The National TeleNursing Center: Transforming Care for Sexual Assault Patients, Providers and Communities.
Telemedicine is a proven vehicle for exporting specialized clinical care and consultation. However, until recently its application for improving care for adult and adolescent sexual assault patients had not been established. The recent launch of a National TeleNursing Center (NTC), a federally funded demonstration project, provides a groundbreaking opportunity to assess the impact of telemedicine on the quality of sexual assault examinations, and the level of support provided to clinicians conducting these examination by increasing access to expert Sexual Assault Nurse Examiners (SANE).
Adult and adolescent sexual assault victims have unique medical, emotional and medical-legal needs which include completion of a physical forensic examination, detailed documentation and forensic evidence collection, skills for which most emergency department clinicians have limited to no training. Sexual Assault Nurse Examiner (SANE) programs have demonstrated improved health care for sexual assault patients, increased quality of forensic evidence collection, and increased success with prosecution. However, access to SANE programs and other medical forensic expertise is not uniformly available throughout the country, particularly in remote and rural areas. In addition, clinicians who have received SANE training have difficulty maintaining proficiency in examinations unless they see a high volume of patients. Furthermore, health care providers often lack the critical debriefing support and ongoing education required for this stressful work, leading to high attrition rates. Telemedicine holds promise as a vehicle for increasing clinician's aptitude for providing care to these unique patient populations and expanding access to forensic nursing expertise both nationally and internationally.
The National TeleNursing Center (NTC) was created in 2012, has progressed through a developmental phase and is currently providing 24/7 expert SANE support and guidance to health care providers serving unique patient populations across the country in 6 hospitals in 3 states as they care for victims of an acute sexual assault, utilizing telemedicine technology and best practice nursing standards. Another marker of success has been increased collaboration and improved multi-disciplinary response across medical, advocacy and criminal justice agencies.
This panel will review the successes and challenges of this project to date. The NTC program team's presentation will review the development of the NTC model describe the telenursing methodology, and highlight progress in providing effective services and challenges related to sustainability. The presentation from the program evaluation team from the University of Illinois at Urbana-Champaign and the University of New Hampshire will discuss findings on impact and sustainability from data gathered from program staff, teleSANEs and site clinicians receiving telenursing consultation. Participants will learn how this novel use of telemedicine holds promise for improving outcomes for sexual assault survivors, increasing community responsiveness and identifying possible avenues for replication.
Director - MA SANE Program, Co-Director - National TeleNursing Center Project
MA Department of Public Health
Joan Meunier-Sham, RN, MS is the Director of the Massachusetts Sexual Assault Nurse Examiner (SANE) Program, responsible for the statewide delivery of Adult/Adolescent SANE services in 30 hospitals, and the delivery of Pediatric SANE services in 8 Children’s Advocacy Centers. She is also the Co-Director of the National TeleNursing Project, a pilot project funded by the National Institutes of Justice, Office of Victims of Crime. This demonstration project uses audio and video telemedicine technology for MA TeleSANEs to provide expert consultation to clinicians caring for sexual assault patients in underserved communities across the nation. Prior to these roles, Ms. Meunier-Sham was the Associate Director of the MA Pediatric SANE Program. In that role she had primary responsibility for the development and implementation of Pediatric SANE services across Massachusetts. Ms. Meunier-Sham has a clinical background in pediatric and pediatric emergency nursing. She received her Bachelor of Science degree from the University of Massachusetts-Dartmouth and her Master of Science degree in Parent/Child Nursing from Boston University.
National TeleNursing Center Education and Outreach Coordinator
MA Department of Public Health
Cynthia Moore, MSN, RN, CPNP is the Education and Outreach Coordinator of the National TeleNursing Center, a pilot project funded by the National Institutes of Justice, Office of Victims of Crime. This demonstration project uses audio and video telemedicine technology for MA TeleSANEs to provide expert consultation to clinicians caring for sexual assault patients in under-served communities across the nation. Ms. Moore is also a currently a consultant for the MA Pediatric SANE Program and in prior years she served as the Clinical Coordinator for the MA Pediatric SANE program. Cynthia is a pediatric nurse practitioner and is certified as a Pediatric Sexual Assault Nurse Examiner, as well as an Adult/Adolescent Sexual Assault Nurse Examiner, in Massachusetts. She formerly served as Acting Medical Director of the Child Protection Team at Boston Medical Center and was a Clinical Instructor at Boston University School of Medicine. She has worked as a Pediatric Nurse Practitioner for the last 15 years and has been a pediatric nurse for 25 years, working in the field of sexual assault and child abuse for the last 14 years. She has lectured locally, nationally, and internationally, providing training and education to law enforcement, medical and nursing staff, social workers, community agencies, and many other disciplines. She has served as a member of multiple state and community based initiatives and committees in the field of child abuse and sexual assault. Ms. Moore has been a member of the International Association of Forensic Nursing, American Academy of Pediatrics, American Professional Society on the Abuse of Children, and CHILD, Inc (Children’s Healthcare Is a Legal Duty).
Ms. Moore received her Master's degree from Simmons College and her undergraduate degree from Western Pennsylvania Hospital School of Nursing.
Research Associate Professor
University of New Hampshire's Crimes Against Children Research Center
Wendy A. Walsh, Ph.D. is a Research Associate Professor at the University of New Hampshire’s Crimes against Children Research Center. For over 15 years she has been conducting research on evaluating child abuse prevention and intervention programs and the criminal justice response to child abuse. Her research areas include the multidisciplinary response to child abuse, Internet crimes against children, child pornography victims, and unwanted sexual experiences during college. She is the author and co-author of numerous articles about child victimization and service use, the impact of victimization, and criminal justice outcomes.