26 Sep Case Study A 6-year-old has come to the attention
Case Study A 6-year-old has come to the attention of the child welfare department as a possible victim of sexual abuse. The child lives in a very rural part of a western state. Rather than have the child travel a distance to experts, she was taken to the nearest clinic with sexual assault nurse examiners and a knowledgeable pediatrician skilled in sexual abuse examinations. At the time of the examination, pictures were taken of the child’s body, including the genital area. These pictures are crucial if charges are filed. To ensure that an accurate diagnosis is made, local experts wish to have a second opinion because the results of the physical examination were not believed to be completely definitive. The experts for the second opinion were linked via the Internet and Internet videoconferencing equipment so that the two teams could talk and view de-identified (because the information was going across unsecure Internet channels) photos. Within 15 minutes, it was determined that the hymen was intact and no penetration had occurred. Other markers indicated that there was evidence of child abuse, but none that supported a claim of sexual assault. This case used an EMR, digitized photos, and Internet consultation to arrive at a diagnosis that had both medical and legal implications. Case Questions 1. Evaluate the impact of the use of these methods in the case on the nurse–patient relationship and on patient confidentiality including HIPAA requirements. 2. Describe other ways might this technology can be used. 3. Assess the human, caring part of the care process in relation to this case description and how these needs will need to be met in the future 4. Describe two ways you can envision technology being used to improve patient care and safety
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