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The Need For Uniform Forensic Policies And Procedures In Healthcare

The Need For Uniform Forensic Policies And Procedures In Healthcare






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The Need For Uniform Forensic Policies And Procedures In Healthcare The Need For Uniform Forensic Policies And Procedures In Healthcare Presentation Transcript

  • The Need For Uniform Forensic Policies And Procedures In Healthcare A Research Project by Paula Walsh, RN
  • Background & Significance
    • The Commonwealth of Massachusetts offers only one uniform forensic policy and procedure that governs how the healthcare industry collects forensic evidence.
      • Sexual Assault victims
  • Background & Significance
    • The
    • Rape
    • Kit
  • Background & Significance
    • Forensic patients in the health care facility:
      • Focus of health care professionals:
        • Lifesaving interventions
        • Lack recognition of potential evidence
        • Protocol & Procedure of organization
        • Training & Education
  • Background & Significance cont.
    • Interagency collaboration between healthcare and law enforcement
    • Creating a medical-legal bridge
    • Imperative for establishing protocols and procedures for the collection of forensic evidence
  • Purpose of the Study
    • To assess the need for the development of uniform forensic policies and procedures between healthcare and legal agencies.
  • Research Question
    • Does a lack of uniform forensic policies and procedures within Massachusetts healthcare facilities have an impact on criminal cases prosecuted in Massachusetts?
  • Study Design
    • Retrospective-correlational
    • Survey
      • Case types
      • Evidence type
      • Disposition of the evidence
      • Case outcomes
  • Theoretical Model: Neuman’s Systems Model
    • Utilizing “a basic structure of concentric rings” (McEwen & Wills, p. 153, 2007) Neuman places the person as the client/client system at the core
    • Protective rings surrounding it providing resistance and defense against environmental forces that would influence and impact the stability and wellness of the client.
  • Assumptions
    • Practice of health care professionals
    • Protocols & procedures of facility
    • Impact of protocols & procedures
    • Quality of evidence
  • Significance to Nursing
    • Development and application of uniform forensic policy and procedure
    • The masters-level Forensic Nurse Specialist
  • History of the Problem
    • Traditionally, evidence has been collected by trained law enforcement personnel.
    • Increased social sensitivity to interpersonal violence over the last decades
    • Significantly shifted the responsibility for evidence collection and its preservation to healthcare providers
  • History of the Problem
    • Methods used for the collection of evidence and the maintenance of the chain of custody are crucial to the integrity of physical evidence that is the basis of successful prosecution.
    • Contamination and even disposal of key evidentiary matter can occur.
  • Synthesis of Literature/Research
    • Many experts and studies have identified the lack of educational resources and/or uniform forensic protocol and procedures in healthcare institutions as a significant problem.
    • Joint Commission recommendations
  • Synthesis of Literature/Research
    • Standard I. Assessment within the standards of practice as established by the American Nurses Association (ANA)
    • Emergency department nurses are required to have specialized training and education.
  • York Hospital 2008 Pilot Study
    • Level II trauma center in York, Pennsylvania
    • Survey of 38 trauma and ICU nurses on their knowledge of forensic practice
  • York Hospital 2010
    • Multidisciplinary team was assembled to develop a set of evidence based guidelines for forensic evidence collection
    • Team was comprised of:
      • an emergency physician
      • seven emergency nurses
      • a master’s prepared forensic nurse
      • a local forensic technician
  • Sexual Assault Nurse Examiner (SANE) Program
    • Demonstrates the successful impact a uniform protocol and procedure can provide between healthcare providers and prosecutors
    • Specialized training
    • Quality and reliability
    • Impact on prosecution
  • Research Design & Method
    • Retrospective – historical look at both the proposed cause and the proposed effect
    • Correlational - examines the relationships among the variables included within a research study
    • Cases outcomes will be examined in relation to the protocols and procedures of evidence collection employed by the healthcare professionals.
    • Therefore, the retrospective-correlational approach to this research study is appropriate.
  • Research Design & Method
    • Participant selection
    • Instrument
    • Protection of Human Subjects
    • Setting
    • Definition of Terms/Variables
  • Research Design & Method
    • Data Collection:
      • Online surveys completed via Tigersurvey.com
      • Results collected through weblink and protected by a secure method of encrytption
    • Data Analysis:
      • Supervised by an experienced researcher
      • SPSS software
  • Results
    • Pending execution of the research study
  • Limitations of Study
    • Lack of evidentiary research
    • Level of participation
    • Lack of knowledge and expertise in the area of trauma situations in health care
  • Discussion
    • Justice / Retribution
    • Treatment of Victim and/or Perpetrator
      • Same facility
      • Management of the forensic patient
        • Training/education/experience of the health care team
  • Direction of Future Research
    • Possible opportunities:
      • Need for more specialized forensic policy and procedure
      • Types of professional relationships
  • Questions ??
  • References
    • Agnew, T. (2004). Expert witnesses. Emergency Nurse , 12 (6), 10-13.
    • American Nurses Association. (2004). Scope and standards of forensic nursing practice. Washington, DC: Author.
    • Assid, P.A.. (2005). Evidence collection and documentation. Are you prepared to be a medical detective? Topics in Emergency Medicine (27) 1, 15-26.
    • Barton, J., Emery, M., Flood, R. L., Selsky, J. W., & Wolstenholme, E. (2004). A Maturing of Systems Thinking? Evidence from Three Perspectives. Systemic Practice and Action Research , 17 (1), 3-36.
    • Benak, L.D.. (2001). Forensics and the critical role of the er nurse. On The Edge (7) 3, pp. 1, 20-22.
    • Budowle, Bruce, Schutzer, Steven E., Burans, James P., Beecher, Douglas J., Cebula, Thomas A., Chakraborty, Ranajit, Cobb, William T., Fletcher, Jacqueline, Hale, Martha L., Harris, Robert B., Heitkamp, Michael A., Keller, Frederick Paul, Kuske, Cheryl, LeClerc, Joseph E., Marrone, Babetta L., McKenna, Thomas S., Morse, Stephen A., Rodriguez, Luis L., Valentine, Nancy B., Yadev, Jagjit. (2006). Quality Sample Collection, Handling, and Preservation for an Effective Microbial Forensics Program. Applied and Environmental Microbiology , 72 (10), 6431–6438.
  • References
    • Burns, N., & Grove, S.K. (2005). The Practice of Nursing Research. Conduct, Critique & Utilization (5 th ed.). Philadelphia: Saunders. (originally published in 1987)
    • Campbell, R., Patterson, D., Bybee, D., & Dworkin, E. R. (2009). Predicting Sexual Assault Prosecution Outcomes: The Role of Medical Forensic Evidence Collected by Sexual Assault Nurse Examiners . Criminal Justice and Behavior , 36 , 712-727.
    • Creswell, J. W. (2009). The Selection of a Research Design. Research design: qualitative, quantitative, and mixed methods approaches (3rd ed.). Thousand Oaks, Calif.: Sage Publications.
    • District Attorney Law & Legal Definition. (n.d.). Legal Definitions Legal Terms Dictionary . Retrieved April 1, 2011, from http://definitions.uslegal.com/d/district-attorney/
    • Eisert, P., Eldredge, K., Hartlaub, T., Huggins, E., Keirn, G., O'Brien, P., & ... March, K. (2010). CSI: New @ York: development of forensic evidence collection guidelines for the emergency department. Critical Care Nursing Quarterly , 33(2), 190-199.
    • Eldredge, K. (2008). Assessment of trauma nurse knowledge related to forensic practice. Journal of Forensic Nursing , 4(4), 157-165.
    • Evans, M.M & Stagner, P.A.. (2003). Maintaining the chain of custody: evidence handling in forensic cases. AORN Journal (78) 4, 563-569.
  • References
    • Evidence Collection and Care of the Sexual Assault Survivor - MINCAVA Electronic
    • Clearinghouse. (n.d.). MINCAVA Electronic Clearinghouse . Retrieved March 19,
    • 2011, from http://www.mincava.umn.edu/documents/commissioned/2forensicevidence/2forensicevidence.html#ledray
    • Garner, B. A., & Black, H. C. (2009). Black's law dictionary (9. ed.). St. Paul, Minn.:
    • Thomson West.
    • Goll-McGee, B. (1999). The role of the clinical forensic nurse in critical care. Critical Care Nursing Quarterly , 22(1), 8-18.
    • Hoyt, C. (1999). Evidence recognition and collection in the clinical setting. Critical Care Nursing Quarterly , 22(1), 19-26.
    • Lawson, L., & Rowe, S. (2009). The scientific foundations of SANE education. Journal of Forensic Nursing , 5(2), 115-118.
    • Martin, N. (2009). Forensic nursing: what, who, where. Kansas Nurse , 84(3), 3-5.
    • McEwen, M., & Wills, E. M. (2007). Theoretical basis for nursing (2nd ed.).
    • Philadelphia: Lippincott Williams & Wilkins.
  • References
    • Neuman, B. A. (1982). The Neuman systems model: application to nursing education
    • and practice. Norwalk, CT: Appleton-Century-Crofts.
    • Office of Human Subjects Research. (n.d.). OHSR . Retrieved April 1, 2011, from http://ohsr.od.nih.gov/info/sheet6
    • Ortiz, V.. (2002). Creating a forensic team in the emergency department. On The Edge (8) 4, 7-8.
    • Porteous, J. (2005). Don't tip the scales! Care for patients involved in a police investigation. Canadian Operating Room Nursing Journal , 23(3), 12.
    • Schofield, S. (2006). Body of evidence.. (cover story). Emergency Nurse , 13(9), 9-11.
    • Sekula, L.K.. (2005). The advance practice forensic nurse in the emergency department. Topics in Emergency Medicine (27) 1, 5-14.
    • Sonsa, T. (2000, Jan. - Feb.). The Need for a Collaborative Theory of Change in a Multi-
    • Disciplinary Program. CWTAC Updates , 3 , 1-3.
    • Standing Bear, Z. (1999). Crime scene responders: the imperative sequential steps.
    • Critical Care Nursing Quarterly , 22(1), 75-89.
    • Summers, A. (2006). So you have been called to court. Emergency Nurse , 14 (1), 10-15.
    • Supreme Judicial Court of Massachusetts. (2007). Massachusetts Guide to Evidence.
    • Retrieved October 28, 2007 from http://www.mass.gov/courts/sjc/docs/guidetoevidence.pdf