Preservation of Forensic Evidence by Nurses in a Prehospital Emergency Care Service in Brazil.

Violence is a growing public health problem worldwide. Nurses increasingly must perform forensic procedures with the responsibility to collect, document, preserve, and store evidence that may be used in the investigation of a violent crime. However, few nurses receive education in forensic evidence collection as part of their training. This study aimed to evaluate the relationship between nurses' knowledge and performance of forensic evidence procedures. This is a descriptive survey study of nurses working in a prehospital emergency care service in Aracaju, Brazil. A 32-question survey related to forensic evidence knowledge and procedures was completed by 128 nurses. Descriptive statistics and Kendall's Tau-b were used to describe the sample and evaluate correlations. Results revealed an overall linear relationship between knowledge and performance of forensic evidence procedures (r = .69). The strongest correlation was between knowledge and documentation (r = .71). Weaker correlations were demonstrated between knowledge and evidence collection (r = .47), evidence preservation (r = .47), and overall evidence procedure execution (r = .53). Forensic nursing knowledge is related to forensic evidence procedure performance. Although the study showed that nurses agreed forensic evidence procedures are important for criminal investigations, most reported they were unprepared to carry out these procedures. The need for additional training and adherence to established institutional protocols are identified as contributing factors.

Burnout within forensic psychiatric nursing: Its relationship with ward environment and effective clinical supervision?

WHAT IS KNOWN ABOUT THIS SUBJECT?: Burnout is a prominent issue in psychiatric nursing and associated with significant adverse consequences for staff, service users and at an organizational level. Exploration of the extent and predictors of burnout in secure settings has received little research attention. It is not fully understood why prevalence rates of burnout in forensic settings are not elevated in comparison to other settings, despite the presence of known risk-related correlates. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: In contrast to previous research, findings suggest that clinical supervision may not be an effective, stand-alone intervention to support staff experiencing burnout. Thus, the current focus on clinical supervision to mitigate burnout may be insufficient in forensic services. The ward environment (specifically how safe staff feel, how therapeutic the ward feels and how well service users relate to one another) was found to be more important than clinical supervision in terms of burnout for forensic psychiatric nursing staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Policies regarding staff health and well-being should be developed with due consideration given to the association between burnout and the working environment. It should not be assumed that clinical supervision is sufficient to mitigate burnout in practice. Further research assessing all types of support and the ward environment is needed to gain a better understanding of its relationship to burnout. ABSTRACT: Introduction Despite extensive research examining burnout in psychiatric nursing staff, literature exploring key predictors of burnout in secure psychiatric settings has been relatively neglected. Research has yet to explore burnout in these settings by adopting previously identified predictors such as support or the ward environment. Aim The current study aimed to reduce this gap by exploring burnout, the perceived effectiveness of clinical supervision and ward environment. Method In 2014, nursing staff working in a medium secure forensic psychiatric unit in the United Kingdom (N = 137) provided demographic information and completed the measures assessing: Burnout, clinical supervision and the ward environment. Results Approximately 10% of nursing staff could be classed as "burnt-out". The main predictors of burnout were age and ward environment. Clinical supervision had minimal association with burnout. Discussion The current study sheds doubt on clinical supervision as a potential intervention for burnout and results appear comparable to research within other settings. The implications of the ward environment, supervision and burnout are discussed herein. Implication for Practice Interventions may need to focus on a positive ward environment (including patient cohesion, experienced safety and enhancing the therapeutic atmosphere). Organizations should support younger nursing staff as they appear particularly vulnerable to burnout.

Burnout symptoms in forensic mental health nurses: Results from a longitudinal study.

Burnout in nursing staff is a major cause for turnover and absenteeism. Identifying risk and protective factors may be helpful in decreasing burnout symptoms. Moreover, research indicates that ambulatory assessments of the autonomic nervous system might be helpful in detecting long-term stress and burnout symptoms. One hundred and ten forensic nursing staff members completed questionnaires measuring experiences with aggressive behaviour, emotional intelligence, personality, and job stress during four waves of data collection across a 2-year period. Multilevel analyses were used to test the predicted associations and moderation effects with (the development of) burnout symptoms. Burnout was predicted by a combination of emotional intelligence, job stress, aggression, personality factors, and skin conductance, but no moderation effects over time were found. Over a period of 2 years, the model approximately predicts a change in one burnout category on the Maslach Burnout Inventory. The amount of burnout symptoms in nurses might be used as an indicator to predict turnover and absenteeism considering the increase in symptoms over time. Nursing staff who experience severe aggression and who have relatively low levels of emotional intelligence and altruism and high levels of neuroticism and job stress should be monitored and supported to decrease the risk of burnout. Staff members can be trained to increase their emotional intelligence and relieve stress to decrease their burnout symptoms and turnover and absenteeism on the long term. Ambulatory assessment might be helpful as a nonintrusive way to detect increasing levels of burnout.

Special observations in forensic psychiatric practice: gender issues of the watchers and the watched.

Special observations in psychiatric practice may create tensions for both the patient under surveillance and the staff undertaking the procedure. This study reports on special observations undertaken in forensic settings focusing specifically on the gender-sensitive issues. The aim of the study was to investigate the specific gender issues relating to special observations in relation to those under the procedure and those engaged in observing. Three medium secure units in the UK formed the sampling frame, and the population studied was eight female and seven male clinical Registered nurses. Semi-structured interviews were conducted, audio-tape-recorded and transcribed for analysis. The analysis involved a Grounded Theory approach to explicate categories and formulate two overarching themes: (1) the psychosocial fusion; and (2) the private as spectacle. There are implications for practice in relation to policy formulation and the implementation of special observations following risk assessment and individual skill identification. It is concluded that gender issues are extremely important for all concerned in this intrusive practice.

Binary constructs of forensic psychiatric nursing: a pilot study.

The aim was to develop an Information Gathering Schedule (IGS) relevant to forensic psychiatric nursing in order to establish the perceived differences in the three levels of security, high, medium and low. Perceived differences in the role constructs of forensic psychiatric nursing is said to exist but the evidence is qualitative or anecdotal. This paper sets out a pilot study beginning in 2004 relating to the development of two rating scales for inclusion into an IGS to acquire data on the role constructs of nurses working in these environments. Following a thematic analysis from the literature two sets of binary frameworks were constructed and a number of questions/statements relating to them were tested. The Thurstone Scaling test was applied to compute medians resulting in a reduction to 48 and 20 items for each respective framework. Two 7-point Likert scales were constructed and test-retest procedures were applied on a sample population of forensic psychiatric nurses. Student's t-test was conducted on the data and the results suggest that the IGS is now suitable for application on a larger study. The IGS was piloted on a small sample of forensic psychiatric nurses. The two scales were validated to coefficient values ranging from 0.7 to 0.9. Amendments were made and the IGS was considered acceptable.