Quality Improvement for Pediatric Sexual Abuse Medical Care

Medical care for pediatric and adolescent victims of sexual abuse includes prophylactic antibiotics, emergency contraception, HIV postexposure prophylaxis, and testing for bloodborne sexually transmitted infections. But guidelines and indications for each category can be complicated. Having demonstrated the success of a quality improvement (QI) program for physical abuse (NEJM JW Emerg Med Jan 2018 and Pediatrics 2018; 141:e20171994), these authors addressed pediatric sexual abuse.

The QI program began with a key driver analysis and included education for emergency department providers and pediatric sexual assault nurse examiners, a best-practice algorithm, and an electronic order set. The main outcome measure was documentation of guideline-…