Prosecutor Preference for Forensic Nurse Testimony: Outcome of Expanding a Forensic Program

IntroductionThe objective was to evaluate the impact of using forensic nurse examiners for patients with trauma on prosecutors’ preference for testimony in criminal court.MethodsA retrospective chart review of a database of 562 subpoenas received from January 2012 to December 2017 was conducted for patients with trauma seen in a level 1 trauma center with a comprehensive forensic nursing program.ResultsThe prosecutors’ preferences in 453 of the 562 subpoenas received by the Forensic Nurse Examiners program involving a patient with trauma were analyzed. The prosecutors preferred the use of the forensic nurse examiner alone in 441 of the 453 cases (97.4%), with a decrease (100% to 2.7%) in preference for physicians testifying in criminal court after the expansion of our forensic nursing program compared with previous years before the program expansion.DiscussionThe quality of the expanded Forensic Nurse Examiner program was validated by an increased prosecutor preference for forensic nurse examiner testimony in criminal court as the program matured over the years.     

Forensic Nurse Hospitalist: The Comprehensive Role of the Forensic Nurse in a Hospital Setting

Forensic nursing is an evolving specialty designed to address the unique, intersecting health and legal needs of patients who are victims, suspects, and perpetrators of trauma. The “Forensic Nurse Hospitalist” is proposed as a new term to describe the role of the nurse who is qualified by licensure and education as a specialist in forensic nursing and practices specifically in the hospital setting. The forensic nurse hospitalist can provide comprehensive, medicolegal care to patients receiving treatment for trauma-related injury and questionable death in the acute care setting. The purpose of this paper is to highlight the need and importance of the forensic nurse hospitalist and describe the multifaceted responsibilities of the role as a transformational leader in health care today. It is vital that health care systems employ forensic nurse hospitalists to deliver expert patient care, offer specialized consultation and collaboration, and implement systemwide policy and educational initiatives to best meet the needs of patients who have experienced intentional or unintentional trauma.     

Embracing a Competency‐Based Specialty Curriculum for Community‐Based Nursing Roles

The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community‐based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross‐mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community‐based specialties and (b) ensure the appropriateness of a Quad Council‐based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross‐mapping process, including validation with practice leaders. Results indicate strong alignment of community‐based specialty competencies with Quad Council competencies. Community‐based specialty‐specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council‐based curriculum is appropriate to prepare graduates in community‐based specialties when attention to the specialty‐specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community‐based specialties.     

Identification of nurses' competencies in primary health care through a Delphi study in southern Brazil

ABSTRACT Objective: This investigation aimed to identify and analyze the general and specific competencies of nurses in the primary health care practice of Brazil.
Design: The Delphi Technique was used as the method of study.
Sample: 2 groups of participants were selected: One contained primary health care nurses ( n =52) and the other specialists ( n =57), including public health nurses and public or community health faculty.
Measurements: 3 questionnaires were developed for the study. The first asked participants to indicate general and specific competencies, which were compiled into a list for each group. A Likert scale of 1–5 was added to these 2 lists in the second and third questionnaires. A consensus criterion of 75% for score 4 or 5 was adopted.
Results: In the nurses' group, 17 general and 8 specific competencies reached the consensus criterion; 19 general and 9 specific competencies reached the criterion in the specialists' group. These competencies were classified into 10 domains: professional values, communication, teamwork, management, community-oriented, health promotion, problem solving, health care, and education and basic public health sciences.
Conclusions: These competencies reflect Brazilian health policy and constitute a reference for health professional practice and education.     

Integrating environmental health into an undergraduate community health nursing course

Nurses are often the first members of the healthcare system to whom the public turns when environmental health hazards cause concern. Yet most nursing programs include scant formal environmental health content. This article describes a project that integrated significant environmental health content into an undergraduate community health nursing course. The revised course included additional environmental health classroom content and field experiences. Details are provided regarding changes to classroom content, revision of written assignments to include environmental health issues, planning and implementation of nursing student field experiences with environmental health professionals, and evaluations of the revised course. The article concludes with three recommendations to guide other schools of nursing, wishing to integrate environmental health into their curricula.     

The Quad Council Practice Competencies for Public Health Nursing

This article describes the most recent efforts by the Quad Council of Public Health Nursing organizations to review and revise the competencies for PHN practice, and highlights the implications of these competencies for practice, education, and research. The Quad Council is a coalition of four nursing organizations with a focus on public health nursing and includes the Association of Community Health Nursing Educators; the Association of Public Health Nursing (known prior to July 1, 2012 as the Association of State and Territorial Directors of Nursing); the Public Health Nursing section of the American Public Health Association; and the Council on Economics and Practice of the American Nurses' Association. The Quad Council competencies are based on the Council on Linkages competencies for public health professionals and were designed to ensure that public health nursing fits in the domain of public health science and practice.     

The healing power of reflective writing for a student victim of sexual assault

The phenomenon of a caring relationship between a teacher and her student, a victim of sexual assault, is mediated through reflective writing assignments in a baccalaureate nursing program. Increased self-awareness, personal transformation, and healing results when the student is encouraged to openly write about her feelings.     

Hints for the Aspiring Public Health Nurse

ABSTRACT The original article from which these excerpts were taken, “Some Hints to the Nurse Who Seeks to Become a Successful Partner in the Community Health Program,” by Mary Margaret Muckley, was published the 1923 volume of the original Public Health Nursing journal. The paper listed practical pointers to nurses wanting to work in the area of public or community health nursing. The author's advice involved personal attributes, professional engagement, skills, effective organization, and community relations. Much of the original article contained sound advice for aspirants to nursing work in community settings, but some advice may be considered too idealistic even for this optimistic time period. While the particular references to organizations and agencies existing in Helena, Montana have been omitted, the nurse reading the paper in 1923 had a general guide to her key stakeholders. The excerpts from this paper may give contemporary readers an appreciation of the endurance of what Muckley terms the public health nurse's “Valuable Assets.”     

Pre-admission nursing assessment in a Welsh Medium Secure Unit (1991-2000): Part 2--comparison of traditional nursing assessment with the HCR-20 risk assessment tool

Pre-admission forensic nursing assessment is a tradition that has no research evidence base, little documentary support and is an expensive drain on nursing resources from clinical environments. Such an expensive practice warrants some evaluation of the quality of these nursing assessments. This study assessed the quality of nursing risk assessments through comparison with the HCR-20, a well-established and widely validated violence risk assessment instrument. There was a high degree of correspondence between nurse assessments and the contents of the HCR-20. The results offer support for forensic nurses' abilities to develop effective measures and practices based upon nursing knowledge and experience where no formal evidence base previously existed.     

Overcoming barriers and improving public health nursing practice

Public health nurses (PHN) are critical to ensuring the health of communities. Absent the most basic information on the PHN workforce in our state, we conducted interviews with 21 PHN and school health nurse (SHN) leaders and an online survey of PHNs and SHNs practicing in Maryland (N = 491). Our study identified an older, very experienced, and well-educated workforce. Both the interviews and survey identified similar barriers: low salaries, recruitment and hiring challenges, limited funding for public health programs, and no opportunities for education or career advancement. Survey participants also identified barriers of inadequate leadership, recognition, and communication including PHNs not being represented at decision-making tables or at the state leadership level. Strategies to promote public health nursing from leaders and survey participants were similar: increasing awareness about what public health and PHNs do and their value; improving advocacy and stakeholder engagement; improving access and availability of services; improving PHN leadership representation at the state level; a improving PHN salaries and benefits including tuition reimbursement. Although results were similar to national studies, comprehensive, granular workforce data is critical to ensure the public health workforce can meet current and emerging public health needs and that public health infrastructure and services are appropriately funded.     

Special Features: Clinical Concepts: Reinvigorating Performance Evaluation: First Steps in a Local Health Department

ABSTRACT The ability of a local health department to assess and improve employee performance through an effective evaluation process is critical to overall organizational success. A constructive performance evaluation process not only provides meaningful feedback on work performance but also provides opportunities to reinforce work behaviors that support the organization's mission, to recognize exceptional work, and to guide future growth and learning. The Los Angeles County Department of Public Health is creating a new approach to performance evaluation that recognizes 3 distinct components of work performance: standard business practices, competencies, and standards of practice. This multidimensional perspective acknowledges that the expectations of workers are complex and that evaluations of performance are not easily captured with single‐dimension assessment tools. This report describes the conceptual relationships of these 3 components and how they integrate to form a single performance evaluation process. Key elements within this structure include a base document of competencies for all workers, expanded competency sets for professional staff, role‐specific duty statements for workers who perform similar work, and standards of competent practice related to the mission of units to which individuals are assigned. Key first steps are to define the terminology of performance evaluation and to create role‐specific duty statements.