Launceston General Hospital

SDMS ID P2010/2160-001 LGH Policy 9.5 / 11 WACS Title: Replaces: Description: Minimising the risk of DNA contamination during forensic/medical examinations New Policy The Launceston General Hospitals Sexual Assault Service will provide a forensically sound environment for the examination of victims of rape and sexual assault and the collection and preservation of forensic samples. The sexual assault room will be decontaminated as per this protocol between each case. Sexual assault forensic nurse examiners, medical officers Contamination, DNA, sexual assault, sexual assault forensic nurse examiner, Sexual Assault Services: LGH Policy 9.1-09WACS

Target Audience: Key Words: Policy Supported: INTRODUCTION

A forensic and or medical examination involves the dual purpose of: providing appropriate medical care and attention and The collection of forensic medical evidence to be used the Judicial system and must be collected according to best practise standards. Forensic/ medical examinations ideally occur within as close to the time of the incident and up to within 7 days of the sexual assault having occurred, depending on the site and source of sampling required, and the documentation of any injuries.

PURPOSE This policy will outline all aspects of the decontamination of the sexual assault examination suite to be followed by the cleaning staff to this area and health care practitioners and list measures to reduce DNA contamination.

DNA Decontamination and Cleaning of Designated room. Cleaning department duties: The Deputy Manager of House Services has overall responsibility for the cleaning of the room. The duties are to be carried out as outlined in the Cleaning Department Launceston General Hospital Daily Cleaning Duties document 3.23B. (Attachment 1)
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This document specifies the necessary cleaning materials to be used by cleaning staff, and also the regimes for cleaning the room for routine daily cleans. Nature and extent of cleans should be entered into Log Book. Health Practitioners are also required to double clean (i.e. clean before and after use) any surfaces or equipment they use in relation to the forensic medical examination to minimise the risk of DNA contamination. Cleaning materials: The cleaning materials to be used are Contain (bleach, also known as sodium hypochlorite) and Methylated spirits as recommended by FSST. Contain is used first and can be used for cleaning floors, walls, chairs, phones, wooden and veneer surfaces, tables, benches, ledges, furniture, vents and all fittings, overall cleaning of toilets. The Methylated spirits is used as a second wipe over.

The log book found in the sexual assault room will be completed by all those entering the room. The date, time, reason for access, level of cleaning and name/s should be noted. If a case has been conducted then it should be documented for cleaning staff that a full clean is required (or contact House Services during business hours). The date and commencement time of each forensic medical examination that occurs in the examination room and the name of the SAFE who conducted the examination must be recorded. Healthcare professionals responsibilities to prevent contamination at time of an examination: Prior to examination: Check hospital cleaning log book for status to determine the examination room was cleaned in the past 24 hours and following any previous use. Commence as per Checklist (see Attachment 2). Document in the log book, that the room has been cleaned following the examination. Complete checklist for all examinations.

Other important principles in regard to DNA contamination Limit access to examination room to decrease the risk of contamination: Access to the sexual assault room should be restricted to staff and persons having bona fide reason to be there, with access logs used. Examination suite will have a warning that unauthorised access may potentially result in a persons DNA being identified in a criminal investigation.

Examinations of suspected sexual offenders: Suspected offenders should not be examined in the same examination rooms where victim are routinely examined to eliminate the risk of DNA contamination.

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Furnishings: The principle of using wipe-able furniture in the examination room, and where possible any waiting areas, allows furniture to be cleaned between examinations which reduces the risk of DNA contamination. These items need to be made of such a material to withstand cleaning by both sodium hypochlorite and methylated spirits. Examiners clothing to conduct examinations: On completion of cleaning the room prior to a case, the examiner should then change into disposable scrubs to commence the case. In the situation where there are subsequent or back-to-back cases, the examiner must either shower or wash thoroughly in between and change into fresh scrubs prior to proceeding. Equipment and supplies: It is important that the equipment and supplies used to conduct forensic medical examinations and collect evidence are readily available in the sexual assault room and are stored and accessed in a way that minimises the risk of DNA contamination and facilitates the double cleaning process. The examination room must contain a lockable storage unit for storing all medical supplies and equipment required for the forensic medical examination. Regular assessment of standards Given the serious implications that may arise if DNA contamination occurs it is important to monitor standards. It is recommended that control swabs be collected bi-annually to ensure room cleaning protocols are adequate for a forensically sound environment for the undertaking of forensic examinations. The log book must be properly maintained and kept securely. It may be audited to verify whether the examination room was cleaned prior to each forensic medical examination. It is recommended an audit be performed by the examiners every 3 months to ensure cleaning standards are being maintained. All medical, nursing, counselling and cleaning staff to be encouraged to lodge their DNA profile on the laboratory register. Examinations to be carried out only by staff appropriately trained in performing forensic/ medical examinations.

All Staff Positions accountable for a) compliance with the policy: medical officers and sexual assault forensic nurse examiners b) monitoring and evaluation of the policy: LGH sexual assault service c) development and revision of the policy: LGH sexual assault service Attachments Attachment 1 Attachment 2
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Launceston General Hospital (LGH), Cleaning Department, Daily Cleaning Duties 3.23B Check list for the minimising DNA contamination of the sexual assault
LGH Policy 9.5/11 WACS

examination room at LGH. Attachment 3 Equipment and materials required for a forensic medical examination

References: State Government Victoria: Interim Practice Arrangements for the provision of forensic medical examinations to victims/survivors of sexual assault in crisis care units to minimise the risk of DNA contamination April 2010 Victoria, Inquiry into the Circumstances that led to the conviction of Mr Farah Abdulkadir Jama, 6 May 2010 [The Hon Frank Vincent QC]

Queensland Government/Queensland Health: Recommendations by A/Prof Bob Hoskins, Director Clinical Forensic Medicine Unit on DNA cross-contamination, March 2010 Performance Indicators: Compliance of this policy will be monitored by the forensic examiners and other forensic service providers. The Forensic Science Service will test swab the examination suite on a twice yearly basis to monitor forensic integrity The policy will be reviewed on an annual basis by the forensic nurse examiners. Review Date: Annually verified for currency or as changes occur, and reviewed every 3 years by the LGH Sexual Assault Service. Medical officers and sexual assault forensic nurse examiners, LGH Sexual Assault Service Medical officers and sexual assault forensic nurse examiners, LGH Sexual Assault Service

Developed By:

Stakeholders:

Dr A Dennis Co-Director (Medical) Womens & Childrens Services

Sue McBeath Co-Director (Nursing & Midwifery) Womens & Childrens Services

Date: ________________________

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