INTERNATIONAL ASSOCIATION OF FORENSIC NURSES SEXUAL ASSAULT NURSE EXAMINER COURSE REVIEW

Transcription

1 SEXUAL ASSAULT NURSE EXAMINER COURSE REVIEW Begin by saving this packet to your My Documents or another file of your choice. As you work, make sure to save your changes. To help standardize education and practice, the Education Department of the International Association of Forensic Nurses is pleased to offer an expert review process for sexual assault nurse examiner (SANE) courses. THE IAFN welcomes individuals or organizations to submit application for review of their adult/adolescent, pediatric/adolescent, or combined SANE course. The IAFN will review the course for compliance with the most current edition of the IAFN SANE Education Guidelines. The review process requires a minimum of 4 weeks from IAFN s receipt of all necessary paperwork and payment to final determination and recommendation. Application Fee(s): IAFN Member: IAFN Non-Member: Accepted forms of payment: $ per application $ per application Visa, Mastercard, Discover, or American Express Refunds will not be given, however, IAFN is committed to working with applicants until the course can meet approval requirements. To receive the member fee discount, the applicant/primary contact listed below must be a member of IAFN before he or she submits the To become a member of IAFN, visit: Required Information (typed; handwritten will not be accepted) Name of Applicant (Individual/Organization): If an Organization, name of the primary contact: Mailing Address: City: State: Zip/Postal Code: Phone: Address: Page 1 of 2

2 SEXUAL ASSAULT NURSE EXAMINER COURSE REVIEW By checking the boxes below, the applicant/primary contact attests that he or she has: Application Materials Payment Planning Table Completed and included all the forms required in the submission packet. Will complete payment online after ing this packet. Included the necessary objectives to meet the IAFN SANE Education Guidelines (listed in the Objectives List document) and completed ALL sections of the Educational Planning Table provided. Hint: from the Objectives List document; the order in which they are listed does not matter. Hint: The Education Guidelines contains a list of references. Download the Guidelines at Bio Form Attendance Tracking Certificate Marketing Material or Brochure Evaluation Attachment Attached a Biographical Form for each individual (names AND credentials) who is in a position to control the content of the SANE training (e.g., planners, presenters, faculty, authors, and/or content reviewers). Hint: Submit one completed form per person. Extra forms available here. Enclosed a copy of attendance sheets/student tracking mechanism for each day of training. If the training is online, explain the tracking process and provide an appropriate example. Hint: Include the attendee s name and address (as the unique identifier). Enclosed a copy of the Certificate of Completion each attendee will receive after course completion. Hint: Include the course title, date, location, attendee name, and contact hours. Hint: Include the accrediting body statement of contact hours issued or the academic equivalent. Academic equivalent means: 1 semester hour = 15 contact hours; 1 quarter hour = 12.5 contact hours Hint: Differentiate an adult/adolescent from a pediatric/adolescent SANE course by title. For a combined course, identify all populations served. Attached a copy of all marketing material (screenshot or copy or print). Hint: Include the accreditation statement and the total number of contact hours given. Attached a copy of the Evaluation Template (uncompleted form or link to an online evaluation). To submit your course for review, please this packet and all required attachments to Jennifer Pierce- Weeks at education@forensicnurses.org. Remember to save a copy in your files. Then, complete payment at: Page 2 of 2

3 Sexual Assault Nurse Examiner Course Review Course Presenter/Planner/Reviewer Bio Form Title of Educational Activity: Role in Educational Activity: (Check all that apply) Educational Activity Date: Nurse Planner Content Expert Faculty/Presenter/Author Content Reviewer Other Describe: Section 1: Demographic Data Name with Credentials/Degrees: If RN, Nursing Degree(s): AD Diploma BSN Masters Doctorate Certifications: SANE-A SANE-P Other Address: Phone Number: Address: Current Employer and Position/Title: Area of content expertise: Law enforcement Crime lab/criminalistics Law (Prosecution/Defense) Child/Adult protection Community-based advocacy Child advocacy (CAC) Systems-based advocacy SART/MDT Other (list) Section 2: Biography In the space below in one or two paragraphs, please summarize the background and expertise of the presenter/planner/reviewer for this SANE training. Additional copies of this Bio form are available here. Page 1 of 1

4 Please see the Objectives List ( that must be used to meet the IAFN SANE Education Guidelines. The course planners may select the order and time frames in which this content is delivered. Failure to include all objectives will result in return for correction of documentation before course approval may be attained. Title of Activity: Type of Activity: Live Online (Enduring) If the Course is offered Online, when will it be reviewed?: CE Providership Accrediting Agency and your Providership Expiration Date: Date(s) of Activity: Location: Forensic Nursing Overview credentials for Page 1 of 26

5 As you work, remember to save your changes! Page 2 of 26

6 Sexual Violence / Child Sexual Abuse / Sexual Violence and Abuse credentials for Page 3 of 26

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8 Victim Responses and Crisis Intervention credentials for Page 5 of 26

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10 Collaborating with Community Agencies credentials for Page 7 of 26

11 Medicolegal History Taking INTERNATIONAL ASSOCIATION OF FORENSIC NURSES credentials for Page 8 of 26

12 Physical Exam credentials for Page 9 of 26

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14 Evidence Collection Patient-Centered Care credentials for Page 11 of 26

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16 Patient-Centered Care credentials for Page 13 of 26

17 Medicolegal Photography credentials for Page 14 of 26

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19 STD Testing and Prophylaxis INTERNATIONAL ASSOCIATION OF FORENSIC NURSES credentials for Page 16 of 26

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21 Pregnancy Testing and Prophylaxis credentials for Page 18 of 26

22 Documentation credentials for Page 19 of 26

23 Discharge and Follow Up credentials for Page 20 of 26

24 Legal Considerations credentials for Page 21 of 26

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26 Judicial Proceedings credentials for Page 23 of 26

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28 General credentials for Page 25 of 26

29 List at least 3 evidence-based references used in developing this educational activity: Method of calculating contact hours used by the approving organization: 60 min = 1 contact hour Other (please describe in detail: Click here to enter text. Number of Contact Hours to be awarded: Completed By: Name and Credentials Date Page 26 of 26