Ethical Expert Witness Testimony.

Forensic nurses are routinely called upon to provide expert consultation and witness testimony. Nearly half of the enumerated standards in the Forensic Nursing Scope and Standards of Practice reference competencies directly related or complementary to ethical testimony. Requests from the field, coupled with the increasing opportunities for forensic nurses to serve as expert witnesses, necessitate the development of clear parameters for ethical expert witness testimony.

Intervenções de enfermagem na prevenção da violência em contexto Forense: uma Scoping Review / Nursing interventions to prevent violence in forensic settings: a scoping review

Introdução: Atualmente, a violência, por ser um fenómeno complexo e dinâmico, exige, dos enfermeiros em geral e em particular daqueles que trabalham em serviços de psiquiatria forense, uma compreensão multidimensional e intervenções sistémicas e resilientes. Objetivo: Mapear as intervenções implementadas pelos enfermeiros, para prevenção da violência por parte das pessoas internadas, em serviços de psiquiatria forense. Metodologia: Protocolo de Scoping Review com base nos princípios preconizados pelo Joanna Briggs Institute, considerando os materiais bibliográficos publicados de janeiro de 2018 a julho de 2023, nas bases de dados CINAHL e MEDLINE e selecionados com recurso à plataforma Rayyan. Esta revisão considerou a inclusão de estudos, independentemente da área geográfica ou do desenho, nos idiomas português, inglês e espanhol, disponíveis sem custos para os revisores. Esta pesquisa procura responder à questão norteadora, fundamentada pela estratégia PopulaçãoConceito-Contexto (PCC): Que intervenções são implementadas pelos enfermeiros, para prevenção da violência por parte das pessoas internadas, em contexto de psiquiatria forense? Resultados: Foram incluídos quatro artigos na revisão e identificadas intervenções e programas de treino para a prevenção/redução da violência, pelos enfermeiros, em serviços de psiquiatria forense. Espera-se que os resultados possam contribuir para melhorar a prática de cuidados à pessoa com doença mental nestes contextos. Conclusão: Esta pesquisa identificou intervenções e programas de treino sustentados, dois deles baseados na Terapia Cognitivo-Comportamental, para prevenção da violência por parte das pessoas internadas, em serviços de psiquiatria forense. Mais estudos devem ser realizados para identificar intervenções inovadoras com foco na prevenção/redução do comportamento violento das pessoas internadas em serviços de psiquiatria forense.

Forensic Nursing.

These nurses practice where the health and legal systems intersect.

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.

Forensic Nursing competencies in disasters situations: scoping review.

OBJECTIVE: To map sources of technical-scientific information on Forensic Nursing competencies in disasters situations. METHOD: Scoping review developed in accordance with the JBI methodology, carried out in three stages by two reviewers independently on selected databases and gray literature, using keywords and descriptors. After reading them in full, we proceeded with data extraction and content analysis of 28 publications. RESULTS: Identified 24 publications in English, 20 of which were produced in the United States of America. 24 competencies of forensic nurses in disasters situations were mapped, including: training; resource management; link with the justice service; direct care; psycho-emotional care; collection and preservation of traces; registration and documentation with photography; body management; maintenance of the chain of custody; and epidemiological surveillance. CONCLUSION: The forensic nurse acts in all phases of disasters with the affected people, families and communities, under an interdisciplinary perspective. The development of competencies aimed at the practice of Forensic Nursing in disasters should be incorporated into the training strategies of these professionals, in order to obtain better response standards.

Clinical Decision Making in Forensic Nursing: A Cross-Sectional Study From an Emergency Nursing Perspective.

BACKGROUND: Appropriate clinical decision making (CDM) is very important for emergency nurses when working with forensic patients with violence-related injuries and can improve patient outcomes. Therefore, it is essential for emergency nurses to have the basic skills to make the right clinical decisions when working with forensic patients. AIM: The aim of this study was to evaluate the CDM of emergency nurses when caring for forensic patients. METHODS: This study was conducted using a cross-sectional design. Nurses working in the seven emergency departments of Rasht hospitals, Guilan Province, Iran, were recruited to take part in the study. Data collection was performed via census sampling from September to November 2019. Data were collected via a two-part questionnaire developed by the researcher(s) that addressed (a) demographic characteristics and (b) simulated scenarios that assessed their CDM in caring for forensic patients. FINDINGS: One hundred ninety-two emergency nurses participated in this study. The mean score of CDM in forensic nursing was moderate (56.46; 95% CI [54.49, 58.43]). Of the participants, 60.42% of the emergency nurses had moderate CDM knowledge related to forensic nursing, whereas only 2.8% had desirable knowledge of CDM. There was a statistically significant relationship between CDM in forensic nursing and the history of encountering forensic patients ( p = 0.008). CONCLUSION: CDM scores regarding emergency nurses' knowledge of forensic nursing were moderate. Knowledge of and CDM in forensic nursing is very important and provides high-quality safe care for forensic patients. IMPLICATIONS FOR CLINICAL FORENSIC NURSING PRACTICE: This study highlights the importance of additional education and professional development in forensic nursing, for emergency nurses, and should be considered further by nursing administrators and nursing educators.

A Trauma-Informed Mentoring Framework for Forensic Nurses: An Overview of STEERR-Structure, Process, and Evaluation.

ABSTRACT: The STEERR Mentoring Framework, grounded in decolonized and feminist mentorship approaches, integrates foundational principles of mentoring with the unique and complex characteristics of the role of the forensic nurse. The primary objective of the program is to support a competent, sustainable, and resilient forensic nursing workforce. In this article, we describe the development process, framework structure, and evaluation approach implemented within a 1-year pilot initiative focused on forensic nurses in the sexual assault nurse examiner role. We reflect on strategies for broader application and replication in forensic nursing programs across the United States.

An Account From a Sexual Assault Nurse Examiner on Caring for a Transgender Survivor: A Case Report.

ABSTRACT: Transgender individuals represent a gender minority population that has been underserved within the healthcare system and underrepresented in population health and sexuality research, specifically as it pertains to sexual assault. This case report aims to explore how sexual assault nurse examiners (SANEs) approach the care of transgender people who have survived sexual assault. Key components and findings related to the SANE's encounter will be examined including an evaluation of the biases and assumptions held by the SANE and other healthcare providers. Concepts such as cisnormativity, heteronormativity, and intersectionality will be examined in terms of how these can shape the experience of the survivor, influence the care provided by SANEs, and interact with gender stereotypes and nonaffirming practices faced by transgender people. This case report highlights the importance of acknowledging and undermining nursing approaches that can (re)traumatize sexual assault survivors and explores ways in which SANEs can help to shift views of gender and bodies with the goal of providing better care for gender minority populations.

Advancing Health Equity Through Graduate Forensic Nursing Education.

ABSTRACT: Social justice is a core value of nursing and is deeply rooted within forensic nursing. Forensic nurses are uniquely positioned to examine and address social determinants of health that contribute to victimization, lack of access to forensic nursing services, and inability to utilize resources and services aimed at restoring health after an injury or illness related to trauma or violence. To achieve this, forensic nursing capacity and expertise must be strengthened through robust education. A graduate, forensic nursing, program sought to address this educational need by integrating content related to social justice, health equity, health disparity, and social determinants of health throughout its specialty curriculum.

Sexual Assault Nurse Examiner Education Needs in Texas.

ABSTRACT: Background: As with many areas of the nation, Texas lacks a robust sexual assault nurse examiner (SANE) workforce. A program in Texas offers courses to educate and expand SANE skills to better provide trauma-informed care to vulnerable populations. Methods: A survey to stakeholders of a SANE educational program, as part of a planned program evaluation, elicited not only barriers to providing care but also specific program needs to better expand access to sexual assault and domestic violence medical forensic examinations in Texas. Results: In January 2022, a total of 40 stakeholders, all registered nurses in the state of Texas, provided vital information on their current program. Analysis of written survey responses provided themes regarding barriers to providing SANE care and suggestions for expanded education. Discussion: The survey provided valuable feedback and comments on the perceptions of the current SANE program. Written responses offered direction for additional learning desires of SANEs associated with the program as well as areas for the program to expand to meet the needs of the learners. This stakeholder guidance has implications beyond this one SANE education program to enhance and expand other programs based on learner needs.

Improving the Forensic Documentation of Injuries Through Alternate Light: A Researcher-Practitioner Partnership.

ABSTRACT: An alternate light source (ALS) is a practitioner-driven technology that can potentially improve the documentation of injuries among victims of interpersonal violence. However, evidence-based guidelines are needed to incorporate and document an ALS skin assessment into a forensic medical examination that accurately reflects the science, context of forensic nursing practice, trauma-informed responses, and potential impact on criminal justice stakeholders. This article introduces the forensic nursing community to a current translation-into-practice project focused on developing and evaluating an ALS implementation program to improve the assessment and documentation of bruises among adult patients with a history of interpersonal violence. Our researcher-practitioner collaboration uses theory-based approaches that consider both the developed program's practice context and stakeholder impact. The goal is to provide evidentiary support for adult victims of violence and a more equitable forensic nursing practice that benefits diverse patient populations.

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.

The Forensic Psychiatric Network of Observation and Documentation: At the Intersection of Review Board Hearings and Nursing Practice.

ABSTRACT: Forensic psychiatric nursing is a specialty at the junction of two well-researched intersecting systems with two mandates: criminal justice and health care. Nurses' involvement at one of the systems' points of juncture, review board (RB) hearings, has largely been left unexplored. At RB hearings, a panel of legal and healthcare professionals determines if persons unfit to stand trial (UST) or not criminally responsible on account of mental disorder (NCR) represent significant threats to the safety of the public and orders conditions aimed at keeping the community safe. The aim of this article is to present the results of a critical ethnography that explored how psychiatric and public safety discourses construct the identity of persons UST or NCR during RB hearings as well as nurses' contribution to such identity construction. The main finding is that the forensic psychiatric structure leverages nursing interventions and documentation as evidence of deviancy, so that persons UST or NCR can be objectified and produced as dangerous. Structures sustaining the forensic psychiatric system inscribe nursing care within a disciplinary scheme, rendering the care-and-custody dichotomy insufficient to explain the complex processes at play in forensic psychiatry. These findings have implications for the practice of nurses working in forensic psychiatric settings and for that of other nurses who practice on the medicolegal borderland.

Forensic Nursing competencies in disasters situations: scoping review / Competências de enfermagem forense em situações de desastres: revisão do escopo / Competencias de la enfermería forense en situaciones de catástrofes: scoping review

ABSTRACT Objective: To map sources of technical-scientific information on Forensic Nursing competencies in disasters situations. Method: Scoping review developed in accordance with the JBI methodology, carried out in three stages by two reviewers independently on selected databases and gray literature, using keywords and descriptors. After reading them in full, we proceeded with data extraction and content analysis of 28 publications. Results: Identified 24 publications in English, 20 of which were produced in the United States of America. 24 competencies of forensic nurses in disasters situations were mapped, including: training; resource management; link with the justice service; direct care; psycho-emotional care; collection and preservation of traces; registration and documentation with photography; body management; maintenance of the chain of custody; and epidemiological surveillance. Conclusion: The forensic nurse acts in all phases of disasters with the affected people, families and communities, under an interdisciplinary perspective. The development of competencies aimed at the practice of Forensic Nursing in disasters should be incorporated into the training strategies of these professionals, in order to obtain better response standards.

RESUMO Objetivo: Mapear fontes de informações técnico-científicas relativas às competências da Enfermagem Forense em situações de desastres. Método: Revisão de escopo desenvolvida de acordo com a metodologia JBI, realizada em três etapas por dois revisores, de forma independente, em bases de dados e literatura cinzenta selecionadas, utilizando palavras-chave e descritores. Depois de lê-los na íntegra, foi feita extração de dados e análise de conteúdo de 28 publicações. Resultados: Identificamos 24 publicações em inglês, das quais 20 foram produzidas nos Estados Unidos da América. Foram mapeadas 24 competências do enfermeiro forense em situações de desastres, entre elas: treinamento; gerenciamento de recursos; vínculo com o serviço de justiça; atendimento direto; atendimento psicoemocional; coleta e preservação de vestígios; registro e documentação com fotografia; gerenciamento de corpos; manutenção da cadeia de custódia; e vigilância epidemiológica. Conclusão: O enfermeiro forense atua em todas as fases dos desastres com as pessoas, famílias e comunidades afetadas, em uma perspectiva interdisciplinar. O desenvolvimento de competências voltadas para a prática da Enfermagem Forense em desastres deve ser incorporado às estratégias de treinamento desses profissionais, a fim de se obter melhores padrões de resposta.

RESUMEN Objetivo: Mapear las fuentes de información técnico-científica sobre competencias de Enfermería Forense en situaciones de catástrofes. Método: Scoping review desarrollada de acuerdo con la metodología del JBI, realizada en tres etapas por dos revisores de forma independiente sobre bases de datos y literatura gris seleccionadas, utilizando palabras clave y descriptores. Tras su lectura completa, se procedió a la extracción de datos y análisis de contenido de 28 publicaciones. Resultados: Se identificaron 24 publicaciones en inglés, 20 de ellas realizadas en Estados Unidos de América. Se mapearon 24 competencias de los enfermeros forenses en situaciones de catástrofes, entre ellas: formación; gestión de recursos; vínculo con el servicio de justicia; atención directa; atención psicoemocional; recogida y preservación de vestigios; registro y documentación con fotografía; gestión de cadáveres; mantenimiento de la cadena de custodia; y vigilancia epidemiológica. Conclusión: El personal de enfermería forense actúa en todas las fases de las catástrofes con las personas afectadas, familias y comunidades, en una perspectiva interdisciplinar. El desarrollo de competencias dirigidas a la práctica de la Enfermería Forense en catástrofes debe incorporarse a las estrategias de formación de estos profesionales, con el fin de obtener mejores estándares de respuesta.

Aspectos sociodemográficos e capacidade funcional associados à violência física em pessoas idosas hospitalizadas / Sociodemographic aspects and functional capacity associated with physical violence in hospitalized elderly people

RESUMO Objetivo analisar a associação dos aspectos sociodemográficos e capacidade funcional com a violência física em pessoas idosas hospitalizadas. Métodos estudo multicêntrico, transversal, com 323 pessoas idosas atendidas em dois hospitais universitários. Foram utilizados o Conflict Tactics Scales, as escalas para avaliação das atividades básicas e instrumentais de vida diária e um questionário adaptado para avaliação de atividades avançadas de vida diária. Os dados foram analisados por estatística descritiva e inferencial. Resultados as atividades individuais de vida diária estiveram associadas à violência física maior, apontando haver uma relação inversamente proporcional entre as variáveis, e pessoas idosas independentes para essas atividades são aquelas que não vivenciam violência física maior (p=0,037). Conclusão a independência funcional para as atividades instrumentais de pessoas idosas internadas apresenta relação com menor probabilidade de ser vítima de violência física. Contribuições para a prática o estudo aponta achados singulares na relação entre violência física e a capacidade funcional, de modo que cada tipo de atividade de vida diária pode resultar em um desfecho diferente para a violência física. Outrossim, ratifica-se a relevância de avaliações individuais e contextualizadas no ambiente hospitalar, o qual pode influenciar os fatores condicionantes a esse agravo.

ABSTRACT Objective to analyze the association of sociodemographic aspects and functional capacity with physical violence in hospitalized elderly people. Methods this was a multi-center, cross-sectional study of 323 elderly people treated at two university hospitals. The Conflict Tactics Scales, the scales for assessing basic and instrumental activities of daily living and a questionnaire adapted for assessing advanced activities of daily living were used. The data was analyzed using descriptive and inferential statistics. Results individual activities of daily living were associated with major physical violence, indicating an inversely proportional relationship between the variables, and independent elderly people for these activities are those who do not experience major physical violence (p=0.037). Conclusion the functional independence for instrumental activities of elderly inpatients is related to a lower probability of being a victim of physical violence. Contributions to practice the study points to unique findings in the relationship between physical violence and functional capacity, so that each type of activity of daily living can result in a different outcome for physical violence. It also confirms the importance of individual and contextualized assessments in the hospital environment, which can influence the conditioning factors for this condition.

Percepção da equipe de enfermagem de serviço de atendimento móvel de urgência acerca das competências forenses / Percepción del equipo de enfermería del servicio móvil de atención de emergencia sobre las competencias forenses / Perception of the nursing team of mobile emergency care service about forensic skills

Objetivo: identificar a percepção da equipe de enfermagem atuante no Serviço de Atendimento Móvel de Urgência acerca das competências forenses. Método: estudo de natureza descritivo-exploratório com abordagem qualitativa,realizado com 11 profissionais que atuam em Serviço de Atendimento Móvel de Urgência. Os dados foram interpretados à luz do referencial teórico segundo Bardin. Resultado: emergiram quatro categorias centrais e uma subcategoria: Percepção da equipe de enfermagem acerca da singularidade da Enfermagem Forense; Sapiência dos participantes no que concerne à especialização da Enfermagem Forense; Experiências e vivências frente ao processo de preservação dos vestígios e evidências durante o resgate em situação forenses; Enfrentamento diante de ocorrências forenses; Vulnerabilidade, sentimentos e lembranças vivenciadas em ocasiões forenses. Conclusão: evidenciou-se a ausência da capacitação dos profissionais envolvidos nesse cenário. Percebeu-se, ainda, durante a análise das respostas dadas, que os participantes conhecem parcialmente o que é, qual a aplicabilidade e quais as competências da enfermagem forense.(AU)

Objective: to identify the perception of the nursing team working in the Mobile Emergency Care Service about forensic competences Method: a descriptive-exploratory study with a qualitative approach, carried out with 11 professionals who work in the Mobile Emergency Care Service. The data were interpreted in the light of the theoretical framework according to Bardin. Result: four central categories and a subcategory emerged: Perception of the nursing team about the uniqueness of Forensic Nursing; Participants' sapience regarding the specialization of Forensic Nursing; Experiences and experiences in the process of preserving traces and evidence during the rescue in forensic situations; Coping with forensic events; Vulnerability, feelings and memories experienced in forensic occasions. Conclusion: the lack of training of professionals involved in this scenario was evidenced. It was also noticed, during the analysis of the answers given, that the participants partially know what it is, what is the applicability and what are the competences of forensic nursing.(AU)

Objetivo: identificar la percepción del equipo de enfermería que actúa en el Servicio de Atención Móvil de Emergencia sobre las competencias forenses Método: estudio descriptivo-exploratorio con enfoque cualitativo, realizado con 11 profesionales que actúan en el Servicio de Atención Móvil de Emergencia. Los datos fueron interpretados a la luz del marco teórico según Bardin. Resultado: surgieron cuatro categorías centrales y una subcategoría: Percepción del equipo de enfermería sobre la singularidad de la Enfermería Forense; Sabiduría de los participantes sobre la especialización en Enfermería Forense; Vivencias y vivencias en el proceso de preservación de huellas y evidencias durante el rescate en situaciones forenses; Afrontamiento de eventos forenses; Vulnerabilidad, sentimientos y recuerdos vividos en ocasiones forenses. Conclusión: se evidenció la falta de formación de los profesionales involucrados en este escenario. También se constató, durante el análisis de las respuestas dadas, que los participantes conocen parcialmente qué es, cuál es la aplicabilidad y cuáles son las competencias de la enfermería forense. Palabras claves: Enfermería Forense; Prueba pericial; Servicios de emergencia; AtenciónPrehospitalaria; Enfermería.(AU)