Rural Availability of Sexual Assault Nurse Examiners (SANEs)

Purpose Sexual assault care provided by sexual assault nurse examiners (SANEs) is associated with improved health and prosecutorial outcomes. Upon completion of SANE training, nurses can demonstrate their experience and expertise by obtaining SANE certification. Availability of nurses with SANE training or certification is often limited in rural areas, and no studies of rural certified SANEs exist. The purpose of this study is to describe rural SANE availability.

Methods We analyze both county-level and hospital-level data to comprehensively examine SANE availability. We first describe the geographic distribution of certified SANEs across rural and nonrural (ie, urban or suburban) Pennsylvania counties. We then analyze hospital-level data from semistructured interviews with rural hospital emergency department administrators using qualitative content analysis.

Findings We identified 49 certified SANEs across Pennsylvania, with 24.5% (n = 12) located in 8 (16.7%) of Pennsylvania's 48 rural counties. The remaining 37 certified SANEs (75.5%) were located in 13 (68.4%) of Pennsylvania's 19 nonrural counties. Interview data were collected from 63.9% of all eligible rural Pennsylvania hospitals (n = 63) and show that 72.5% (n = 29) have SANEs. Of these, 20.7% (n = 6) have any certified SANE availability. A minority of hospitals (42.5%; n = 17) have continuous SANE coverage.

Conclusions Very few SANEs in rural Pennsylvania have certification, suggesting barriers to certification may exist for rural SANEs. Though a majority of hospitals have SANEs, availability of SANEs was limited by inconsistent coverage. A lack of certified SANEs and inconsistent SANE coverage may place rural sexual assault victims at risk of receiving lower quality sexual assault care.

This is the peer reviewed version of the following article: [Rural Availability of Sexual Assault Nurse Examiners (SANEs). The Journal of Rural Health 37, 1 p81-91 (2021)], which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions:



Work Title Rural Availability of Sexual Assault Nurse Examiners (SANEs)
Open Access
  1. Elizabeth Thiede
  2. Sheridan Miyamoto
License In Copyright (Rights Reserved)
Work Type Article
  1. Wiley
Publication Date December 6, 2020
Publisher Identifier (DOI)
  1. 10.1111/jrh.12544
  1. The Journal of Rural Health
Deposited June 15, 2022




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