Enhancing Access and Care

Penn State aims to improve the quality of care for victims of assault by partnering with underserved communities across Pennsylvania.

Sheridan Miyamoto is director of the Sexual Assault Forensic Examination and Training (SAFE-T) Center at Penn State. Utilizing telehealth technology within the College of Nursing, Miyamoto plans to partner with communities to provide mentoring, education and support for nurses who provide examinations to victims of sexual assault, particularly those in rural areas of Pennsylvania.

Within the state, Miyamoto observed that of those nurses who are certified as sexual assault nurse examiners (SANE) by the International Forensic Nurse Association, many tend to reside in urban areas. Sexual assault rates are higher in rural areas versus urban settings, yet because these areas are less populated, there are not enough opportunities for nurses to attain or retain proficiency at conducting these technically challenging examinations. Through the use of telehealth, her focus became how to build a network and connect resources across the state to address the needs of underserved areas.

A woman stands in front of a green screen in a production studio.

The SAFE-T Center lab will provide forensic nurses in underserved areas with access to experts and advanced training in the care of sexual assault victims. Image: Patrick Mansell

“Sexual assault is a traumatic experience. Ensuring that compassionate, high-quality, evidence-based care is available wherever it is needed is essential,” says Miyamoto. “Forensic nurses are one of the first professionals that a victim interacts with following this trauma. When trained, compassionate and confident nurses are available, the experience can be a positive one and is often the first step toward healing from an assault.”

Funded by a $4.1 million U.S. Department of Justice, Office for Victims of Crime grant, the overall goal of the SAFE-T program is two-fold, according to Miyamoto, first to enhance access to high-quality care for victims of assault, and second to demonstrate the effectiveness of a statewide model to support forensic nurses to deliver such care in underserved communities. She considers Penn State the ideal university for such an undertaking.

“Penn State has a strong nursing presence both in educational programs and in the Community Based Research Network, allowing us to introduce nurses to the field of forensic nursing during their training. They are then more likely to practice within the communities where there is need. If our research determines that this model improves access, quality of care and the quality of forensic evidence collected, we will know it is the right thing to do. That is my great hope,” Miyamoto said.

"The Penn State campuses are conveniently distributed across the state and there is a strong nursing presence both in educational programs and in the Community Based Research Network." Miyamoto said.

The goal is to empower those nurses who want to provide this type of service to their community to work with experienced nurse examiners via a video telehealth set-up. Using a high-definition camera and videoconferencing technology, the nurses work together to provide a positive, timely, and thorough evaluation.

“Experienced nurse examiners have the opportunity to mentor those that are less experienced in a partnership designed to result in higher quality patient care and a more forensically defensible exam,” says Miyamoto. “The consultant nurse team will offer 24/7 live exam guidance and mentoring to the nurses in the rural communities, who are meanwhile enhancing and developing their skills so they can become the local experts.”

Using a high-definition camera and videoconferencing technology, the nurses work together to provide a positive, timely, and thorough evaluation.

The SAFE-T Center aims to take a step further outside the hospital doors by engaging Community and Expert Advisory Boards, made up of a multidisciplinary group of community leaders and researchers, to engage in planning for the success and future growth of a state-wide network to support this field. Miyamoto has already enlisted the contributions of 18 board members external to Penn State who represent domains including advocacy, policy, law enforcement, PA Department of Health, rural community and hospital system interests, and rural pilot site hospital champions.   

Miyamoto stresses the importance of role diversity within the coalition.

“Sexual assault is a multi-faceted issue,” she said. “We need law enforcement, district attorneys, health care, children and youth services and advocacy groups all at the table. We need to ask how we can together build a solution, how we can regionalize service and meet the needs of victims of assault. Together, we can produce the change we wish to see.”