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WestCASA

This document provides a summary of best practice in relation to WestCASA. The summary has been created to support staff during the Sunshine Hospital Emergency Department Redevelopment transition and early post-move period, and has been endorsed by the ED Leadership Team.

Overview

This QRG provides an overview of the WestCASA service for victims/survivors of sexual assault.

Applicability

This QRG is applicable to all SHED nursing and medical staff.

Responsibility

It is the responsibility of the Nurse Unit Managers and Medical Directors of the SHED to ensure the relevant staff know about this procedure, that is implemented according to the guidelines as outlined within, and that there is compliance by all staff members.

Guideline/Process Details

Service overview

The WestCASA service provides crisis response for recent sexual assaults through the Crisis Care Unit (CCU), located on Level One of the SHED.

Presentation of children (≤17 years 364 days) following sexual assault

Children and young people 17 years and under who present following sexual assault should be referred to the Gatehouse Centre at the Royal Children’s Hospital as per the Victorian Forensic Paediatric Medical Service (VFPMS) guidelines.

  • In hours (0900 – 1700): (03) 9345 6391
  • Out of hours: (03) 9345 5522 request that the Gatehouse Centre after hours clinician is contacted

Table 1 – Keys located with ED NIC to access WestCASA area

Key Number Access
WestCASA 1 WestCASA and Adult Fast Track First floor
WestCASA 2 WestCASA and Adult Fast Track First floor
WestCASA 3 WestCASA and Adult Fast Track First floor
Fast Track 1 Adult Fast Track First floor
Fast Track 2 Adult Fast Track First floor

Self-presentation or AV Transport

When a patient self-presents to ED and is not accompanied by police or a WestCASA counsellor, the Triage Nurse is to provide the patient with information about WestCASA and the CCU support available at Sunshine Hospital. Consideration should be made to undertake triage process in a Triage Assessment Room to afford the patient with appropriate privacy.

The patient has the right to choose:

  • Whether or not they want to speak to a sexual assault counsellor/advocate
  • To receive medical treatment from ED medical staff or nursing staff, rather than proceeding with a forensic medical examination

Forensic medical examinations can only be requested if a patient is prepared to disclose the sexual assault to police. Police are the only agency permitted to request the attendance of forensic medical officers (FMO) from the Victorian Institute of Forensic Medicine (VIFM).

If a script is required for a WestCASA patient, this should be organised through the Consultant/Senior Registrar on the floor (or a delegate nominated by them).

If a Doctor’s Certificate is required for a WestCASA patient, this should be organised through the Consultant/Senior Registrar on the floor (or a delegate nominated by them).

If a patient chooses to proceed with treatment by ED medical or nursing staff, they should be informed that this decision is supported, however will compromise the integrity of a forensic examination should the client change their mind in the proceeding 72 hours.

If the patient consents to a service response from WestCASA the Nurse in Charge (NIC) is to contact:

  • In hours (0900 – 1700): WestCASA ph. 9216 0444
  • Out of hours (1700 – 0900 weekdays/24-hours weekends and public holidays): Sexual Assault Crisis Line (SACL) Police/Emergency Services line ph. 8345 3494
  • A self-presenting patient is to remain in an Adult Acute Area until the WestCASA counsellor arrives at the Department. Once the WestCASA counsellor arrives the counsellor and the patient are to be transferred to the WestCASA room on Level 1 – accompanied by a Western Health Security Officer.
  • The Western Health Security Officer will round the area every thirty minutes when the WestCASA suite is occupied by a patient and a counsellor.
  • The Nurse escorting the WestCASA counsellor and the patient to the WestCASA suite will orientate the counsellor to the room and let them know where the duress buttons are, they will also provide the counsellor with the Nurse In Charges (NIC) phone number to initiate direct contact for further support. All staff members must sign in and out of the log book when entering/exiting the WestCASA space.
Figure 1: WestCASA transfer of patient to level 1

Attendance with Police/WestCASA

Where a patient is to be accompanied by Police (SOCIT) or WestCASA, the agency will contact the NIC to notify of impending CCU and WestCASA staff will attend within 30 minutes of notification.

Prior Arrangement with Police/WestCASA/SACL

In some circumstances, Police, WestCASA or SACL may make arrangements with the client to meet the responding agency at the hospital. Where this occurs, the responding agency will contact the NIC to notify them of the CCU and provide an estimated time of arrival.

Telephone contact to ED

If a client phones ED and discloses a sexual assault, the NIC will inform the client of sexual assault service supports available at the hospital. With the client’s consent, the NIC can facilitate a notification to WestCASA (during hours) or SACL (out of hours) to arrange a CCU.

Alternatively, the NIC can provide the following contact numbers for the client to initiate contact:

  • In hours: WestCASA ph. 9216 0444
  • Out of hours: SACL ph. 1800 806 292

In circumstances where WestCASA, SACL or Gatehouse Centre cannot be contacted, please escalate in the following order:

  1. CCU Coordinator (0402 788 948)
  2. WestCASA MDC Team Leader (0411 442 589)
  3. WestCASA CEO (0448 843 251)

Mental Health Assessments for West CASA presentation:

  • WestCASA counsellors may request an EMH assessment, as a secondary consult in the West CASA suite. The request for EMH support should be facilitated through the ED NIC.
  • The West CASA counsellor may feel that the patient needs extended emergency mental health care. This observation may be made with or without a secondary consultation from EMH. In this case, the patient should be admitted to an appropriate emergency department clinical space and referred to EMH as per usual process.

Daily cleaning of the Crisis Care Unit to minimise the risk of DNA contamination:

  • CCU to be cleaned daily by PSA in accordance with “High Risk Category B” of the Cleaning Standards for Victorian Health Facilities 2009.
  • The following cleaning products are required to be available and stored within CCU for use of the Forensic Medical Practitioners:
    • Microshield for hand washing
    • Hospital grade bleach disinfectant (e.g. Det-Sol 500 or hypochlorite)
    • Cleaning products routinely used in hospital (please refer to Interim Practice Arrangement)
  • The cleaning staff must sign and out of log book and collect swipe key from SHED NIC.

Door top alarms in WestCASA:

The WestCASA ensuite are fitted with doortop alarms (DTA). The DTAs function to:

  • DTA activate when weight/pressure is applied to the top of the door.
  • The DTA alert is silent but will alert on the Nurse call annunciator.
  • DTA and alarm tones differ from other nurse call tones.

In the event the DTA is triggered the following response should be enacted:

  • The emergency response team are to assemble in the main emergency department and proceed together to the WestCASA suite.
  • The response team will need to collect the emergency responder trolley from the designated area in Fast Track.
  • A Western health security officer will present to the West CASA suite and provide access and people management support.

*Please refer to supporting documents for further information on DTA

Emergency Response WestCASA:

The Adult Fast Track Resus Trolley will be located out the WestCASA Consultation Room Door. It will be checked daily by the Resus Nurse for stock and testing of Defib. The Nurse checking this trolley will retrieve the Fast Track swipe card from the NIC and will access Fast Track only (not going into WestCASA space. If an emergency call is made from WestCASA the Adult Acute team will respond and collect the swipe key from the NIC to access emergency resus equipment in Fast Track.

*Please refer to supporting documents for further information.

Figure 2: WestCASA location of Emergency Trolley and Defibrillator

Figure 3: WestCASA process flow chart

Supporting Documentation

Document Governance

Title: WestCASA
Version: 2.0
Date Published: May, 2021
Date of scheduled review: 01/05/2022
Author: Approver:
FIona Pazsa SHED Leadership Team
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