Integrating forensic nursing into the undergraduate nursing curriculum: a solution for a disconnect

Teaching strategies to develop skills to address social inequalities in nursing education: A scoping review

OBJECTIVES

to identify teaching strategies for developing skills to address social inequalities in nursing education.

DESIGN

Following the Joanna Briggs Institute and PRISMA-ScR guidelines, a scoping review was performed to answer the following research question: "What are the teaching strategies employed to develop nurses' skills to address social inequalities?"

DATA SOURCES

Bibliographical search was conducted seven electronic databases until December 29, 2020, and updated on March 25, 2022. Papers published in Portuguese, English, and Spanish on competence and professional practice, social inequality, education/training, and nursing were included.

REVIEW METHODS

Seven reviewers screened the articles by reading titles and abstracts. Studies on teaching strategies used to develop nurses' skills to address social inequalities were included. Of the 1137 articles found, 61 were selected by the first screening, and 23 were included in the final sample. Data were analyzed and summarized as a narrative.

RESULTS

The included papers were published between 2000 and 2020, predominantly in the United States. Curricular and learning strategies, including service, experience, and interactive, were the most common, followed by university programs and civil society initiatives. Courses, classes, debates, and practical activities predominated as teaching activities. Teaching techniques focus on resources such as posters, videos, workshops, and seminars.

CONCLUSIONS

This review identified teaching strategies used to develop nurses' skills to address social inequalities. Curricular initiatives, learning strategies, university programs and civil society initiatives can expand students' understanding of social inequalities and be used to develop skills.

Evaluation of teaching forensic nursing course on undergraduate nursing student’s forensic nursing knowledge

Background

The aim of the forensic nursing (FN) education is to provide nursing students with the basic knowledge of FN that they can use in the clinical area.

Objective

The study evaluated the effect of integrating forensic nursing into the undergraduate nursing curriculum on 2nd- and 4th-year students’ knowledge level of FN.

Participants

The target population of this study was composed of 2nd- and 4th-year students in the nursing department at a foundation university in Istanbul. The study was conducted with 95 nursing students who agreed to participate in the study.

Methods

The research was planned as cross-sectional and descriptive. The questionnaire form was developed with the help of literature by experts in the field. Each correct answer was scored as 4 points, and the total score could range from 0 to 100.

Results

The average age was 21.64 ± 1.16, and 66.3% (n = 63) was female. Out of the 95 students, 50.5% (n = 48) were in 2nd year, and 49.5% (n = 47) were in 4th year. A total of 47.4% (n = 45) of the students took a FN course, and 52.6% (n = 50) did not take FN course. The average level of knowledge for those who took FN course was 52.09 ± 12.31 and for those who did not take FN course was 46.16 ± 12.18. According to the status of taking FN course, a significant difference was found between the average level of knowledge (p < 0.05).

Conclusions

These results emphasize the importance of integration of FN into the undergraduate nursing curriculum.

Educational Needs of U.S. Emergency Nurses Related to Forensic Nursing Processes

BACKGROUND

Forensic nursing is a specialty deployed in patient care areas, including emergency departments, intensive care units, labor and delivery suites, and psychiatric units treating persons who have suffered trauma from a violent or criminal act. The recognition of violence-related injuries in patients presenting to health care facilities is critical to an appropriate care trajectory. These patients require specialized resources beyond the treatment of physical injuries to include psychosocial and legal care that supports patient recovery and pursuit of criminal justice.

OBJECTIVE

The purpose of this study is to obtain a broad view of current forensic knowledge and training for emergency nurses working in U.S. emergency departments and to identify gaps in nursing skills and practice such that appropriate education can be developed for this nursing specialty.

METHODS

The study was conducted using a quantitative exploratory, descriptive approach via an emailed cross-sectional survey sent to a convenience sample of U.S. emergency nurses.

RESULTS

A total of 43,775 emails were sent out to members of the Emergency Nurses Association. Of that group, 2,493 recipients opened the email, and 1,824 completed the survey, resulting in a total response rate of 4% and a 73% response rate from those who opened the email. Few respondents self-reported competence in the care of patients who experienced child abuse (13.1%), elder abuse (12.4%), interpersonal violence (17.6%), sexual assault (19.2%), human trafficking (7.4%), developmental challenges (7.2%), strangulation (12.5%), or who were suspected of committing a violent crime (11.4%).

CONCLUSIONS

There is a compelling need to expand forensic education to advance knowledge and skill acquisition in emergency nursing practice and provide staff with additional resources that support a holistic trauma-informed approach to patient care.

The assessment and exploration of forensic nursing concepts in undergraduate nursing curricula: a mixed-methods study

OBJECTIVES

The purpose of this study was to assess the importance and explore the inclusion of forensic nursing concepts in undergraduate nursing curricula.

METHODS

This study used a mixed method design to survey undergraduate nurse educators (n=1,000) across the United States. Utilizing a convergent parallel design, data were analyzed independently, sequentially, and combined to synthesize the results and cultivate the overall conceptualization of the findings.

RESULTS

Significant differences were found about the importance and the integration of forensic concepts in the curricula based on the faculty member's teaching area and area of clinical practice. Triangulation of data determined faculty valued their role of improving holistic care to victims of violence. However, time, curriculum rigidity, and lack of forensic concept knowledge hindered the inclusion of forensic nursing concepts in curricula.

CONCLUSIONS

Findings from this study support the recommendation for faculty development, community collaboration, and utilizing teaching modalities to integrate forensic nursing concepts into undergraduate curricula.

A cross-sectional study of domestic violence instruction in nursing and midwifery programs: Out of step with community and student expectations

BACKGROUND

Domestic violence is a global health concern. Nurses and midwives must respond to those who experience domestic violence, although many are not prepared to do this. The World Health Organization recommend that domestic violence content be included in all pre-registration training as a matter of urgency.

OBJECTIVES

To examine self-reported undergraduate student perceptions of domestic violence content in their programs of study and student attitudes and beliefs about domestic violence.

DESIGN

A cross-sectional research design with online survey was employed from June to October 2017.

METHODS

Using convenience sampling, 1076 students were recruited to the study from a total population sample of just over 6000 undergraduate nursing and midwifery students; a response rate of 17.9%. Survey data reported the nature and frequency of teaching and learning along with student attitudes and beliefs about domestic violence. Open ended responses were examined via thematic analysis.

SETTINGS

Nine Australian universities offering undergraduate nursing and midwifery degrees.

PARTICIPANTS

Undergraduate university nursing and midwifery students.

RESULTS

Over half of students surveyed (53.7%, n = 578) reported that domestic violence was not addressed in their program of study. A direct correlation was found between students' perceived preparedness to assess and respond to domestic violence, and the amount of taught content in their program of study.

CONCLUSION

This major gap in curricula has significant implications for professional practice preparedness. Further research should focus on examining the reasons why quality domestic violence content is lacking in undergraduate nursing and midwifery programs and how prioritisation of domestic violence content can be improved.

Knowledge of Forensic Nursing Practices: Efficacy of an Intervention for Nursing Students

BACKGROUND

Forensic science has become increasingly relevant to health professionals' roles in preserving trace evidence when crimes have been committed.

OBJECTIVE

The aim of the study was to assess the efficacy of a structured intervention to improve nursing students' knowledge of forensic nursing practices.

METHODS

A pretest/posttest quasi-experimental study, without a control group, was conducted. A nonprobabilistic sample of students from the third and fourth years of a nursing degree program took part in the study. The General Questionnaire on Forensic Nursing and the Questionnaire on Knowledge of Forensic Nursing Practices were administered before and after a structured intervention.

RESULTS

Eighty-seven students (mean age of 22.8 ± 3.9 years) took part in the study. Of the participants, 85.7% were female, 98.8% claimed they had not received training in forensic nursing during their degree, and 97.6% reported that they did not have contact with situations that involved the collection and preservation of forensic evidence during their internships. As for their knowledge of forensic practices, out of a total of 74 questions, the number of right answers after the course (69.15 ± 3.05) was higher than the result obtained previously (62.95 ± 4.47). The difference was statistically significant (p < 0.01), leading to the conclusion that the structured intervention was effective in improving knowledge of forensic nursing practices.

CONCLUSION

The results demonstrated the importance of specific training in forensic nursing and support the conclusion that a curricular unit in this area should be developed for inclusion in nursing degree curricula.

Infusing the Principles of Trauma-Informed Care Into Emergency Nursing: A Comprehensive Approach to Change Practice

The emergency department is a frequent entry point into the healthcare system for victims of violence. Currently, a knowledge deficit and clinical practice gap exists among emergency nurses regarding their consistent ability to implement a trauma-informed approach in their interactions with forensic clients. Emergency nurses at all levels of professional development, senior undergraduate nursing students, new graduate nurses, and experienced nurses should be well informed regarding the prevalence of violence, basic clinical forensic nursing practice, and the principles of trauma-informed care. A comprehensive approach is required to both identify and address the trauma associated with violence. Through reflecting on Benner's Novice to Expert framework, strategies are proposed for the implementation of a comprehensive plan. An inclusive approach to the implementation of the principles of trauma-informed care into emergency nursing may ultimately lead to a transformation in culture in which nurses ask, "What has happened to you?" instead of "What is wrong with you?"

Knowledge, Attitudes, and Beliefs of Prenursing and Nursing Students About Sexual Assault

Sexual assault has been identified as a major public health problem in the United States, yet little research has been done regarding nursing students' knowledge, attitudes, and beliefs about sexual assault. Lack of knowledge, or victim-blaming attitudes held by healthcare providers can be problematic for the care of the sexual assault victim, leaving them feeling upset and distressed after the healthcare encounter. Prenursing and nursing students were surveyed about their knowledge, attitudes, and beliefs about sexual assault. A knowledge test, the Illinois Rape Myth Acceptance scale, and the Attitudes Toward Rape Victims scale were utilized in the survey; 297 students completed the survey. Results indicate that rape myth acceptance is lower for nursing students in their last semester of college than in the prenursing group; and that last-semester nursing students held less victim-blaming attitudes toward rape victims than prenursing students. The knowledge test highlights problem areas that need to be addressed by nursing education to improve the care of sexual assault patients.

Toward the establishment of a forensic nursing specialty in Brazil: an integrative literature review

BACKGROUND

Over the past two decades, Brazil has made progress in bringing political and community attention to issues related to violence. The recognition of links between violence and health has intensified calls to accelerate the development of a forensic nursing specialty in Brazil.

AIM

The aim of this study was to systematically examine and synthesize the literature on the development of the forensic nursing specialty around the globe and to extract important lessons for the establishment of a forensic nursing specialty in Brazil.

METHOD

An integrative review was conducted according to the method described by Whittmore and Knafl (2005). Electronic searches of the following databases were conducted between December 2012 and March 2013: CINAHL Plus with Full Text, Criminal Justice, Index to Legal periodicals, MEDLINE, Soc Index with Full Text, Social Work Abstracts, SCOPUS, and PsycINFO. The search terms used were: [(TI nurs* or SU nurs*) and [TI (forensic* or penal or prison*) or SU (forensic* or penal or prison*)] and (sexual assault nurse examiner*). Preestablished inclusion/exclusion criteria were used to select published articles for review.

RESULTS

Twenty-three articles met inclusion criteria and were included in the full review. Important lessons for Brazil are discussed in terms of education and curricular issues and forensic psychiatric nursing.

CONCLUSIONS

In Brazil, there is a window of opportunity to contribute the theoretical foundations of forensic nursing science and to advance nursing specialty practice in the areas of Sexual Assault Nurse Examiners and forensic psychiatric nurses.

A review of the health effects of sexual assault on African American women and adolescents

OBJECTIVE

To review the research findings for mental and physical health outcomes and health behaviors of African American women and adolescents after sexual assault.

DATA SOURCES

Searches of the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO, and PubMed from January 2001 through May 2012 using the terms Blacks, African Americans, sexual abuse, sexual offenses, and rape.

STUDY SELECTION

Criteria for inclusion included (a) results of primary research conducted in the United States and published in English, (b) African American females age 13 and older, (c) sexual assault or sexual abuse reported as distinct from other types of abuse, and (d) health status as an outcome variable. Twenty-one publications met inclusion criteria.

DATA EXTRACTION

Articles were reviewed for the mental and physical health and health behavior outcomes associated with sexual assault of African American women and adolescents.

DATA SYNTHESIS

Sexual assault was associated with increased risk of poor mental and physical health outcomes in the general population of women and adolescents. There was an increased risk of unhealthy behaviors (e.g., drinking, drug use, risky sexual behaviors) for all women and adolescents, with the highest risk reported for African American women and adolescents. Help seeking from family and friends demonstrated conflicting results. Cumulative effects of repeated assaults appear to worsen health outcomes.

CONCLUSION

Sexual assault has significant effects on the physical and mental health and health behaviors of women and adolescents in the general population. Less evidence is available for differences among African American women and adolescents. More research is needed to understand the influence of race on women's and adolescents' responses to assault.

Caring for the forensic population: recognizing the educational needs of emergency department nurses and physicians

The Emergency Department (ED) is a point of contact for victims of violence after an act of criminal activity has occurred. Hence, ED clinicians are in a key position to have a significant impact on both the medical and legal outcomes of the forensic patient population. The purpose of this study was to describe and compare forensic knowledge, practice, and experiences of ED nurses and physicians. Specific aims were to (1) describe experiences of nurses and physicians related to forensic practice; (2) compare clinical forensic knowledge and experience between nurses and physicians; and (3) describe forensic learning needs. This descriptive, correlational study utilized a survey questionnaire completed by 134 ED nurses and physicians. Results of the survey revealed no significant differences in the education, knowledge, and confidence with forensic patients between ED nurses and physicians. However, just over half of the sample reported feeling confident in managing forensic patients indicating a need for increased forensic education. Practice implications indicate that forensic education is needed and desired among ED nurses and physicians within the clinical setting. Further studies must be done to gain a more in depth understanding of existing forensic practices and protocols to elevate the level of care received by forensic patients within the ED setting.

Enhancing assessment of interpersonal violence (IPV) pregnancy-related homicide risk within nursing curricula

Pregnancy and motherhood traditionally represent evolution of the next generation; yet, contemporary research and analyses confirm that this time can also be manifested in fear by the expectant mother within an environment of battering, cruelty, physical and emotional abuse, and sexual assault. Often to the surprise of many healthcare providers, the Centers for Disease Control and Prevention have consistently reported that Interpersonal Violence (IPV) related homicide is a leading cause of traumatic death among new and expectant mothers. In spite of these staggering statistical and anecdotal findings, universal screening for violence during pregnancy continues to be minimal. Forensic nurses might be prompted to respond to the consequences of violence and its resultant negative effects on expectant mothers by strategically incorporating systematic and consistent assessment into foundational nursing curricula regarding IPV as a leading risk factor for injury or death.