CSI: New @ York Development of Forensic Evidence Collection Guidelines for the Emergency Department

National assessment of emergency staff level of practice in the management of forensic evidence

The emergency room is the most likely location where victims of violent crime would be encountered by the healthcare system, as the emergency staff is the first to evaluate the victim or culprit, exposing them to a range of forensic evidence. Forensic evidence can help exclude, identify, and prosecute a suspect and is classified as informational or physical evidence. Emergency staff must be proficient and knowledgeable in gathering, preserving, and documenting forensic evidence in their practice. To our knowledge, this is the first study that assesses the emergency staff's level of practice in managing forensic evidence. The aims of this study are to assess the level of practice of emergency staff in managing forensic evidence and observe an association between emergency experience and the level of practice in managing forensic evidence, study a connection between forensic education/training and the level of practice in the management of forensic evidence. This observational cross-sectional analytical study in Saudi Arabia was conducted from January 2022 to December 2022. Participants completed a self-administered online survey. Measuring the level of practice was implemented through a researcher-designed questionnaire based on a paper that provided guidelines for forensic evidence collection in the emergency department. Most emergency healthcare workers had a good level of practice in managing forensic evidence (64.7%). Those with excellent practice scored the lowest in documentation, whereas participants in the poor practice category scored the lowest in the trace evidence and clothes domains. Emergency workers who encountered less number of forensic cases per month, i.e. less than two or three to five cases, were found to be more likely to have poor management of forensic evidence. Emergency personnel with no prior education or training are more likely to engage in poor practice in forensic evidence collection. Furthermore, those who had acquired forensic education/training had higher percentages of excellent forensic practice (56.52%) compared to poor practice (7.14%). Those who claimed that their institution had issued guidelines were more likely to have excellent practice (75.36%), whilst those who did not receive guidelines were more likely to have poor forensic evidence management (85.71%). More research is required involving local hospitals and utilizing consistently validated methods in evaluating forensic evidence collection.

Key points

A national assessment of emergency staff level of practice in the management of forensic evidence was performed.Most emergency staff had a good level of practice in the management of forensic evidence.More training and education are needed for emergency staff in the field of forensics.National evidence-based guidelines for managing forensic evidence in the emergency setting should be established.

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.

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.

Active Shooters: What Emergency Nurses Need to Know

Active shooter incidents have been on the rise in the United States in the last 2 decades, specifically events occurring in public areas traditionally considered safe such as churches, schools, and hospitals. An examination of historical events shows that the emergency department (ED) nurse must be equipped to handle any situation that may arise, including the increasing likelihood of an active shooter situation. Hospital response to these occurrences is changing, and protocols for staff response are being adjusted on a regular basis. Immediate response, postevent actions, and evidence collection procedures must be a part of the ED nurses' ongoing education. Lessons learned from events that have occurred must be examined so ED nurses can be more aware and ready to respond to the increasing chance of an event such as this occurring in their ED.

Forensic nursing science knowledge and competency: the use of simulation

Forensic nursing is a nursing specialty that provides services to a variety of patient populations who have experienced violence, including interpersonal violence, sudden or unexpected death, and motor vehicle collisions. However, many critical care nurses have received the background knowledge or practical skills required to provide the level of care required by many forensic patients. The purpose of this study was to determine whether differences in knowledge or practical competence exist between participants using 2 different learning modalities: medium fidelity simulation versus face-to-face lecture. Participants who were enrolled in an elective online forensic nursing science course were randomly assigned to an intervention or control group. The 18 intervention group participants were given three 2-hour forensic simulation sessions in the laboratory. The 17 control group participants attended 3 face-to-face lectures covering forensic science topics. All study participants also received the same forensic course content via the online Blackboard platform. No significant differences were found between the 2 groups in either knowledge or practical competency. The lack of results may have been heavily influenced by the small sample size, which resulted in insufficient power to detect possible differences.

The importance of scientific evaluation of biological evidence--data from eight years of case review

In 2009, the National Research Council published a report stating that the addition of more science and technology into the field of forensic science in the United States would be of great benefit to the judicial system. As a starting point to address this NRC report, one needs to make an assessment of the system. One factor that is continuously requested is an estimate of an error rate. In any given scientific area of forensics that is difficult to quantitate except by external review and audits. After eight years of requested defense review of cases with biological and DNA evidence, most cases appear to be scientifically sound in test methods and procedures. However, there were some cases where errors in the forensic science process did occur. This article takes information compiled from those eight years of defense review and summarizes the cases where errors have been discovered and discusses the scientific implications of these errors. The scope of this article is limited to crime scene collection and forensic science laboratory testing of biological materials for body fluid identification and DNA individualization to a source. The greatest value of defense review comes from (a) providing effective balance and independent oversight to the judicial process and (b) collecting data into a format that can be useful as a guide in training programs.