Multicenter evaluation to determine the deficiencies of emergency nurses in forensic case management.

INTRODUCTION: Emergency services are the first places where victims and/or perpetrators of different types of violence are brought for medical treatment. Emergency service nurses are the first health workers who first encounter with the forensic case, first communicate and are in an important position in the rapid and accurate continuation of the forensic process. In this study, it was aimed to determine the level of knowledge of emergency department nurses regarding the management of forensic cases. METHODS: The study was a cross-sectional, descriptive. Ninety-eight emergency nurses working in the emergency departments of three different public hospitals in the same province participated in the study. Study data were collected with the "Nurse Personal Information Form" and the "Knowledge Levels of Nurses related to the Approaches to Forensic Cases Questionnaire". RESULTS: 70.4 % of the nurses participating in the study were women, their mean age was (X ± SD = 27.36 ± 5.21). It is seen that 87.8 % of the nurses have a total working time in the emergency unit between 1 and 5 years and 11.2 % have received training on forensic nursing. "Total Knowledge Score" of undergraduate graduate nurses The mean score was higher and there was a significant difference between the groups (p > 0.05). The nurses who received in-service training and forensically evaluated all cases admitted to the emergency department had a higher mean score in the "Knowledge Score Regarding the Duties of Nurses Regarding Forensic Cases" mean was higher and there was a significant difference between the groups (p > 0.05). CONCLUSION: We recommend the use of institutional guides/protocols together with in-service training for emergency nurses to provide medically and legally correct forensic care and to have sufficient knowledge.

Nurses' experiences of racism in mental health settings through patient and family interactions: A systematic review.

Nursing staff engage readily with patients and associates in mental health/forensic inpatient settings. These settings are known to have instances of workplace violence directed towards staff and such violence includes racism. Racism is a form of workplace violence that must be better understood and supported within this complex setting. Completing a systematic review to coalesce preexisting research and suggested interventions can be beneficial to supporting nurses. Systematic review following PRISMA guidelines. CINAHL, PsycInfo, Medline, British Nursing Database and Web of Science databases were searched. Reviewers screened the papers for inclusion (29 articles out of 7146 were selected for inclusion) and completed the quality appraisal using the Mixed Methods Appraisal Tool. Subsequently, data extraction was completed, and findings were summarised through narrative synthesis. The way racism was conceptualised impacted how data was collected, reported and interpreted; racism was silenced or exposed depending on how studies were undertaken. If exposed, evidence indicates racism is a problem but is not always acknowledged or acted upon. Some evidence determined racism led to negative work-related outcomes. The literature provided limited examples of interventions. These included changing education/orientation for staff, openly discussing racist events and better planning for patients among colleagues and management. Increasing diversity within the workforce requires more research exploring and addressing issues related to racism towards nurses. Narratives of racism being normalised and embedded in mental health/forensic settings need to be challenged.

The Nurse-Police Assistance Crisis Team (N-PACT): A new role for nursing.

AIM: This study aimed to gain insights into forensic nurses' perspectives and approaches to behavioural crisis situations, comparing them to disciplines traditionally involved in first-line behavioural crisis response. DESIGN: This study used a descriptive, qualitative exploratory design and was informed by Systems Theory. METHODS: The study was carried in the United States, between 2022 and 2023. Data were gathered through four focus groups: police officers (n = 12), co-response (mental health) clinicians (n = 13), sexual assault nurse examiners (n = 6) and correctional nurses (n = 4). Thematic analysis was performed. REPORTING METHOD: The Standards for Reporting Qualitative Research (SRQR) guidelines were used. RESULTS: Findings revealed temporal themes in crisis response: (1) Searching for Historical Information; (2) Safety and Acting at the Present Scene; and (3) Future Strategies and Interventions. Common priorities (e.g. safety and de-escalation) were identified across groups. Notably, nurses demonstrated a comprehensive approach, addressing physical and mental health assessments, substance involvement, and physical injury evaluation. CONCLUSION: This study proposes the creation of a novel nursing role within first-line multidisciplinary teams (MDTs) for crisis response-the Nurse-Police Assistance Crisis Team (N-PACT). Nurses bring expertise and comprehensive assessment skills to enhance crisis responses, particularly in cases involving mental health emergencies, medical crises, and drug-related incidents. IMPLICATIONS: Forensic nurses, with their diverse competencies and comprehensive training, are highly valuable assets within MDTs. Their expertise extends to proficiently conducting mental and physical assessments, ensuring safety and adeptly navigating situations that intersect with the legal system. IMPACT: The N-PACT concept can improve outcomes and streamline the allocation of resources, particularly considering the number of police calls involving behavioural crises. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Forensic nursing in the emergency department: the distance between nurses' performed role behaviors and their perception of behaviors' importance.

BACKGROUND: Emergency department nurses often deal with victims of violence and trauma. In the emergency department, the main focus is on saving lives and stabilizing patients' conditions. The next important task is to preserve any valuable evidence that could potentially help identify a crime. It is important to describe how nurses currently practice in the emergency department and perceive their role in caring for forensic patients. This study aimed to investigate the frequency of performance and perception of the importance of forensic nursing role behaviors among emergency department nurses as well as the correlation between mean scores of performance and perception. METHODS: This is a cross-sectional correlational descriptive study. This non-observational survey study used a questionnaire to investigate the frequency of performance and perception of the importance of forensic nursing role behaviors among 274 emergency department nurses. RESULTS: The total mean scores for frequency of performed behaviors and their perceived importance were 2.36±0.65 and 4.23±0.64 respectively. The overall mean scores of importance were significantly higher than frequency. There was a significant correlation between the frequency of performance and perception of the importance of twenty-eight items (twenty-four positive correlations and 4 negative correlations) (p<0.05). The frequency of performed behaviors positively correlated with participants' type of shift worked and their personal experiences of legal and judicial claims. The female gender of respondents positively correlated with behaviors' perceived importance. CONCLUSION: The study revealed a significant discrepancy between the frequency of forensic nursing role behaviors performed and their perceived importance in the emergency department. This gap emphasizes the pressing requirement for forensic nursing subjects to be incorporated into graduate and undergraduate nursing curricula, as well as ongoing training programs and courses. It is crucial to establish and implement forensic nursing protocols for the care of trauma victims, and to foster collaboration between healthcare systems, law enforcement, and forensic investigators to streamline the process.

Poststructuralism and the construction of subjectivities in forensic mental health: Opportunities for resistance.

Nurses working in correctional and forensic mental health settings face unique challenges in the provision of care to patients within custodial settings. The subjectivities of both patients and nurses are subject to the power relations, discourses and abjection encountered within these practice milieus. Using a poststructuralist approach using the work of Foucault, Kristeva, and Deleuze and Guattari, this paper explores how both patient and nurse subjectivities are produced within the carceral logic of this apparatus of capture. Recognizing that subjectivities are fluid and dynamic, and capable of change, Deleuze and Guattari's concept of deterritorialization will illustrate opportunities for resistance, where nurses can begin to practice outside the dominant carceral logic (and restrictions) of the system.

Exposure to patient aggression and health outcomes for forensic mental health nurses: A cross-sectional survey.

AIMS: The aims of the study were to determine the types and prevalence of forensic mental health nurse exposure to patient aggression and explore the impact of these exposures on their physical and mental health and work absences. DESIGN: Cross-sectional survey conducted January to April 2020. METHODS: All 205 nurses working in an Australian high-security inpatient forensic mental health hospital were invited to participate. An online survey included the Perception of Prevalence of Aggression Scale to measure respondent exposure to types of patient aggression, and the SF-36v2 to measure mental and physical health. Absence from work and other work and individual characteristics were also explored. RESULTS: Sixty-eight respondents completed the survey. Verbal abuse was the most experienced aggression type, followed by physical violence and observing violence, patient self-harming behaviours and sexual violence. Nurses who worked in acute units experienced significantly more exposure to overall aggression than nurses in non-acute units. Higher level of aggression was associated with number of days sick leave taken and days off due to aggression or violence. Higher level of aggression was associated with poorer mental health, and patient self-harming behaviour was associated with poorer physical health. CONCLUSIONS: Nurses in acute units experience higher levels of inpatient aggression and are therefore at increased risk of being impacted by the exposure. Findings indicate a psychological impact of exposure to frequent aggression and potential for an accumulative effect of exposure to traumatic events on nurse well-being. Nurses who are victim of, or witness, physical violence are most likely to take time off work. IMPACT: This study provides further evidence that forensic mental health nurses are frequently exposed to various forms of patient aggression. For some nurses, this exposure to patient aggression negatively impacted their mental and physical health. Employing organizations should therefore prioritize provision of formal support for nurses. No patient or public contribution.

Development and evaluation of a forensic nursing competency-based hybrid simulation education program: A quasi-experimental design.

AIM: This study aimed to develop and validate the effectiveness of a hybrid simulation education program designed to enhance the forensic nursing competency of emergency department nurses. BACKGROUND: Emergency nurses often bear the responsibility of conducting forensic nursing assessments and interventions, such as patient recognition and evidence collection, to safeguard patients' legal rights, given their frequent encounters with emergency department patients. Simulation methods have proven effective in training for forensic nursing care. However, there is still a need for the development of forensic nursing education using simulation methods. DESIGN: This study employed a one-group pre-test/post-test quasi-experimental design. A four-hour simulation education program was developed based on the analysis, design, development, implementation, and evaluation model, with a focus on enhancing forensic nursing competency. METHODS: Nurses with more than six months of clinical experience in the emergency department in South Korea were divided into an experimental group (n=23) and a baseline comparison group (n=24). Both groups completed self-evaluations of their forensic nursing competency through a survey. The experimental group underwent the simulation education program, and their forensic nursing performance was evaluated before and after the program. Following the training, participants completed a questionnaire to assess their forensic nursing competency and satisfaction with the program. RESULTS: The initial forensic nursing competency of the experimental and baseline comparison groups was found to be similar. However, the forensic nursing competency and performance of the experimental group exhibited significant improvement after the training. Regarding program evaluation, the average scores on a 5-point scale were as follows: theoretical lecture (4.79 SD 0.27), simulation education (4.78 SD 0.29), simulation design (4.42 SD 0.45), and satisfaction with the educational program (4.82 SD 0.28). CONCLUSIONS: The forensic nursing competency-based simulation education program herein improved the relevant competency and performance of emergency nurses.

Documentation of wounds in emergency departments through a forensic lens.

BACKGROUND: Nurses document wounds to direct and evaluate the care. People admitted to emergency departments with wounds should be regarded as potential forensic patients, requiring meticulous documentation for evidence purposes. AIM: To explore the documentation of wounds in emergency departments through a forensic lens and compare it between different levels of emergency departments. METHODS: In this descriptive retrospective study, we randomly sampled 515 paper-based medical files of patients who sustained wounds admitted to three selected emergency departments. The files were analysed using a structured data collection tool the data were descriptively analysed. RESULTS: All files included information on the type of wound (100%) and the site of the wound (100%) with most files including the mechanisms of injury (98.6%). Few files included information on blood loss (18.1%) and the size of the wound (15%). Only one file included information on the contents of the wound. No files included information on the wound's shape and the surrounding skin's condition. CONCLUSION: Wounds were poorly documented in emergency departments, irrespective of the level of care. Nurses in emergency departments should have strict guidelines for documenting wounds since accurate documentation protects patients' human rights and protects nurses.

Modeling wellbeing for U.S. correctional nurses: A cross sectional survey.

BACKGROUND: Nurses work in stressful environments, and this stress has negative consequences on health. Correctional nurses experience unique job stress in their roles. However, there has been limited research exploring how the correctional environment impacts nurse health and wellbeing. OBJECTIVE: This study aimed to evaluate the relationship between the variables of organizational characteristics (i.e., job demands, job control, manager support, peer support, workplace relationships), job stress, and wellbeing levels in a sample of U.S. correctional nurses, while exploring socio-demographic covariates. METHODS: Using a convenience sampling method, 270 U.S. correctional nurses completed a cross-sectional online survey. Informed by the Job Demands-Resources Theory, a conceptual model was created and tested in this sample. Analysis involved multiple linear regression and structural equation modeling. RESULTS: The model significantly fit the data (CI: 0.71-0.83, CFI = 0.51, SRMR: 0.37, and RMSEA = 0.08) revealing the direct relationship between job stress, job demands, job control, and workplace relationships and wellbeing. This study also provided evidence that job stress mediates the relationship of job control and job demands with wellbeing. CONCLUSION: Results underscore the opportunity for correctional organizations to consider targeting job demands, job control, workplace relationships, and job stress in future interventions to improve the correctional nursing work environment and support correctional nurse wellbeing. TWEETABLE ABSTRACT: A recent study found evidence for a relationship between organizational characteristics & job stress and U.S. correctional nurse wellbeing.

Knowledge of child abuse and neglect in nursing students: Assessment and perspectives.

Misdiagnosis of child abuse and neglect can delay early treatment. Some authors have pointed out that nurses can miss child abuse and neglect diagnoses due to a lack of knowledge. It is unclear whether the lack of knowledge is due to students' insufficient preparation in nursing school and/or a deficiency in continuing education. An 18-item questionnaire was administered to final-year nursing students to assess their degree of knowledge on child abuse and neglect and to evaluate if the lack of knowledge was due to insufficient teaching/training during nursing school. The students were also asked to evaluate themselves by assigning a score to their knowledge. A statistical comparison was performed to define whether sufficient/insufficient results were associated with the following variables: sex, pediatric or general nursing student, attending pediatric lectures, training in pediatric wards/ambulatories, and attending specific lectures on child abuse and neglect. The study population comprised 175 students (154 females, 20 males, 1 unknown). Exactly 66.3% of the participants had ≤9/18 correct answers. Of all students, 77.7% self-evaluated their level of knowledge as ≤5/10. The comparisons yielded statistically significant differences between the groups with sufficient objective knowledge and those unrelated to training in pediatric wards/ambulatories or pediatric nursing students. Overall, there was little objective knowledge on the subject, which may be related to insufficient teaching/training in nursing schools. Useful corrective strategies include further teaching on child abuse and neglect, preferably using a practical approach. Further, common teaching/training programs should be conducted by both pediatric and general nursing schools.

Sexual Assault Nurse Examiner (SANE) program: Long-term impact on confidence and attitudes on SANE trainees.

AIM/OBJECTIVE: The current study examined the long-term impact of SANE programming on the confidence of SANE trainees and on their attitudes toward the SANE role after obtaining SANE certification. BACKGROUND: Nationally, sexual assault examiners (SANEs) are in short supply. However, the shortage of SANE nurses takes on a special meaning in the medically underserved United States- Mexico border region where human trafficking is seen as a threat in the region and sexual assaults may be less likely to be reported. In recent years, SANE training programs have established across the country to address the shortage of SANEs. Although positive outcomes have been reported among SANE training programs, the long-term outcomes of programming for trainees are not known. DESIGN: A descriptive longitudinal study with repeated measures was conducted. METHOD: A total of N = 66 registered nurses who had more than 2 years of nursing work experience were recruited to participate in a SANE training program. The current study included only n = 27 participants who completed the questionnaire at 3 points (Time 1) baseline, (Time 2) 6 months after SANE certification, and at (Time 3) 12 months after SANE certification. General linear modeling and repeated measures analysis of variance were used to analyze the data. Type 1 error was set at p = 0.10. An original 43-item questionnaire was developed to measure the SANE trainees' confidence and their attitudes toward the SANE role. RESULTS: Initially, an increased sense of self-confidence was found among trainees at least six months after completing SANE certification; however, this slowly diminished after one year. Likewise, attitudes toward the SANE role deteriorated six months after obtaining SANE certification. CONCLUSION: Lack of support and infrastructure to integrate SANE into the wider medico-legal community could explain the diminishing confidence and attitudes of SANE toward the role. The findings of this study have implications for the establishment of support infrastructures in the workplace and community to enhance the recruitment of nurses in SANE programs, the retention of SANEs in the workforce, the sustainability of SANE programs in underserved communities, and the establishment of protocols to integrate SANEs into sexual assault response teams (SARTs), especially in medically underserved US-Mexico border regions.

Multidisciplinary Perspectives on the Implementation of a Comprehensive Sexual Assault Telehealth Program in Rural Communities: A Qualitative Study.

Access to quality sexual assault (SA) care in rural communities is limited by challenges surrounding building and sustaining a skilled SA nurse examiner workforce. Telehealth can facilitate access to expert care while cultivating a local sexual assault response. The Sexual Assault Forensic Examination Telehealth (SAFE-T) Center aims to decrease disparities in SA care by providing expert, live, interactive mentoring, quality assurance, and evidence-based training via telehealth. This study examines multidisciplinary perceptions of pre-implementation barriers and SAFE-T program impact using qualitative methods. Implications for the implementation of telehealth programs to support access to quality SA care are considered.

Analysis of the descriptive characteristics of female victims of violence applying to the domestic violence office of a court of law.

INTRODUCTION AND PURPOSE: Intimate partner violence is a worldwide problem violating fundamental human rights. The aim of this study was to analyse the sociodemographic characteristics of women who have experienced intimate partner violence, the type and prevalence of violence, the mechanisms of injury as determined by forensic reports, the characteristics of the perpetrator, and the women's statements. MATERIALS AND METHODS: This was a single-site descriptive study conducted at the Office of Domestic Violence and Violence Against Women of a Court of Law located in the city of Izmir in western Turkey. The researchers reviewed forensic medicine case reports and prosecutorial writs in this office's files for women over 18 who had experienced violence over the period 2016-2019. The study sample consisted of the judicial application files of women who had experienced intimate partner violence and met the inclusion criteria (n = 350). The data in the files were entered into a standard form prepared by the researchers according to the file content. Written permission was obtained from the Ministry of Justice and Ege University Ethics Committee, and the verbal consent of the Prosecuting Officer was also obtained for the research. RESULTS: The ages of the women ranged from 19 to 80 years (mean age 35, SD 9.6), with 43.1% ranging from 30 to 39 years old. Of the women, 46.6% had a maximum primary school education, and 65.4% were homemakers. Incidents of intimate partner violence mainly occurred at home for 89.1% of women. A combination of verbal and physical violence was the most frequent form of violence affecting 303 women (83.4% of cases). The facial area was predominantly the target of attack for 59 (16.9%) victims, only the upper extremity for 55 (15.7%) and the face and upper extremity for 36 (10.2%) women. The statements of the victims of violence who described their experience were evaluated, and it was determined that the reasons for the emergence of violence were frequently alcohol and substance use, financial problems, jealousy, sexual problems, communication problems, and cheating. CONCLUSION AND SUGGESTIONS: Most of the women in the study who had applied to law enforcement due to intimate partner violence were victims of physical violence. The descriptive information obtained from these files constitutes essential data for health professionals in their efforts to deliver primary healthcare to women who are victims of intimate partner violence. Health professionals can provide immediate protection by identifying women at high risk of violence, monitoring them more frequently, and activating the support mechanisms they need.

The role of legal medicine professionals in preventing pregnancy and sexually transmitted infections among female victims of sexual assault.

Sexual violence can have an overwhelming impact on the victim's physical and mental health; the consequences include unintended pregnancy and sexually transmitted infections (STIs). Therefore, the examiners must assess victims for possible pregnancy and sexually transmitted infections as a part of the sexual assault examination. This article aims to orient the medico-legal examiners towards their role in preventing unintended pregnancy and sexually transmitted infections among victims of sexual assault. Prompt detection of pregnancy or STIs is critical, as any delay would adversely affect the successful administration of emergency contraception and post-exposure prophylaxis (PEP) against human immunodeficiency virus (HIV) and other sexually transmitted infections.

Characterizing Possible Acute Brain Injury in Women Experiencing Intimate Partner Violence: A Retrospective Chart Review.

Survivors of intimate partner violence (IPV) often experience violent blows to the head, face, and neck and/or strangulation that result in brain injury (BI). Researchers reviewed the de-identified forensic nursing examination records of 205 women. More than 88% of women were subjected to multiple mechanisms of injury with in excess of 60% experiencing strangulation. About 31% disclosed various symptoms consistent with BI. Women experiencing strangulation were 2.24 times more likely to report BI-related symptoms compared to those who reported no strangulation. In conclusion, women experiencing IPV are prone to BI suggesting early screening and appropriate management are warranted.

Violência contra pessoa idosa: análise da consistência interna de instrumentos* / Abuse against the elderly person: analysis of the internal consistency of instruments* / Violencia contra los ancianos: análisis de la coherencia interna de los instrumentos*

RESUMO: Objetivo: avaliar a consistência interna de instrumentos utilizados no Brasil para mensuração de situações de violência contra pessoa idosa em dois estados. Método: estudo de corte transversal, desenvolvido com 481 idosos, em duas amostras, estados e recorte temporal diferentes. Foram aplicados dois instrumentos de mensuração de violência contra pessoa idosa. Os dados foram analisados, e a consistência interna entre os itens foi medida pelo coeficiente de Alfa de Cronbach. Resultados: o Hwalek-Sengstock Elder Abuse Screening Test apresentou o coeficiente de α = 0,08 para amostra coletada na Paraíba, enquanto, em Pernambuco, foi α = 0,57. A Conflict Tactics Scale apresentou alta precisão para definição da violência com coeficiente de α = 0,81 e α = 0,80 para as duas amostras. Conclusões: apenas a Conflict Tactics Scale apresentou-se confiável e estável para determinação da violência de natureza física e psicológica entre idosos, contribuindo assim, como uma possibilidade de desvelar o fenômeno.

ABSTRACT Objective: to evaluate the internal consistency of instruments used in Brazil to measure situations of violence against the elderly in two states. Method: a cross-sectional study with 481 elderly people in two different samples, states, and time periods. Two instruments were used to measure violence against the elderly person. The data was analyzed and the internal consistency between the items was measured by the Cronbach's alpha coefficient. Results: the Hwalek-Sengstock Elder Abuse Screening Test showed a coefficient of α = 0.08 for the sample collected in Paraíba, while in Pernambuco it was α = 0.57. The Conflict Tactics Scale was highly accurate in defining violence, with a coefficient of α = 0.81 and α = 0.80 for the two samples. Conclusions: only the Conflict Tactics Scale turned out to be reliable and stable for determining physical and psychological violence among the elderly, thus contributing as a way of uncovering the phenomenon.

RESUMEN Objetivo: Evaluar la consistencia interna de instrumentos utilizados en Brasil para medir situaciones de violencia contra ancianos en dos estados. Método: Estudio transversal realizado con 481 ancianos en dos muestras, estados y periodos de tiempo diferentes. Se utilizaron dos instrumentos para medir la violencia contra ancianos. Se analizaron los datos y se midió la consistencia interna entre los ítems mediante el coeficiente alfa de Cronbach. Resultados: el Hwalek-Sengstock Elder Abuse Screening Test presentó un coeficiente de α = 0,08 para la muestra recogida en Paraíba, mientras que en Pernambuco fue de α = 0,57. La Escala de Tácticas de Conflicto fue altamente precisa en la definición de violencia, con coeficientes de α = 0,81 y α = 0,80 para ambas muestras. Conclusiones: sólo la Escala de Tácticas de Conflicto demostró ser fiable y estable para determinar la violencia física y psicológica entre ancianos, contribuyendo así a desvelar el fenómeno.

Strategies for coping with COVID-19 in prisons: a scoping review

Introduction: The poor health of prisoners in penitentiaries demonstrates a very favorable condition for the spread of the virus. Objective: To revise in the scientific literature the actions carried out by health professionals in prison units to face COVID-19. Method: Scoping review, guided by the recommendations of the Joanna Briggs Institute and structured from the acronym Population, Concept, and Context. The searches were carried out in 11 databases, with the inclusion criteria being studies in English, Portuguese, and Spanish; publications in 2019/2020 and available in full. For the selection of studies, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews flowchart was used. A total of 1,624 studies were found, of which 13 were eligible for the review. Results: From the analysis of the studies, two categories emerged: the first, diagnosis/control, which presented as proposed strategies isolation, screening, improvement of basic sanitation, education, social distancing, use of personal protective equipment, reinforcement of ventilation measures and the use of remote connection; and, the second, treatment that encompassed screening, support, and medicalization of the relevant symptoms of the pathology linked to emotional assistance. Conclusion: the analyses carried out indicate the need to develop a standard operating procedure that systematizes assistance, including prevention, diagnosis/control, and treatment of SARS-CoV-2 within the penitentiary system, briefly presenting priority actions to be carried out, emergencies needed and the flow in the services of the care network of the health systems.

Competências da enfermagem forense em situações de desastres: protocolo de revisão de escopo / Forensic nursing competencies in disaster situations: a scoping review protocol

OBJETIVO: mapear fontes de informação técnico-científicas sobre as competências da enfermagem forense em situações de desastres. MÉTODO: protocolo de revisão de escopo, desenvolvido em conformidade com a metodologia Joanna Briggs Institute (JBI). A busca será realizada em três etapas, por dois revisores, de maneira independente, em bases de dados selecionadas e na literatura cinzenta, por meio das palavras-chaves e dos descritores. A seleção, inicialmente, será por meio de títulos, resumos e descritores, observando os critérios de inclusão. Posteriormente, os textos serão arquivados em pastas digitais e lidos na íntegra por dois pesquisadores com o apoio de instrumento. Após a extração dos dados, será procedida a análise de conteúdo. A síntese dos resultados será apresentada na forma de gráficos, diagramas, tabelas e fluxos, buscando-se os devidos alinhamentos com o objetivo e a pergunta de pesquisa.

OBJECTIVE: to map the sources of technical-scientific information on forensic nursing competencies in disaster situations. METHOD: scoping review protocol, developed following the Joanna Briggs Institute (JBI) methodology. The search will be carried out in three stages, by two reviewers, independently, in selected databases and the grey literature, using keywords and descriptors. The selection, initially, will be conducted through the screening of titles, abstracts, and descriptors, observing the inclusion criteria. Subsequently, the texts will be filed in digital folders and read in full by two researchers with the support of an instrument. After extracting the data, the content analysis will be carried out.The summary of the results will be presented using graphs ,diagrams ,tables ,and flow diagrams for the proper alignment with the review's objective and question.

A critical ethnographic perspective on risk and dangerousness in forensic psychiatry.

In the Canadian forensic psychiatric context, the concepts of risk and dangerousness interact, intersect, and morph into the notion of significant threat to the safety of the public. Stemming from the results of a critical ethnography of the Ontario Review Board, this article unpacks the central role of forensic psychiatric nursing, as an example of a 'psych' discipline (e.g., psychiatry and psychology), in a system that is built to produce risky persons and to legitimize their detention and supervision. By using excerpt of interviews conducted with nurses, ethnographic observations of Review Board hearings, and other documentary artifacts, the findings illustrate how rationalizations of risk and dangerousness are contingent on space, time, and observer. Depending on the time of the assessment or on the health-care professional who performs it, different elements including, but not limited to, mental illness, interpersonal relationships, financial instability, and sexual vulnerability, are relied upon in very fluid, interchangeable, and discretionary ways to justify findings of dangerousness. Such a dynamic expands the reach of psychiatry's legitimacy at identifying risky conduct and controlling risky persons to domains very loosely associated with the notion of dangerousness. The work of Foucault and Castel provides the theoretical backdrop on which rests the discussion and the implications for nursing.

The emergence of custodial health nursing as a specialty whose time has come: An Australian experience.

BACKGROUND: Nurses provide healthcare in prisons worldwide. Working within security restraints, in environments not designed for nursing care, custodial health nurses (CHNs) use specialist nursing skills and knowledge to do essential work. Rapid increases in prisoner age, infirmity and ill-health of prisoners mandate their access to these nurses. AIM: To raise awareness of the CHNs struggle for specialty status within the nursing profession, public health frameworks and prisons. SOURCES OF EVIDENCE: Publicly available information is organised and analysed through the author's lens of 20 years working in the Australian prison system as a general nurse and nurse practitioner. DISCUSSION: CHNs efforts towards becoming a specialty within nursing, public health and prisons are ongoing. Overcoming barriers and maximising facilitators to effective CHN practice would be indicators of successful incorporation of nursing models that assist prisoner patients. Prison healthcare contexts are unique regarding prisoner health and funding that impacts the CHNs resourcing, their scope of practice and acceptance of nursing in prison systems and the broader healthcare sectors. CONCLUSION: Greater visibility of the CHNs will help promote policy reforms regarding nursing services within a changing prisoner demographic. Changes to educational and professional support for CHNs are needed. Policy restrictions on funding for CHN models in Australia fall short of international standards for prison healthcare; however, political and organisational commitment in this area will be necessary to attain community-equivalent healthcare standards across the custodial setting. IMPLICATIONS FOR NURSING AND OTHER POLICIES: Professional structures, competencies and specialty policy frameworks are required to promote CHNs as advocates for prisoners needing care and their professional development. CHNs at the forefront of policy development and review will benefit all stakeholders in custodial health.