IU Health Foundation, IU School of Nursing secure $1.39 million grant to increase statewide corps of nurses trained to treat survivors of sexual violence and collect forensic evidence

Despite having higher rates of sexual assault and child abuse than other states, Indiana has a severe shortage of specially trained nurses who can conduct forensic exams, collect evidence necessary for pursuing court cases against perpetrators, and facilitate supportive services.

A grant secured by Indiana University Health Foundation and Indiana University School of Nursing from the federal Health Resources and Services Administration is aimed at resolving this crisis.

The $1,396,401 grant will fund the “IU Health and IU School of Nursing Academic-Practice Partnership for Forensic Nursing” project to increase the supply and distribution of Sexual Assault Nurse Examiners (SANEs) throughout Indiana. The goal is to have more than 340 SANEs trained by 2027.

THE PROBLEM IN INDIANA

One in five women in Indiana has been sexually assaulted, and the state ranks fourth-highest in the nation for the number of reported rapes among high school girls. Still, about 85% of assaults are not reported to police – far above the national non-reporting rate of 63%.

One reason for low reporting rates is that Indiana has a shortage of SANEs, nurses with the specialized training to support people who have been sexually assaulted. As of 2020, only 32 of Indiana’s 92 counties had a forensic nurse at all. That means victims face a choice of not getting treatment, getting an exam by an untrained provider who will not collect evidence admissible in court, or traveling as much as two hours or more to the closest county with a trained provider. In addition to waiting after a traumatic incident, traveling for an exam works against the need for timely evidence collection.

“Our primary concern is always the patient, and a greater number of SANE-trained nurses in Indiana means patients have greater access to trauma-informed care,” said project director Barbra Bachmeier, JD, MPH, MSN, APRN, NP-C,CPH, DF-AFN, FAEN, an Advanced Practice Provider/Forensic Nurse. “We know that how a patient is treated before, during, and after an exam is critical, for their well-being and for reporting the crime. When patients can stay in their communities, trust rises dramatically.”

IU Health and the IU School of Nursing will use the grant to train approximately 300 people over the next three years, at no cost to participants, thanks to the grant. Classes, simulation trainings, clinical preceptorships and evidence-based continuing education opportunities begin in October 2024. The program is open to registered nurses with at least two years of experience in clinical practice.

“The IU Health and IU School of Nursing partnership is unique – it's the only place in Indiana where nurses can work side-by-side with an experienced forensic nurse in a hospital for their clinical training,” said Paula Reiss, IU School of Nursing faculty, Liaison to the program, and Resilience Coach. “Simulated learning experiences are important; however, the expertise, knowledge, and caring that experienced nurses demonstrate at the bedside make all the difference.”

IU Health Methodist Hospital has the largest forensic nursing unit in the state, and it is one of only a few hospitals in the state with 24/7, in-house SANE providers. Those providers have seen steadily increasing workloads: The number of IU Health Methodist patients requiring forensic exams jumped by 40% between 2019 and 2023, from 1,486 to 2,053. In 2023, IU Health Riley Hospital for Children treated 127 victims of sexual abuse or assault ages 15 and younger – a number that has been steadily increasing every year.

The effort to increase SANEs in Indiana was in response to a needs assessment of forensic nurses conducted by the Indiana Emergency Nurses Association (ENA) in 2023 and anecdotal evidence from the SANE program at IU Health Methodist.

“Our criminal justice system can’t be as successful at prosecuting offenders if we don’t have evidence, and we need more SANEs to gather that evidence,” said Cassandra Tice, grants director at IU Health Foundation. “We’re grateful to HRSA for recognizing the need for more SANEs in Indiana, and to our partners at the IU School of Nursing for developing this solution. More SANEs will help survivors heal and ensure that justice is served.”