In my role as an advanced practice nurse, I partnered with an interprofessional team that included an engineer to study and evaluate the use of a self-sampling device for cervical cancer screening among individuals who are unhoused. Although I did not contribute to the design and development of the device, I have been involved in the planning, study, and evaluation of using the device in practice.

Case Study for Cervical Self-Screening

Assigned females and individuals with a cervix who are unhoused have an increased risk (https://doi.org/10.1177/17455065211029238) for cervical cancer and a lower rate of Pap screening, sometimes because of past trauma. The new technology uses a trauma-informed care (https://voice.ons.org/news-and-views/trauma-informed-care-provides-person-centered-support-for-patients-during-deep) approach to provide an avenue for those individuals to self-sample and test for the human papillomavirus. A secondary benefit is that the technology could also improve the post–COVID-19 pandemic’s declines in cancer screening (https://doi.org/10.1371/journal.pone.0282853) and higher rates (https://doi.org/10.1371/journal.pone.0282853) of cervical cancer mortality and disparities in Black, Hispanic, and rural populations in Indiana, the state where I practice. 

Before implementing the device in the community, we are doing groundwork to create a foundation for its success: 

• We are currently conducting community-based participatory research to learn more about cervical cancer screening behaviors, barriers, and interest in individuals who are unhoused. 
• After that, we will conduct qualitative interviews to further explore the community’s knowledge, attitudes, and behaviors around cervical cancer screening. 
• Finally, we will begin to offer cervical self-sampling and navigation to study participants. 

We presented about our nursing-engineering collaboration in a poster (https://ons.confex.com/ons/2024/cp/eposterview.cgi?eposterid=3777) at the 49th annual ONS Congress® in April 2024. “Collaboration between oncology nurses and engineers facilitates creative solutions to unmet clinical needs. Both professions use a problem-solving approach, complemented by specialty knowledge in their areas of expertise,” we said (https://ons.confex.com/ons/2024/meetingapp.cgi/Paper/14803).

How I Contributed to the Nurse–Engineer Collaboration and Translation to Practice

As an oncology advanced practice RN, I had several opportunities to share my knowledge and experience for studies and procedures that will bring the technology to practice. See the sidebar for the project activities I participated in under an oncology nurse collaborator role. 

A significant role has been leading an interprofessional advisory board of local community stakeholders. The group reviews interview questionnaires, provides unique perspectives regarding barriers and navigation issues, and collaborates to improve processes and care for individuals who are unhoused. The quarterly advisory board meetings provide a mutually beneficial opportunity to collaborate and share findings. 

As an educator, I took advantage of the increased opportunities to work with community healthcare workers and nursing students to develop a women’s health assessment, discuss cancer screening guidelines, and provide trauma-informed care. 

Individuals who are unhoused are more likely to refuse (https://doi.org/10.1177/17455065211029238) Pap tests because of past experiences with physical, sexual, or emotional trauma. Negative healthcare experiences, such as discrimination and stigma (https://voice.ons.org/news-and-views/stop-stigma-and-discrimination-in-health-care-to-improve-equity-and-patient-outcomes), can also result in trauma that may influence (https://doi.org/10.1177/15248380221120836) cancer screening and treatment decision-making. Providing trauma-informed care, including (https://stacks.cdc.gov/view/cdc/56843) safety, choice, collaboration, trustworthiness, empowerment, and consideration of cultural, historical, and gender issues, promotes (https://doi.org/10.1188/23.CJON.576) patient healing and recovery.

Ultimately, oncology nursing–engineering collaborations combine diverse skill sets to develop and implement innovative solutions to unmet clinical needs. Both oncology nurses and oncology advanced practice providers have the creativity to navigate those new partnerships in concept, leadership, and support.