the hospital has obtained Magnet recognition Susan has returned to her
chief focus of improving and progress-
ing the MCR SANE program. She is always seeking increased sources of continuing education for her SANE team. Although the MCR Foundation has a SANE
fund for education and training, Susan
says that readily available continuing
education for forensic nurses is not always abundant. Other goals for 2011
and beyond include adding a few new
SANEs to their team, enhancing their
pediatric skills, and facilitating the
transfer of appropriate medical forensic
information to law enforcement in a
more efficient manner. When asked
what has kept her in a sometimes disheartening profession for 14 years,
Susan pointed to the impact SANEs
have on the patient experience. Patients often arrive traumatized and withdrawn but Susan related, “by the end of
the exam they’re thanking me for my
care and thanking me for the job that
the SANE nurses do and have virtually
opened up to me by the end of the
exam.” The dedication of Susan and the
MCR SANE team to their patients and
the SANE cause is a true labor of love;
one which, Susan noted, they do not do
without outside support. Without the
support of Ann Yanagi, Debbie Delk and
the dedicated SANE team, “the program
would not be what it is today.” Ann Yanagi has been the program’s physician
advisor since its inception in 1999. As
one who has completed the SANE training, Dr. Yanagi not only acts as an active
“The SANE nurses at Medical
Center of the Rockies have
provided invaluable testimony on
a number of high profile sexual
assault cases over the last several
years. As a direct result of their
professionalism and expertise,
several dangerous sexual
predators have been convicted,
making Weld County a safer
place”
-Steve Wrenn, Chief Deputy District
Attorney for 19th Judicial District
participant in the program by taking call
when needed and attending MCR SANE
meetings, but she also provides an important link to the medical community.
Debbie Delk, Clinical Director of Emergency Services Support at MCR, has
also provided crucial support to the
SANE program. During the 2008 transition to MCR, Ms. Delk, “stepped in providing administrative liaison and support, which assisted in making the transition successful.” Susan also related
that Ms. Delk, “has gone to a great deal
of effort to get the program established
in our growing geographic region by attending the meetings at the out of
county agencies with Ann and I to acknowledge the hospital commitment.”
Finally, Susan thanks
Val Sievers, the Colorado SANE Project Director, for providing the
training and being there
for them. “When we
have questions, problems, or just need to
vent about something
she’s been a wonderful
support.” The contributions and support that
the MCR SANE program
has received from the
hospital and surrounding communities makes
them a model for successful forensic nursing
practice.
www.uccs.edu/bethel/SANE.htm
Page 4
Updated DFSA Kit A new Drug-Facilitated Sexual Assault (DFSA) evidence collection kit has been developed and released for purchase
and use. The Colorado SANE Project updated the previous DFSA kit provided by the Colorado Department of Public Health
and Environment by the addition of 4 new documents to be included with the kit:

Patient consent form

Patient information form

Specimen collection instructions

Chain of custody sticker on the outside of the box
The aim of revising the DFSA kit by the addition of standardized documentation was to increase the thoroughness and
consistency in the collection of evidence in suspected cases of DFSA. The Colorado SANE Project worked with the developers of the current DFSA kit, Therapak and the Colorado Department of Public Health and Environment, to update the
DFSA kits. Hospitals and health care facilities may purchase the kits directly from Therapak:
Therapak Corporation
Beverly Threadgill
Customer Service
1-888-505-7377, ext. 221
BThreadgill@therapak.com
Please reference the kit as:
Part Number: 38520G
CDPH Sexual Assault Collection Kit 48/case
Cost is $189.60 per case
AN ONLINE DFSA BEST PRACTICE MODULE WILL BE AVAILABLE SUMMER 2011 GENITAL INJURY RESEARCH IN COLORADO Little research has been done to address the types and
Patricia Keller
Megan Lechner
meaning of genital injury in sexual assault victims,
specifically injury to the cervix. In order to increase evidencebased practice in forensic nursing and strengthen the
validity of expert witness testimony from medical providers,
Patricia Keller MSN, CNS, RN, SANE-A/P and Megan Lechner
MSN, CNS, RN, SANE-A/P developed a study to examine the
frequency and types of cervical injuries in women following
sexual assault, as well as the mechanisms that are related
to specific injuries. A retrospective chart review of 114 SANE
exams (conducted at two Colorado hospitals) provided the
data for the study. In analyzing the genital summary
narratives and cervical diagrams of patient charts, the
authors found that 87.8% (n = 100) presented with no injury
to the cervix, and 12.3% (n = 14) had documented injury.
Although their findings indicate that, “injuries to the cervix
appear to be relatively rare,” their study implicated the
need for additional research with larger samples of consensual and non-consensual cases of sexual intercourse, “to
determine the significance, occurrence, and cause of injuries to the cervix, in sexual assault patients, and to compare
them to occurrence in other normal circumstances and the
consensual intercourse population.” The full article,
“Injuries to the Cervix in Sexual Assault Victims,” can be
found in the December 2010 issue of the “Journal of Forensic Nursing,” (6: 196–202). Both authors currently practice
as Forensic Clinical Nurse Specialists and Sexual Assault
Nurse Examiners (SANEs) in Colorado. In addition, both
teach online courses in Forensic Nursing at the Beth-El College of Nursing and Health Sci“Forensic nurse researchers must continue to investigate and add to the small ences at the University of Colorado
Colorado Springs. See page 4 for
body of genital injury research, including injuries to the cervix, to maintain
additional information on forensic
credibility as expert witnesses, and to best serve justice.”
nursing education opportunities.
(Keller & Lechner, 2010)
www.uccs.edu/bethel/SANE.htm
Page 5
Colorado forensic nurses share some quality time at the Assembly.
Colorado forensic nurses attend a “Roaring 20s”
fundraiser at the 18th annual Scientific Assembly.
Inter national
Association of
Forensic Nurses
Meets in
Pittsburgh
The 18th annual Scientific Assembly of the International Association of Forensic Nurses (IAFN) took
place in Pittsburgh, PA during October 2010. There
representing Colorado, were 26 forensic nurses and
SANEs from throughout the state. To address the
theme of, “Ending Violence: Leading the Healthcare
Response,” the assembly offered more than 60 educational sessions presented by specialists in forensic
health care. General topics included forensic nursing
care across the lifespan, SANE practice, domestic
violence, human trafficking, comparing and contrasting innovative forensic nursing practice skills and
strategies, legal issues in forensic nursing, death
investigation, and supporting the advancement of
global forensic nursing practices. The focus of the
assembly was to put state-of-the-art science and evidence-based practice into action to create best
practices for forensic nursing across the world and
across the lifespan. The international assembly also
provided nurses the opportunity to meet with and learn
from other forensic nurses from around the country and
the globe. In addition to attending educational sessions,
nurses were invited to attend a gathering of the Colorado Chapter of IAFN. The state chapter of the international organization was started by forensic nurses wishing to develop a network within Colorado to provide support and cohesion, and opportunities for multidisciplinary education and understanding. To learn more about
the Colorado Chapter of the IAFN please contact:
Kim Nash, RN, SANE-A, SANE-P
President of the Colorado Chapter
International Association of Forensic Nurses
dnknash@hotmail.com
office: 719-365-8666
www.uccs.edu/bethel/SANE.htm
Page 6
E D U C AT I O N A L O P P O R T U N I T I E S CCASA: "Problem Pics?: Understanding Sexting
Issues and Advocacy"
Spring 2011 SANE Education and Training
Adult/Adolescent: April 18, 19, 20 & 21
Pediatric: May 17, 18 & 19
Wednesday, March 16, 2011, 12:00-1:30pm
http://www.uccs.edu/~bethel/SANE.htm
FREE for CCASA members & $10 for nonmembers. Info at: www.ccasa.org
Fall 2011 SANE Education and Training
Adult/Adolescent: August 2011
Pediatric: September 2011
SAVE THE DATE!: Education Day honoring the
National Forensic Nurses Week
http://www.uccs.edu/~bethel/SANE.htm
Friday, November 11th (tentative)
Advanced Forensic Nurse Examiner Course
Presented by the Colorado Chapter of IAFN
2011
If you are interested in presenting, please contact
Kim Nash at: dnknash@hotmail.com or
office: 719-365-8666
Online certificate in Forensic Nursing
Online certificate in Correctional Health Education
ANNOUNCEMENTS Colorado sane
project
Offices for the Colorado SANE
Project are located at:
The University of Colorado
Colorado Springs
Beth-El College of Nursing &
Health Sciences
1420 Austin Bluffs Parkway
Colorado Springs, CO 80918

The Colorado Chapter of the International Association of Forensic Nurses
(IAFN) will be launching a new website. The expected launch date is May 1,
2011 and the site will be accessible through IAFN’s home website:
www.iafn.org

The next call for SANE applications will be in April 2011. Please contact Val
Sievers or Bethany Miller with any questions or to request an application.

Colorado has 5 new SANE Coordinators:
 Elisabeth Almond: Memorial Health System, Colorado Springs
 Jennifer McConnell: St Anthony Summit Medical Center, Frisco
 Sandy Barela, Parkview Medical Center, Pueblo
 Arlyn Oaks: San Luis Valley Regional Medical Center, Alamosa
 Casey Thompson: Lincoln Community Hospital and Nursing Home, Hugo
Contact information for all SANE Coordinators around the state can be found
at: www.uccs.edu/bethel/saneColorado.htm.

The Colorado SANE Advisory Board is pleased to announce its newest member,
Dr. Jennie Buchanan, MD. Dr. Buchanan is currently a staff physician at Denver Health Medical Center and an Assistant Professor at the University of Colorado School of Medicine. Dr. Buchanan also provides expertise as a Medical
Toxicologist through the Rocky Mountain Poison and Drug Center.
www.uccs.edu/bethel/SANE.htm
Colorado SANE Project
Director
Val Sievers: 719-255-3585
vsievers@uccs.edu
Colorado SANE Project
Assistant
Bethany Miller: 719-255-4354
bmiller2@uccs.edu
Email future educational opportunities or announcements to Bethany Miller at: bmiller2@uccs.edu