The role of Victorian emergency nurses in the collection and preservation of forensic evidence: a review of the literature

Misplaced Evidence, Missed Opportunities: Protocols for Handling Ballistic Evidence in Pediatric Patients

BACKGROUND

Gun-related injury is now the number one cause of death in pediatric trauma patients. Many hospitals lack dedicated forensic nurses or updated protocols for handling ballistic evidence. Evidence not collected, handled improperly, or misplaced may deny a victim the basic human right to justice.

OBJECTIVE

This article aims to describe an initiative to highlight the importance of proper management of ballistic evidence and to educate medical providers on best practices for the documentation, handling, removal, and transfer of ballistic evidence.

METHODS

After discovering 24 "orphaned" bullets and bullet fragments in our hospital that had not been turned over to law enforcement, we sought to turn in evidence to the proper authorities and implement protocols to prevent this error in the future. New protocols were written by forensic staff, and education on new protocols was provided via in-person training, grand rounds, emails, and other collaborative initiatives.

RESULTS

Evidence was matched to police reports using the patient name and date of birth on evidence labels. The median (interquartile range [IQR]) time of lost ballistic evidence was 1,397 (903, 1604) days, with the oldest bullet removed in 2015. All bullets were successfully returned to law enforcement with a median (IQR) time from bullet discovery to collection of 78 (78, 174) days.

CONCLUSIONS

Ballistic evidence handling protocols are essential for all hospitals. Dedicated, trained forensic staff should be employed to ensure proper evidence handling.

Preservation of forensic traces by Nursing in emergency services: a scoping review

OBJECTIVE

to map the scientific production on the preservation of forensic traces by Nursing professionals working in emergency services.

METHOD

a scoping review, with searches for studies carried out in six databases, in the gray literature available in Google Scholar and in the references of the studies selected. For analysis, the data reduction method was adopted.

RESULTS

26 studies were included, organized into five categories: 1) Nursing professionals' knowledge on the preservation of forensic traces; 2) Procedures performed by Nursing to preserve traces in the victim's body; 3) Procedures performed by Nursing to preserve traces in the victim's belongings/objects; 4) Procedures performed by Nursing to document traces; and 5) Actions to maintain the chain of custody performed by Nursing.

CONCLUSION

the studies showed situations in which the emergency nurse may act in the preservation of forensic traces present in the victim's body and in objects, as well as in the registration of traces, verifying the role of Nursing to ensure integrity of the chain of custody, especially in situations of aggression, firearm injury, sexual violence, child abuse and assistance to trauma victims.

Preservación de los rastros forenses que realizan los enfermeros en los servicios de emergencias: revisión de alcance

Resumen Objetivo: mapear la producción científica sobre la preservación de rastros forenses por profesionales de enfermería que trabajan en los servicios de emergencias. Método: revisión de alcance, con búsqueda de los estudios realizados en seis bases de datos, en la literatura gris disponible en Google Scholar y en las referencias de los estudios seleccionados. Para el análisis, se adoptó el método de reducción de datos. Resultados: se incluyeron 26 estudios organizados en cinco categorías: 1) Conocimiento de los profesionales de enfermería sobre la preservación de rastros forenses; 2) Procedimientos que realizan los enfermeros para preservar rastros en el cuerpo de la víctima; 3) Procedimientos que realizan los enfermeros para preservar rastros en las pertenencias/objetos de la víctima; 4) Procedimientos que realiza el personal de enfermería para documentar los rastros; y 5) Acciones que llevan a cabo los enfermeros para mantener la cadena de custodia. Conclusión: los estudios demostraron que hay situaciones en las cuales el enfermero de emergencias puede actuar para preservar los rastros forenses presentes en el cuerpo de la víctima y en los objetos, así como también registrar los rastros, lo que comprueba la actuación del enfermero para garantizar la integridad de la cadena de custodia, particularmente en situaciones de agresión, heridas con arma de fuego, violencia sexual, abuso infantil y asistencia a víctimas de trauma.

Preservation of forensic traces by Nursing in emergency services: a scoping review

Objective:

to map the scientific production on the preservation of forensic traces by Nursing professionals working in emergency services.

Method:

a scoping review, with searches for studies carried out in six databases, in the gray literature available in Google Scholar and in the references of the studies selected. For analysis, the data reduction method was adopted.

Results:

26 studies were included, organized into five categories: 1) Nursing professionals’ knowledge on the preservation of forensic traces; 2) Procedures performed by Nursing to preserve traces in the victim’s body; 3) Procedures performed by Nursing to preserve traces in the victim’s belongings/objects; 4) Procedures performed by Nursing to document traces; and 5) Actions to maintain the chain of custody performed by Nursing.

Conclusion:

the studies showed situations in which the emergency nurse may act in the preservation of forensic traces present in the victim’s body and in objects, as well as in the registration of traces, verifying the role of Nursing to ensure integrity of the chain of custody, especially in situations of aggression, firearm injury, sexual violence, child abuse and assistance to trauma victims.

Awareness of Forensic Cases Among Nurses: A Descriptive, Cross-Sectional Study

PURPOSE

This study reports the knowledge, experience, and attitudes of nurses toward forensic cases in Turkey; critically evaluates the appropriateness of current practices in the collection and preservation of evidence; and assesses nurses' level of awareness on the law enforcement perspective of forensic cases. The study, thereby, seeks to offer solutions to some practical difficulties faced by nurses in clinical practice in Turkey.

METHODS

The study involved 178 nurses of 202 employed in three healthcare centers operated by the same private healthcare group located in Istanbul, Turkey. The primary method of data collection was a questionnaire composed of three sections. The first section recorded data concerning the participants' age, gender, number of years spent in the profession, number of years spent in current workplace, department in which they worked, and their job title. The second section sought to assess the participants' academic background and, specifically, the extent of their educational training on forensic cases at the undergraduate and graduate levels. Finally, the third section aimed to assess the participants' knowledge of and approach toward the management of forensic cases in real-life time setting by collecting data on their previous experience with forensic cases.

RESULTS

Of 178 nurses, 139 (78.1%) were female and 39 (21.9%) were male. The mean age was 28.6 years, ranging from 18 to 51 years. The participants expressed that they experienced difficulties in medicolegal procedures (21.9%), evidence collection (14.0%), history taking and preparation of the patient (10.1%), forensic case reporting (10.1%), registry (9.0%), and physical examination (7.9%). The level of knowledge of the collection of forensic evidence and the protection of wet evidence was statistically higher among the participants who previously received training on the collection, preservation, and transfer of forensic evidence versus those who were not previously trained (p < 0.001 for both).

CONCLUSION

Our study results highlight the need for medicolegal regulations and legislation allowing for the creation of specific positions for forensic nurses in Turkey. We also concluded that these nurses should be trained and equipped with necessary knowledge and skills in forensic nursing.

Healthcare Personnel's Knowledge and Management of Frequently Encountered Forensic Cases in Emergency Departments in Turkey

BACKGROUND

Emergency department (ED) personnel frequently encounter incidents related to crime, violence, and suspicious injuries. The aim of this descriptive study was to determine the knowledge levels of ED healthcare personnel in their handling of frequently encountered forensic cases.

METHODS

A cross-sectional descriptive study composed of ED healthcare personnel at all state, education and research, and university hospitals with EDs, located in Ankara, Turkey, was completed. Participants at the 15 hospitals in question were interviewed via a questionnaire developed by the researchers.

RESULTS

Three hundred fifty healthcare personnel who worked agreed to participate in the study. The results show that ED healthcare personnel have less knowledge than expected of the right way to handle frequently encountered forensic cases. Very few of the healthcare professionals who participated in the study had received any training or education in the field of forensic nursing. Among participants, postgraduates, health professionals educated in forensic nursing, and healthcare staff who used additional resources to understand forensic cases, and those who had evaluated cases that presented to the ED as forensic cases, had significantly higher levels of knowledge.

IMPLICATIONS

This study supports the need for professional development in forensic nursing, such as in-service training, and curriculum development for a certificate in forensic nursing to enhance the practical training of healthcare professionals who work in EDs.

Forensic Cases in the Operating Room: Knowledge and Practices of Physicians and Nurses

PURPOSE

The purpose of this study was to investigate physicians' and nurses' knowledge and practices regarding forensic cases in the operating room.

DESIGN

This is a descriptive study.

METHODS

The sample consisted of 139 physicians and 59 nurses working in the operating rooms of a university hospital. Data were collected via a question form prepared by the researchers.

FINDINGS

Approximately half of the physicians and nurses did not know whether a patient brought to the operating room was a forensic case. Most of the physicians and nurses working in the operating room felt their knowledge and practice regarding the preservation and storage of evidence in forensic cases was inadequate.

CONCLUSIONS

The results of this study highlight the necessity of an increased focus on forensic case process.

[Legal medicine specialists within the framework of acute care : Analysis of legal medicine consultations in relation to the victims' statistics of the state office of criminal investigation in Saxony-Anhalt]

BACKGROUND

In acute medical care, there are patients who have been injured by the influence of others. The aim of this study was to analyze all cases which were presented to the Institute for Legal Medicine of the University Halle (Saale). The cases where analyzed in relation to the victims' statistics of the state office of criminal investigation in Saxony-Anhalt.

MATERIALS AND METHODS

The consultations of the Institute for Legal Medicine Halle-Wittenberg for 2012-2015 were evaluated with regard to the age and gender distribution, the reasons for the consultation and time until the request for consultations. These cases were statistically compared to the victims' statistics of the state office of criminal investigation in Saxony-Anhalt 2014-2015.

RESULTS

A total of 536 cases (55.6% male and 44.4% female patients) were evaluated. In all, 62.1% of patients were under 18 years of age; 43.5% of all consultations were requested by pediatric (surgery) clinics. The most common reasons for consultation were sexual child abuse or violence against children (50.7%). Compared to the victims' statistics, significantly more children were examined by legal medicine specialists than could have been expected (p < 0.001). In adult patients, the most common causes for consultation were acts of violence (20.4%) and domestic violence (10.1%). Among adults, significantly more women and fewer men were presented than expected (p = 0.001).

CONCLUSION

There were only a small number of consultations of legal medicine specialists in relation to the victims' statistics. Most of them were children and women. The temporal latency between the act of violence and the consultations was one day and more. The latency and the renunciation of the consultation of the legal medicine specialists can lead to loss of evidence.

The approach of prehospital health care personnel working at emergency stations towards forensic cases

Objectives

The objective of this study is to determine the states of health care personnel, working at 112 emergency stations in the province of Artvin, to encounter with regarding forensic cases and determine their practices aimed at recognizing, protecting, and reporting the evidences that may affect the forensic process.

Materials and methods

This descriptive study was conducted with nurses and emergency medicine technicians working at 112 emergency stations in Artvin between January 2013 and February 2014.

Results

Of 141 health personnel that constituted sample of the study, 48.9% were nurses, 9.9% emergency medicine technicians, and 41.1% ambulance and emergency care technicians. The rate of feeling sufficient in coping with forensic cases and incidents was 20.6%. There was a lower rate of receiving education about the approach towards forensic cases (15.6%). In the study, the frequency of encountering with at least one forensic case was 88.7%. Traffic accidents (72.5%), suicides (41.5%) and assaults (41.5%) were among the most frequent reasons of forensic cases. The practices of nurses were more successful in woundings by firearms compared to other health personnel (p < 0.05). The rate of recognizing the evidences was 81.6–96.5%. Almost one fourth of the personnel had no sufficient information about storing and protecting the evidences.

Conclusions

The personnel working at 112 emergency stations in the province of Artvin frequently encounter with forensic cases. The personnel with higher educational level and nurses have more successful practices in forensic cases. Health personnel have approaches that may negatively affect the solution of forensic cases.

A case report of gunshot terror attack in pregnancy: implications for forensic nursing

We present a case report of a third trimester pregnant woman who endured a gunshot terror attack. We demonstrate the complexity involved in the treatment of mother-infant, and suggest implementing the role of forensic nurse in Israel as a way to enhance the treatment of trauma patients within the hospital setting.

The role of the dentist at crime scenes

The medical response to a mass casualty further complicates the hectic environment that follows a terrorist event. In addition to providing treatment, medical professionals may discover items or persons of interest to the pending investigation and should be aware of how to handle these situations appropriately. Examples of case law are provided to illustrate how practitioners' actions could help or hinder prosecution. The traditional forensic role of dental professionals is identifying victims through dental records. In this article, the dental professional is considered a member of a disaster response team, and the differences in responsibilities are highlighted.