“The Scope and Standards of Nursing Practice in Correctional Facilities,” published in , currently is undergoing revision. The American Nurses Association (ANA) Corrections Working Group requests that nurses in this field forward their review comments and recommendations about the draft “Corrections Nursing: Scope and Standards of Practice” document by 4 p.m. on Oct. 1, .
To download a PDF of the document, go to: http://www.nursingworld.org/practice/fieldrev.pdf.
Comments should be sent to Dr. Carol J. Bickford at by 4 p.m. on Oct. 1, .
The text of the draft document is as follows:
Corrections Nursing: Scope of Practice
Health Care in Corrections Settings
Through most of its history, the American corrections system had little or no medical care available to inmates as the courts typically took a “hands-off” approach to correctional issues and avoided interfering in the administration and operation of correctional facilities. This gave correctional administrators enormous freedom with little regulation or accountability imposed on daily operations. Public interest was minimal and government agencies saw no reason to pour tax money into the prison system. The lack of oversight generated by this philosophy allowed serious abuses to occur behind the walls of correctional institutions.
The civil rights movement in the s focused public attention on reform and the improvement of conditions for the less fortunate. The inevitable scrutiny of conditions and practices in correctional facilities forced the American judicial system to begin to respond to inmate claims.
In , the United States Supreme Court established a constitutional standard for inmate health care in the Texas case, Estelle v. Gamble. Inmate Gamble claimed that prison officials inflicted undue suffering on him when they failed to provide adequate care for an injury sustained in prison. The court ruled that “deliberate indifference to serious medical needs constitutes cruel and unusual punishment, which is prohibited by the 8th Amendment to the United State Constitution. The indifference does not have to be intended maliciously to count as deliberate.” The decision led to several reforms in inmate litigation that included the following list of inmate rights related to health care:
o The right to access care
o The right to professional judgment
o The right to care that is ordered
o The right to informed consent
o The right to refuse treatment
o The right to medical confidentiality
Federal enforcement of these rights forced correctional agencies to restructure their inmate healthcare systems. During the years since Estelle v. Gamble decision, the development of both case law and national standards on correctional health care have affirmed that prisoners had a right to be free of “deliberate indifference to their serious health care needs.”
Population Served
In 6.7 million people were under some form of correctional supervision. Today there are over adult and juvenile correctional facilities in the United States. The adult incarcerated population reportedly equals 2,033,331, or one out of every 32 adults or 3.1 percent of all US adult residents. An estimated 106,000 juveniles are incarcerated in residential facilities. After dramatic increases in the s and s, the incarceration rate has leveled off at a 3.6 percent increase per year (Sourcebook of Criminal Justice Statistics, ).
Today’s inmates are older, sicker, and remain imprisoned longer when compared to the inmates of 20 years ago. In general, inmates come from socioeconomic groups at high risk for poor health and have not had access to regular medical care or proper treatment for medical conditions. They also have a disproportionately greater number of chronic illnesses and infectious diseases than the non-incarcerated population.
The incidence of AIDS in prisons and jails is substantially higher than in the population at large due to an over representation of those with a history of high risk behaviors. The CDC reports that in approximately 17 percent of all persons with HIV had been released from corrections facilities (www.cdc.gov). As of state and federal prisoners known to be positive for the human immunodeficiency virus (HIV) and confirmed AIDS cases totaled 24,147 (21,268 male and 2,265 female) (Sourcebook of Criminal Justice Statistics, ).
Tuberculosis is one of the most threatening infectious diseases facing correctional systems. An estimated 35 percent of all active TB cases in passed through the correctional system. In the National Commission on Correctional Health Care identified the prevalence of active TB among inmates is between four and 17 times greater than among the total U.S. population (NCCHC, , p. xi).
Hepatitis C, identified in , has infected an estimated 3.9 million Americans. The most common form of transmission is through intravenous drug use. Approximately 83 percent of the nation’s drug users are incarcerated at some time and research indicates that 80 percentof inmates have a history of substance abuse (NCCHC, ).
Advances in medical science, longer prison terms, mandatory sentences and more restrictive policies are keeping inmates in prison longer with lower chances of parole, thereby resulting in a much older population. “From to January 1, , the number of state and federal inmates age 50 and older increased from 6 to 113, 358, a staggering increase of 172.6 percent” (Anno, Graham, Lawrence, & Shanksy, , p. 7).
As of , inmates age 50 and older represent 7.9 percent of the prison population. Inmates suffer from age-related conditions earlier in life. Personal histories of poor nutrition, lack of preventative care and high risk behavior such as smoking and drug use are all common in the general incarcerated population. This makes a 50-year old inmate’s health status comparable to that of a free 65-year old living in the community.
Women are the fastest growing segment of the correctional population. In the nearly 150,000 females behind bars represented about 11 percent of the total jail population and 6 percent of the state and federal prison population (Greenfeld, L.A., & Snell, T.L., ). Although more than half of these women are under the age of 35, the majority have unhealthy past lifestyles which include drug and alcohol abuse, sex work and multiple partners which put them at high risk for chronic and communicable diseases (Anno, ).
In addition to basic medical care needs, these women have special health care needs associated with their reproductive systems and thus pose a great challenge in the correctional health care system geared to house male inmates. Like the incidence of use in the freeworld community, women offenders use health services more frequently than do their male counterparts (Goldkuhle, U., ). They have higher rates of diabetes, HIV and sexually transmitted diseases than male offenders. Women inmates also have higher rates of serious mental illnesses, drug abuse, depression and other emotional problems than the male population. Approximately 6 percent are pregnant on admission to jails and prisons and account for an estimated 8,820 of the 3.8 million births in the United States each year. Due to unhealthy lifestyles prior to incarceration, most of these pregnancies are classified as high risk (Greenfeld and Snell, ).
The deinstitutionalization of persons with mental illness over the last several decades has had a dramatic impact on the corrections environment. New therapies, decreased insurance reimbursements, and tightening state and local healthcare budgets resulted in decreased length of stay and a drastic reduction in the number of state and county mental hospitals and inpatient beds. In , there were approximately 368,000 beds in mental institutions, while in , that number had decreased to 84,000 beds. Lack of available community financial and social system supports has therefore resulted in persons with mental illness often becoming nomads who then eventually end up residing in ever increasing numbers in America’s jails and prisons. Estimates indicate that 10%-20% of inmate populations are suffering from major psychiatric disorders and require mental health services.
Nurses Within the Corrections Environment
The history of corrections nursing began as early as with the opening of the New York City Newgate Prison. Its warden, Thomas Eddy, believed that criminals could be rehabilitated and established a school for the inmates as well as the first prison hospital and pharmacy. However, nursing as a profession in the correctional setting did not appear until the ’s and began to gain some increased visibility toward the end of the 20th century.
Rena Murtha () described entering a large correctional facility where the nurse was perceived as a “tool of the warden, a slave of the physician and an unknown to the patient”. Since that time, the role of the nurse has evolved from that of a pill pusher to that of an equal and respected member of the healthcare provider team, a case manager, a crisis intervener, a suicidologist, a counselor and more.
Just as it is difficult to ascertain the numbers and characteristics of the corrections population, this nursing specialty continues to be hidden in the statistical reporting about nurses and their employment and work settings. For example, the only reference to this nursing specialty in the National Sample Survey of Registered Nurses is the projected number of 18,033 registered nurses working in prisons or jails. The Sourcebook of Criminal Justice Statistics does not report the numbers of registered nurses or other healthcare providers working in corrections settings in its statistics and tables. Likewise, the American public is unaware of the complex conditions and great strains on the essential qualities of nursing that face nurses working in correctional health care settings. Even corrections nurse themselves are often unaware of how their colleagues practice behind these closed doors.
Correctional systems are under increasing pressure from the federal courts to provide adequate and humane levels of health care with limited resources and little public sympathy. Social and political conditions facing nurses in these settings are demanding and appeal to the noblest of humanitarian instincts. Nurses are often the foundation of the correctional health care system and in many cases the only providers of health care services in correctional systems. Utilizing the expertise and unique knowledge and skills of registered nurses provides correctional systems the opportunity to meet their responsibility to provide adequate and safe health care delivery to those incarcerated.
Some nursing professionals are hired to perform specialized services within the correctional environment to avoid sending inmates out for health care and to comply with court ordered reform. In other cases, they may be managing health care departments. The type and number of nurses employed and their roles vary according to the size of the facility and its mission. In all cases, nursing is carried out in a very litigious environment where patients frequently file legal action against the healthcare providers. Much of the early reform in correctional health care was as a result of inmate initiated lawsuits.
Nurses are usually direct employees of the correctional facility and may be in the same organizational hierarchy as the correctional officers. Nurses can often experience a division of interest and personal and professional conflict in these practice settings. On one hand, they are employees of an institution whose mission is security and public safety. On the other hand, they are healthcare providers whose mission is health and wellness.
The goals of security and nursing are often incompatible, and the nurses may be asked to compromise their philosophy by performing activities that are not related to nursing or health care. There is firm support in national standards to support the restriction of participation by nursing in activities related strictly to security (NCCHC, ). It is imperative that nurses in correctional settings recognize their professional responsibility to role development and clarification based on a commitment to quality nursing care according to recognized standards.
The corrections nurse is an essential part of the correctional system and faces the daily challenges of providing health care to the incarcerated population. The American Nurses Association and other organizations, such as the American Correctional Health Services Association, the American Correctional Association, and the Academy of Correctional Health Professionals, are membership organizations that serve as a forum for current issues and needs confronting corrections nurses. As the correctional system grows and evolves, the corrections nurse will continue to provide care and promote wellness to the detained and incarcerated while upholding the standards of professional nursing practice.
Beliefs That Guide Corrections Nursing
Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations. (ANA, , p. 7) Nursing is a science and an art, the essence of which is caring for and respecting human beings, including those in the corrections environment. The following beliefs serve as the underpinning for corrections nursing:
-- A registered nurse’s primary duty in the corrections setting is to restore and maintain the health of patients in a spirit of compassion, concern and professionalism.
-- Each patient, regardless of circumstances, possesses intrinsic value and should be treated with dignity and respect.
-- Each encounter with patients and families should portray professionalism, compassion and concern.
-- Each patient should receive quality care that is cost-effective and congruent with the latest treatment parameters and clinical guidelines.
-- Patient confidentiality and privacy should be preserved.
-- Nurses should collaborate with other health care team members, correctional staff and community colleagues to meet the holistic needs of patients, which include physical, psychosocial and spiritual aspects of care.
-- Nurses should encourage each individual, through patient and family education, to take responsibility for disease prevention and health promotion.
-- Monitoring and evaluating nursing practice is each nurse’s responsibility and is necessary for continuous quality improvement.
-- Nurses should resist assuming custodial functions that compromise the nurse’s role in providing therapeutic health care.
-- Nursing leadership should promote the highest quality of patient care through application of fair and equitable policies and procedures in collaboration with other health care services team members and corrections staff.
-- Nursing services should be guided by responsible leaders who are sensitive to employee needs and give support, praise and recognition to encourage professional and personal development. These Nurse Administrators should encourage professional growth and development through continuing education, participation in professional organizations and generation of knowledge through research.
Role of the Corrections Nurse
Corrections nursing is the practice of nursing and the delivery of patient care within the unique and distinct environment of the criminal justice system. The criminal justice system includes jails, prisons, juvenile detention centers, substance abuse treatment, and other facilities of detainment. Unlike the majority of their nursing colleagues, registered nurses working in corrections must demonstrate the essence of nursing in a practice environment that does not have health care as its primary mission. Matters of nursing judgment are solely the domain of the registered nurse.
The incarcerated vary from youths to aged adults, include men and women, and are individuals of all racial and ethnic backgrounds who are often disenfranchised, economically challenged, educationally limited, and largely ignored by society. These individuals enter the corrections system with communicable and chronic diseases and complications resulting from a previous lack of appropriate healthcare services. The work of corrections nurses contributes to limiting the health care disparities experienced by this unique and extremely diversified corrections population.
Corrections nurses are expected to deliver patient care with compassion, empathy, commitment, competency, dedication and a positive attitude undaunted by the circumstances surrounding incarceration. Although the length of incarceration differs in the various settings, the corrections nurse plays an integral role in providing health services to this population through patient education, patient advocacy, and the delivery of patient care. Therefore, it is inappropriate for nurses to be involved in the security aspects of the facility, disciplinary decisions or committees, or participate in procedures performed solely for correctional purposes, such as body cavity searches or executions by lethal injections.
Nursing Practice in Correctional Settings
Correctional health care is one of the fastest growing specialties in health services today and offers new and unique roles for nursing in the evolving correctional healthcare settings. Because healthcare services are provided within juvenile detention centers, community corrections facilities, jails, and both juvenile and adult correctional institutions, the registered nurse must be prepared in women’s health and pediatric through geriatric and end of life care.
The major emphasis of nursing care in correctional settings is the provision of primary care services for the population. Clinical settings include outpatient and urgent care clinics, acute care, skilled nursing, and long term care inpatient medical facilities. Primary health services include the provision of intake evaluations, health screenings, direct healthcare services, analyzing individual health behaviors, teaching, counseling, and assisting individuals in assuming responsibility for their own health to the best of their ability, knowledge, and circumstances. Specialized mental health and chemical dependency units and facilities, critical care, neuro trauma, and dialysis services supplement the primary care resources.
Registered nurses as the primary healthcare providers in correctional settings also are challenged in dealing with public health issues, providing health education and health promotion activities, evaluating the effectiveness of planned care, and encouraging preventive behavior within the prison setting as it relates to infectious diseases. In addition, the registered nurse coordinates the linkage to community resources prior to the offender’s release from incarceration, a critical function that provides the inmate the opportunity for continuity of care and facilitates a successful return to the community.
General Nursing Practice
Nursing care within the corrections setting may be provided in collaboration with other nurses and health professionals, or independently, which is most often the case in a small or rural facility. Nursing care may be provided by a team of nurses with differing levels of preparation and licensure, i.e. advanced practice registered nurse, registered nurse, and licensed practical nurse.
The registered nurse, in addition to providing direct nursing care, assesses the patient’s health care status, analyzes the assessment data, develops or modifies diagnoses, develops or modifies the plan of care based on those assessments and diagnoses, and evaluates the effectiveness of the plan of care. The preferred educational preparation of the registered nurse for entry into corrections nursing practice is at the baccalaureate level. Continuing professional development is expected, including further educational preparation leading to one or more graduate degrees.
The corrections nurse is often the only healthcare provider on site and must be able to demonstrate good assessment and organizational skills as well as critical decision-making and thinking skills. The registered nurse is involved in caring for patients with multiple and complex diagnosis requiring an increased intensity of care. The nursing activities includes patient assessment, decisions about medication and treatment delivery and assessment of their effects, crisis intervention, triage, education, and patient advocacy. The needs of the correctional population demand the corrections nurse have a sound background in medical-surgical, psychiatric, emergency, and in some settings, critical care nursing. Skills in negotiation, problem solving, listening skills and communication are invaluable.
Correctional facilities vary in size, demographics and age. The overriding mission of security with locks, cameras, bars, correctional officers and searches creates an environment of noise, distractions and confusion which must be managed appropriately to maintain a therapeutic environment for nursing care. Nursing practice must be balanced with the goals of corrections and the incarcerated person’s rights to appropriate health care. The published Standards for Health Services in Correctional Institutions of the American Public Health Association, the American Correctional Association and the National Commission on Correctional Health Care standards, along with state laws and state nurse practice acts and regulations, can provide guidance and support for the corrections nurse.
Working inside a correctional setting requires the corrections nurse have knowledge of the legal aspects of nursing and litigation related to correctional health care. The corrections nurse must be acutely aware of the need for appropriate documentation of care rendered. Maintaining confidentiality of patient health information often requires special attention, especially when corrections staff must assist in monitoring the health status of patients.
The corrections nurse is expected to demonstrate integrity, highly ethical and moral practice appreciating the legally mandated obligation to deliver nursing care regardless of the individual’s circumstances or offenses.
The licensed practical or vocational nurse, in accordance with the licensure laws of his/her state and under the direction of a registered nurse or advanced practice clinician, provides basic nursing care, assists via collaboration with other members of the health care team in the development and implementation of a nursing plan of care, and contributes to an evaluation of the effectiveness of that plan.
Advanced Practice Registered Nurse
The advanced practice registered nurse (APRN) guides the practice and critical thinking of nursing and other health care personnel; carries out direct advanced clinical practice; manages one or more clinical practice settings; incorporates scientific knowledge from other disciplines into practice and management; and evaluates the health care provided in those settings through a comprehensive quality assurance system. Often the APRN is a nurse practitioner serving as the sole primary care provider. More limited practice opportunities are available for the clinical nurse specialist (CNS), certified registered nurse anesthetist (CRNA) and certified nurse midwife (CNM). The APRN’s practice is characterized by the depth and breadth of knowledge in a nursing specialty and the ability to incorporate knowledge of the correctional field in planning, implementing, and managing health care.
Role Specialty Practice
Corrections nurses may engage in role specialty practice when their primary efforts are focused on education, discharge planning, case management, or administration. Their work most often requires a systems perspective and incorporates fiscal and regulatory considerations in decision-making.
The education and knowledge base acquired at the baccalaureate and master’s level prepares corrections nurses to function as Health Services Managers and Chief Nurse Administrators for large systems. Their clinical expertise combined with their administrative training gives them the depth and breadth of preparation to serve at the senior executive and manager levels for all aspects of the complex and political correctional health care deliver system.
Certification
Certification and Advanced Certification in correctional health is available through the National Commission on Correctional Health Care. This organization identifies the two types of certification as CCHP, and CCHP-A for the advanced level. Certification in nursing administration is available through the American Nurses Credentialing Center (ANCC). Other certification and credentialing processes may also be recommended or required for specific corrections settings.
Ethics
The registered nurse in the corrections environment is bound by the profession’s Code of Ethics for Nurses With Interpretive Statements (ANA, ).
The privacy provision of the Health Insurance Portability and Accountability Act of became mandatory in and has been applied in correctional health care systems. Correctional facilities are struggling to determine the relevance and applicability of HIPPA to their operations. Although few state systems have the funds available to support compliance (Orr & llederstein, ), the corrections nurse must continue to assure confidentiality and security of patient information, and also advocate for patient privacy as appropriate.
Corrections nursing, by nature of the practice environment, lends itself to considerations of maintaining public safety. Security issues and concerns are paramount within the correctional institution. Delegation of the authority of patient care is done in collaboration with the corrections administrators. Nurses do not work independently of security but in partnership to provide nursing and medical care to confined individuals. The focus of maintaining security makes correctional nursing practice unique and dynamic, requiring a careful balance of priorities.
The maintenance of professional boundaries is essential in the corrections environment. The nurse must act in a manner that is in the best interest of the patient's medical condition while maintaining a safe and secure environment. Those actions taken by the nurse establish the difference between providing care for the patient and meeting the nurse’s own personal needs. Those who cross professional boundaries place themselves, their peers and others, including the patient, in a position of compromised security.
Trends and Issues in Corrections Nursing
The goal of the corrections nurse becomes that of maintaining confinement and public safety while providing medically necessary health care and health promotion. The application of telehealth technology has become an enhancement to nursing practice in the corrections environment. The maintenance of public safety by decreasing movement of patients out of the correctional setting and the practical aspects of making specialist care more readily accessible to more individuals has made the correctional settings a perfect venue for telehealth. Issues of documentation and confidentiality must be addressed while interacting with physicians and other healthcare providers in other locations than that of the correctional facility.
Corrections nurses must be advocates for maintaining good conditions of confinement by meeting national standards and monitoring basic needs of daily living in the corrections environment. Constant monitoring of infectious diseases, such as tuberculosis, HIV and hepatitis, in the corrections setting is an important process. Education and prevention become a public health obligation to the corrections nurse in the preventing the spread and enhancing the treatment of these infectious diseases in the corrections population, as well as the corrections staff assigned to the facility. This becomes even more important as the incarcerated individual returns to the community and has not yet been cured.
The constitutional right to health care and the changing of community standards of care need to be considered by corrections nurses when developing and reviewing policies in the corrections setting. Research and current practice trends need to be consulted and integrated when appropriate. For example, research is supporting the use of treatment modalities based on cognitive restructuring to change antisocial behaviors for the corrections populations. These new approaches have significant implications for the corrections nurse working with an aging population, increased numbers of the chronically mentally ill, increased numbers of incarcerated women, and individuals with drug and alcohol abuse.
The increasing numbers of chronically ill, elderly, and terminally ill inmates raise organizational and facility issues that must be addressed. Should elderly and infirm inmates be housed in a separate care setting or be mainstreamed with younger, active and possibly more aggressive inmates? Prisons are not designed or staffed to provide sophisticated and intensive care for large numbers of chronically ill people. Do new or renovated corrections facilities need to be designed to easily accommodate those with disabilities, such as visual or auditory deficits, wheelchair bound or dependent on other mobility assistance? What constitutes a “good death” in the corrections environment?
The managed care environment is part of corrections nursing. The significant trend of notable budget cuts for health care of inmates is reflective of current times. The frontline corrections nurse manager is charged with maintaining medically necessary care to patients within the confines of limited budgetary resources. Nurses are encouraged to uphold the intrinsic values of good nursing care and take action if these values are compromised.
The effects of the current nursing shortage have similarly influenced the recruitment and retention for this nursing specialty. Corrections nursing, with it focus on special populations in remote and poorly resourced settings, continues to challenge those desiring to practice in these environments. The monetary remuneration in these settings is often far behind that offered in larger urban settings.
The use of contract or agency nursing and healthcare staff has become very prevalent in correctional health care settings. Contract staff are employed by outside agencies not affiliated with the correctional administration. Their mission, goals, services and salaries are congruent with the healthcare market in the community at large. Use of these contractors often brings nursing staff into correctional settings from free world hospitals who possess state of the art, current skills thereby enhancing the clinical care delivered to the offenders. Often contractors are successful in recruiting nurses to remote areas due to their competitive salaries and short term contracts. These nurses, however, may require significant orientation to the constraints and limits imposed on health care provided in a corrections environment.
Such challenges and issues, competing with so many other more favorable options, may deter the desire of others to choose this nursing specialty. Couple these factors with the restrictions placed on individuals working in correctional institutions and the case is clear for establishing a nurse friendly workplace where nursing practice can be delivered with satisfaction.
STANDARDS OF CORRECTIONS NURSING PRACTICE
STANDARDS OF PRACTICE FOR CORRECTIONS NURSING
The corrections nurse is a registered nurse working in a corrections environment or with confined or detained individuals.
STANDARD 1. ASSESSMENT
The corrections nurse collects comprehensive data pertinent to the patient’s health and condition or the situation.
Measurement Criteria:
The corrections nurse:
Collects data in a systematic and ongoing process.
Involves the patient, family, other healthcare and community providers, as appropriate, in holistic data collection.
Prioritizes data collection activities based on the patient’s immediate condition, the environment of care, or anticipated needs of the patient or situation.
Uses appropriate evidence-based assessment techniques and instruments in collecting pertinent data.
Uses analytical models and problem-solving tools.
Synthesizes available data, information, and knowledge relevant to the situation to identify patterns and variances.
Documents relevant data in a retrievable format.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse initiates and interprets diagnostic tests and procedures relevant to the patient’s current status.
STANDARD 2. DIAGNOSIS
The corrections nurse analyzes the assessment data to determine the diagnoses or issues.
Measurement Criteria:
The corrections nurse:
Derives the diagnoses or related issues based on assessment data.
Validates the diagnoses or issues with the patient, family, and other healthcare and community providers when possible and appropriate.
Documents diagnoses or issues in a manner that facilitates the determination of the expected outcomes and plan.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Systematically compares and contrasts clinical findings with normal and abnormal variations and developmental events in formulating a differential diagnosis.
Utilizes complex data and information obtained during interview, examination, and diagnostic procedures in identifying diagnoses.
Assists staff in developing and maintaining competency in the diagnostic process.
STANDARD 3. OUTCOMES IDENTIFICATION
The corrections nurse identifies expected outcomes for a plan individualized to the patient or the situation.
Measurement Criteria:
The corrections nurse:
Involves the patient, family, and other healthcare and community providers in formulating expected outcomes when possible and appropriate.
Derives culturally appropriate expected outcomes from the diagnoses.
Considers associated risks, security issues, benefits, costs, current scientific evidence, and clinical expertise when formulating expected outcomes.
Defines expected outcomes in terms of the patient, patient values, ethical considerations, environment or situation with such consideration as associated risks, security issues, benefits and costs, and current scientific evidence.
Includes a time estimate for attainment of expected outcomes.
Develops expected outcomes that provide direction for continuity of care.
Modifies expected outcomes based on changes in the status of the patient or evaluation of the situation.
Documents expected outcomes as measurable goals.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Identifies expected outcomes that incorporate scientific evidence and are achievable through implementation of evidence-based practices.
Identifies expected outcomes that incorporate cost and clinical effectiveness, patient acceptance, and continuity and consistency among providers.
Supports the use of clinical guidelines linked to positive patient outcomes.
STANDARD 4. PLANNING
The corrections nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes.
Measurement Criteria:
The corrections nurse:
Develops an individualized plan considering patient characteristics or the situation (e.g., age, gender, and culturally appropriate; environmentally sensitive).
Develops the plan in conjunction with the patient, family, community and public health resources, security personnel, and others, as appropriate.
Includes strategies within the plan that address each of the identified diagnoses or issues, which may include strategies for promotion and restoration of health and prevention of illness, injury, and disease.
Provides for continuity of care within the plan.
Incorporates an implementation pathway or timeline within the plan.
Establishes the plan priorities with the patient, family, security personnel, and others as appropriate.
Utilizes the plan to provide direction to other members of the healthcare team and the security personnel.
Defines the plan to reflect current statutes, rules and regulations, guidelines, and standards.
Integrates current trends and research affecting care in the planning process.
Considers the economic impact of the plan.
Uses standardized language or recognized terminology to document the plan.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Identifies assessment, diagnostic strategies and therapeutic interventions within the plan that reflect current evidence, including data, research, literature, and expert clinical knowledge.
Selects or designs strategies to meet the multifaceted needs of complex patients.
Includes the synthesis of patients’ values and beliefs regarding nursing and medical therapies within the plan.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty:
Participates in the design and development of multidisciplinary, interdisciplinary, and interagency processes to address the situation or issue.
Contributes to the development and continuous improvement of organizational systems that support the planning process.
Supports the integration of clinical, human, financial, and security resources to enhance and complete the decision-making processes.
STANDARD 5. IMPLEMENTATION
The corrections nurse implements the identified plan.
Measurement Criteria:
The corrections nurse:
Implements the plan in a safe and timely manner.
Documents implementation and any modifications, including changes or omissions, of the identified plan.
Utilizes evidence-based interventions and treatments specific to the diagnosis or problem.
Utilizes corrections facility and community resources and systems to implement the plan.
Collaborates with nursing colleagues, healthcare team members, security personnel, and others to implement the plan.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Supports collaboration with healthcare colleagues, security personnel, and other disciplines to implement the plan.
Incorporates new knowledge and strategies to initiate change in healthcare practices if desired outcomes are not achieved.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty:
Facilitates utilization of systems and community resources to implement the plan.
Implements the plan using principles and concepts of project or systems management.
Fosters organizational systems that support implementation of the plan.
STANDARD 5A: COORDINATION OF CARE
The corrections nurse coordinates care delivery.
Measurement Criteria:
The corrections nurse:
Coordinates implementation of the plan.
Employs strategies to promote health and a safe and secure environment.
Documents the coordination of the care.
Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Provides leadership in the coordination of multidisciplinary health care for integrated delivery of patient care services.
Synthesizes data and information to prescribe necessary system and community support measures, including environmental modifications.
Measurement Criteria for the Nurse in the Role Specialty:
The corrections nurse in the role specialty:
Coordinates system and community resources that enhance delivery of care across continuums.
Evaluates fiscal impact and needs when making decisions related to the delivery of care.
STANDARD 5B: HEALTH TEACHING AND HEALTH PROMOTION
The corrections nurse employs strategies to promote health and a safe environment.
Measurement Criteria:
The corrections nurse:
Provides health teaching to patients, family, colleagues, and security personnel that addresses such topics as healthy lifestyles, risk reducing behaviors, developmental needs, activities of daily living, and preventive self-care.
Uses health promotion and health teaching methods appropriate to the situation and the patient’s developmental level, learning needs, readiness, ability to learn, language preference, and culture.
Seeks opportunities for feedback and evaluation of the effectiveness of the strategies used.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Synthesizes empirical evidence on risk behaviors, epidemiology, and other related theories and frameworks when designing health information and patient education.
Provides patient education appropriate to the patient’s developmental level, learning needs, readiness to learn, and cultural values and beliefs.
Additional Measurement Criteria for the Nursing Role Specialty:
Synthesizes empirical evidence on risk behaviors, learning theories, behavioral change theories, motivational theories, epidemiology, and other related theories and frameworks when designing health information and patient education.
Designs health information and patient education appropriate to the patient’s developmental level, learning needs, readiness to learn, and cultural values and beliefs.
Designs, implements, and supports health teaching that addresses chronic illness, communicable disease, access to health care, and emergency care specific for the corrections environment.
Evaluates health information resources, such as the Internet, within the area of practice for accuracy, readability, and comprehensibility to help patients access quality health information.
STANDARD 5C: CONSULTATION
The advanced practice registered nurse and the nursing role specialist provide consultation to influence the identified plan, enhance the abilities of others and effect change.
Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Synthesizes clinical data, theoretical frameworks, and evidence when providing consultation.
Facilitates the effectiveness of a consultation by involving the patient in decision-making and negotiating role responsibilities.
Communicates consultation recommendations that facilitate change.
Measurement Criteria for the Nursing Role Specialty
The corrections nurse in a nursing role specialty:
Synthesizes data, information, theoretical frameworks and evidence when providing consultation.
Facilitates the effectiveness of a consultation by involving the stakeholders in the decision-making process.
Communicates consultation recommendations that influence the identified plan, facilitate understanding by involved stakeholders, enhance the work of others, and effect change.
STANDARD 5D: PRESCRIPTIVE AUTHORITY AND TREATMENT
The advanced practice registered nurse uses prescriptive authority, procedures, referrals, treatments, and therapies in accordance with state and federal laws and regulations.
Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Prescribes evidence-based treatments, therapies, and procedures considering the patient’s comprehensive healthcare needs.
Prescribes pharmacologic agents based on a current knowledge of pharmacology and physiology.
Prescribes specific pharmacological agents and/or treatments based on clinical indicators, the patient’s status and needs, and the results of diagnostic and laboratory tests.
Evaluates therapeutic and potential adverse effects of pharmacological and non-pharmacological treatments.
Provides patients with information about intended effects and potential adverse effects of proposed prescriptive therapies.
Provides information about costs, alternative treatments and procedures, as appropriate.
STANDARD 6. EVALUATION
The corrections nurse evaluates progress towards attainment of outcomes.
Measurement Criteria:
The corrections nurse:
Conducts a systematic, ongoing, and criterion-based evaluation of the outcomes in relation to the structures and processes prescribed by the plan and the indicated timeline.
Includes the patient and others involved in the care or situation in the evaluative process.
Evaluates the effectiveness of the planned strategies in relation to patient responses and the attainment of the expected outcomes.
Documents the results of the evaluation.
Uses ongoing assessment data to revise the diagnoses, outcomes, the plan, and the implementation as needed.
Disseminates the results to the patient and others involved in the care or situation, as appropriate, in accordance with state and federal laws and regulations.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Evaluates the accuracy of the diagnosis and effectiveness of the interventions in relationship to the patient’s attainment of expected outcomes.
Synthesizes the results of the evaluation analyses to determine the impact of the plan on the affected patients, families, groups, communities, corrections and other institutions.
Uses the results of the evaluation analyses to make or recommend process or structural changes including policy, procedure or protocol documentation, as appropriate.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty:
Uses the results of the evaluation analyses to make or recommend process or structural changes, including policy, procedure, regulation and legislation, or protocol documentation, as appropriate.
Synthesizes the results of the evaluation analyses to determine the impact of the plan on the affected patients, families, groups, communities, and corrections and other institutions, networks, and organizations.
STANDARDS OF PROFESSIONAL PERFORMANCE FOR CORRECTIONS NURSING
STANDARD 7. QUALITY OF PRACTICE
The corrections nurse systematically enhances the quality and effectiveness of nursing practice.
Measurement Criteria:
The corrections nurse:
Demonstrates quality by documenting the application of the nursing process in a responsible, accountable, and ethical manner.
Uses creativity and innovation in nursing practice to improve care delivery.
Incorporates new knowledge to initiate changes in nursing practice if desired outcomes are not achieved.
Participates in quality improvement activities. Such activities may include:
Identifying aspects of practice important for quality monitoring.
Using indicators developed to monitor quality and effectiveness of nursing practice.
Collecting data to monitor quality and effectiveness of nursing practice.
Analyzing quality data to identify opportunities for improving nursing practice.
Formulating recommendations to improve nursing practice or outcomes.
Implementing activities to enhance the quality of nursing practice.
Developing, implementing, and evaluating policies, procedures and/or guidelines to improve the quality of practice.
Participating on interdisciplinary teams to evaluate clinical care or health services.
Participating in efforts to minimize costs and unnecessary duplication.
Analyzing factors related to safety, satisfaction, effectiveness, and cost/benefit options.
Analyzing organizational systems for barriers.
Implementing processes to remove or decrease barriers within organizational systems.
Uses the results of quality improvement activities to initiate changes in nursing practice, in the healthcare delivery and the correctional system.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Obtains and maintains professional certification if available in the area of expertise.
Designs quality improvement initiatives.
Implements initiatives to evaluate the need for change.
Evaluates the practice environment and quality of nursing care rendered in relation to existing evidence, identifying opportunities for the generation and use of research.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty:
Obtains and maintains professional certification if available in the area of expertise.
Designs quality improvement initiatives.
Implements initiatives to evaluate the need for change.
Evaluates the practice environment, including the quality of nursing care, in relation to existing evidence, identifying opportunities for improvement, including the generation and use of research.
STANDARD 8. EDUCATION
The corrections nurse attains knowledge and competency that reflects current nursing practice.
Measurement Criteria:
The corrections nurse:
Participates in ongoing educational activities related to appropriate knowledge bases and professional issues.
Demonstrates a commitment to lifelong learning through self-reflection and inquiry to identify learning needs.
Seeks experiences that reflect current practice in order to maintain skills and competence in clinical practice or role performance.
Acquires knowledge and skills appropriate to the specialty area, practice setting, role, or situation.
Maintains professional records that provide evidence of competency and life long learning.
Seeks experiences and formal and independent learning activities to maintain and develop clinical and professional skills and knowledge.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Uses current healthcare research findings and other evidence to expand clinical knowledge, enhance role performance, and increase knowledge of professional issues.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty:
Uses current research findings and other evidence to expand knowledge, enhance role performance, and increase knowledge of professional and leadership issues.
STANDARD 9. PROFESSIONAL PRACTICE EVALUATION
The corrections nurse evaluates one’s own nursing practice in relation to professional practice standards and guidelines, relevant statutes, rules, and regulations.
Measurement Criteria:
The corrections nurse’s practice reflects the application of knowledge of current practice standards, guidelines, statutes, rules, and regulations.
The corrections nurse:
Provides nursing care considering age, culture, ethnicity and the unique aspects of the correctional environment.
Engages in self-evaluation of practice on a regular basis, identifying areas of strength as well as areas in which professional development would be beneficial.
Obtains informal feedback regarding one’s own practice from patients, peers, professional colleagues, and others.
Participates in systematic peer review as appropriate.
Takes action to achieve goals identified during the evaluation process.
Provides rationales for practice beliefs, decisions, and actions as part of the informal and formal evaluation processes.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse engages in a formal process seeking feedback regarding one’s own practice from patients, peers, professional colleagues, and others.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty engages in a formal process seeking feedback regarding role performance from individuals, professional colleagues, representatives and administrators of corrections, government or corporate entities, and others.
STANDARD 10. COLLEGIALITY
The corrections nurse interacts with and contributes to the professional development of peers and colleagues.
Measurement Criteria:
The corrections nurse:
Shares knowledge and skills with peers and colleagues as evidenced by such activities as patient care conferences or presentations at formal or informal meetings.
Provides peers with feedback regarding their practice and/or role performance.
Interacts with peers and colleagues to enhance one’s own professional nursing practice and/or role performance.
Maintains compassionate and caring relationships with peers and colleagues.
Contributes to an environment that is conducive to the education of healthcare professionals.
Contributes to a supportive and healthy work environment.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Models expert practice to interdisciplinary team members and healthcare consumers.
Mentors and precepts other corrections nurses and colleagues as appropriate.
Participates with interdisciplinary teams that contribute to role development and advanced nursing practice and health care.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty:
Participates on multi-professional teams that contribute to role development and, directly or indirectly, advance nursing practice and health services.
Mentors and precepts other corrections nurses and colleagues as appropriate.
STANDARD 11. COLLABORATION
The corrections nurse collaborates with patient, family and others in the conduct of nursing practice.
Measurement Criteria:
The corrections nurse:
Communicates with patient, family, healthcare providers, and corrections staff regarding patient care and the nurse’s role in the provision of that care.
Collaborates in creating a documented plan focused on outcomes and decisions related to care and delivery of services that indicates communication with patients, families, and others.
Partners with others to effect change and generate positive outcomes through knowledge of the patient or situation.
Documents referrals, including provisions for continuity of care.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Partners with other disciplines to enhance patient care through interdisciplinary activities, such as education, consultation, management, technological development, or research opportunities.
Facilitates an interdisciplinary process with other members of the healthcare team.
Documents plan of care communications, rationales for plan of care changes, and collaborative discussions to improve patient care.
Additional Measurement Criteria for Nursing Role Specialty:
The corrections nurse in a nursing role specialty:
Works with others to enhance health care, and ultimately patient care, through interdisciplinary activities such as education, consultation, management, technological development, or research opportunities.
Facilitates an interdisciplinary process with corrections staff and community resources.
Documents plans, communications, rationales for plan changes, and collaborative discussions.
STANDARD 12. ETHICS
The corrections nurse integrates ethical provisions in all areas of practice.
Measurement Criteria:
The corrections nurse:
Uses the Code of Ethics for Nurses With Interpretive Statements (ANA, ) to guide practice.
Delivers care in a manner that preserves and protects patient autonomy, dignity and rights.
Maintains patient confidentiality within legal and regulatory parameters considering the unique corrections environment.
Serves as a patient advocate assisting patients in developing skills for self advocacy.
Maintains a therapeutic and professional patient-nurse relationship with appropriate professional role boundaries.
Demonstrates a commitment to practicing self-care, managing stress, and connecting with self and others.
Contributes to resolving ethical issues of patients, colleagues, or systems as evidenced in such activities as participating on ethics committees.
Reports illegal, incompetent, or impaired practices.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Informs the patient of the risks, benefits, and outcomes of healthcare regimens.
Participates in interdisciplinary teams that address ethical risks, benefits, and outcomes.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty
Participates on multidisciplinary and interdisciplinary teams that address ethical risks, benefits, and outcomes.
Informs administrators or others of the risks, benefits, and outcomes of programs and decisions that affect healthcare delivery.
STANDARD 13. RESEARCH
The corrections nurse integrates research findings into practice.
Measurement Criteria:
The corrections nurse:
Utilizes the best available evidence, including research findings, to guide practice decisions.
Actively participates in research activities at various levels appropriate to the nurse’s level of education and position. Such activities may include:
Identifying clinical problems specific to nursing research (patient care and nursing practice)
Participating in data collection (surveys, pilot projects, formal studies)
Participating in a formal committee or program
Sharing research activities and/or findings with peers and others
Conducting research
Critically analyzing and interpreting research for application to practice
Using research findings in the development of policies, procedures, and standards of practice in patient care
Incorporating research as a basis for learning
Recognizes the unique requirements of human subjects’ protection in the corrections environment.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Contributes to nursing knowledge by conducting or synthesizing research that discovers, examines and evaluates knowledge, theories, criteria, and creative approaches to improve healthcare practice, especially within the corrections environment.
Formally disseminates research findings through activities such as presentations, publications, consultation, and journal clubs.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty:
Contributes to nursing knowledge by conducting or synthesizing research that discovers, examines and evaluates knowledge, theories, criteria, and creative approaches to improve health care.
Formally disseminates research findings through activities such as presentations, publications, consultation, and journal clubs.
STANDARD 14. RESOURCE UTILIZATION
The corrections nurse considers factors related to safety, effectiveness, cost, benefits, and impact on practice in the planning and delivery of nursing services.
Measurement Criteria:
The corrections nurse:
Evaluates factors such as safety, security, effectiveness, availability, cost and benefits, efficiencies, and impact on practice, when choosing practice options that would result in the same expected outcome.
Assists the patient, family, corrections staff and community resources in identifying and securing appropriate and available services to address health-related needs.
Assigns or delegates tasks, based on the needs and condition of the patient, potential for harm, stability of the patient’s condition, complexity of the task, and predictability of the outcome.
Assists the patient and family in becoming informed consumers about the options, risks, and benefits of treatment and care.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Utilizes organizational and community resources to formulate multidisciplinary or interdisciplinary plans of care.
Develops innovative solutions for patient care problems that address effective resource utilization and maintenance of quality.
Develops evaluation strategies to demonstrate cost effectiveness, cost benefit, and efficiency factors associated with clinical practice.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty:
Develops innovative solutions and applies strategies to obtain appropriate resources for nursing initiatives.
Secures organizational resources to ensure a work environment conducive to completing the identified plan and outcomes.
Develops evaluation methods to measure safety, security, and effectiveness for interventions and outcomes.
Promotes activities that assist others, as appropriate, in becoming informed about costs, risks, and benefits of care or of the plan and treatment strategies.
STANDARD 15. LEADERSHIP
The corrections nurse provides leadership in the professional practice setting and the profession.
Measurement Criteria:
The corrections nurse:
Engages in teamwork as a team player and a team builder.
Works to create and maintain healthy work environments in local, regional, national, or international communities.
Displays the ability to define a clear vision, the associated goals, and a plan to implement and measure progress.
Demonstrates a commitment to continuous, life long learning for self and others.
Teaches others to succeed by mentoring and other strategies.
Exhibits creativity and flexibility through times of change.
Demonstrates energy, excitement, and a passion for quality work.
Willingly accepts mistakes by self and others thereby creating a culture in which risk-taking is not only safe, but expected.
Inspires loyalty through valuing of people as the most precious asset in an organization.
Directs the coordination of care across settings and among caregivers, including oversight of licensed and unlicensed personnel in any assigned or delegated tasks.
Serves in key roles in the work setting by participating on committees, councils, and administrative teams.
Promotes advancement of the profession through participation in professional organizations.
Additional Measurement Criteria for the Advanced Practice Registered Nurse:
The advanced practice registered nurse:
Works to influence decision-making bodies to improve patient care.
Provides direction to enhance the effectiveness of the healthcare team.
Initiates and revises protocols or guidelines to reflect evidence-based practice, to reflect accepted changes in care management, or to address emerging problems.
Promotes communication of information and advancement of the profession through writing, publishing, and presentations for professional or lay audiences.
Designs innovations to effect change in practice and improve health outcomes.
Additional Measurement Criteria for the Nursing Role Specialty:
The corrections nurse in a nursing role specialty:
Works to influence decision-making bodies to improve patient care, health services, delivery systems, and organizational and governmental policies.
Promotes communication of information and advancement of the profession through writing, publishing, and presentations for professional or lay audiences.
Designs innovations to effect change in practice and outcomes.
Provides direction to enhance the effectiveness of the multidisciplinary or interdisciplinary team.
GLOSSARY
Assessment – a systematic, dynamic process by which the corrections nurse through interaction with the patient, family, groups, communities, populations and healthcare providers collects and analyzes data. Assessment may include the following dimensions: physical, psychological, socio-cultural, spiritual, cognitive, functional abilities, developmental, economic, and lifestyle.
Caregiver – a person who provides direct care for another, such as a child, dependent adult, the disabled or the chronically ill.
Code of Ethics – a list of provisions that makes explicit the primary goals, values and obligations of the profession.
Continuity of care – an interdisciplinary process that includes patients, families and significant others in the development of a coordinated plan of care. This process facilitates the patient’s transition between settings and healthcare providers, based on changing needs and available resources.
Corrections environment - a facility or place of confinement, which houses offender, detainee, or convicted clientele.
Corrections nursing - the practice of nursing and the delivery of care within the unique and distinct environment of the criminal justice system.
Criteria – relevant, measurable indicators of the standards of practice and professional performance.
Data – discrete entities that are described objectively without interpretation.
Diagnosis – a clinical judgment about the patient’s response to actual or potential health conditions or needs. The diagnosis provides the basis for determination of a plan to achieve expected outcomes. Corrections nurses utilize nursing and/or medical diagnoses depending upon educational and clinical preparation and legal authority.
Disease – a biological or psychosocial disorder of structure or function in a patient, especially one that produces specific signs or symptoms or that affects a specific part of the body, mind, or spirit.
Environment – the atmosphere, milieu, or conditions in which an individual lives, works or plays.
Evaluation – the process of determining the progress toward attainment of expected outcomes, including the effectiveness of care, when addressing one’s practice.
Expected outcomes – end results that are measurable, desirable, observable, and translate into observable behaviors.
Evidence-based practice – a process founded on the collection, interpretation and integration of valid, important and applicable patient-reported, clinician-observed and research-derived evidence. The best available evidence, moderated by patient circumstances and preferences is applied to improve the quality of clinical judgments.
Family – family of origin or significant others as identified by the patient.
Guidelines –systematically developed statements that describe recommended actions based on available scientific evidence and expert opinion. Clinical guidelines describe a process of patient care management that has the potential of improving the quality of clinical and consumer decision-making.
Health – an experience that is often expressed in terms of wellness and illness, and may occur in the presence or absence of disease or injury.
Healthcare providers – individuals with special expertise who provide healthcare services or assistance to patients. They may include nurses, physicians, psychologists, social workers, nutritionists/dietitians and various therapists.
Holistic – an understanding that the parts of a patient are intimately interconnected and physical, mental, social, and spiritual factors need to be included in any interventions. The whole is a system that is greater than the sum of its parts.
Illness – the subjective experience of discomfort.
Implementation – activities such as teaching, monitoring, providing, counseling, delegating and coordinating.
Information – data that are interpreted, organized, or structured.
Interdisciplinary – overlapping skills and knowledge of each team member and discipline resulting in synergistic effects where outcomes are enhanced and more comprehensive than the simple aggregation of any team member’s individual efforts.
Knowledge – information that is synthesized so that relationships are identified and formalized.
Multidisciplinary – each team member or discipline contributes discipline-specific skills.
Patient – recipient of nursing practice. The term patient is used to provide consistency and brevity, bearing in mind that other terms such as client, individual, resident, family, groups, communities or populations, might be better choices in some instances. When the patient is an individual, the focus is on the health state, problems or needs of the individual. When the patient is a family or group, the focus is on the health state of the unit as a whole or the reciprocal effects of the individual’s health state on the other members of the unit. When the patient is a community or population, the focus is on personal and environmental health and the health risks of the community or population.
Peer review – a collegial, systematic, and periodic process by which corrections nurses are held accountable for practice and which fosters the refinement of one’s knowledge, skills and decision-making at all levels and in all areas of practice.
Plan – a comprehensive outline of the components that need to be addressed to attain expected outcomes.
Quality of care – the degree to which health services for patients, families, groups, communities or populations increase the likelihood of desired outcomes and are consistent with current professional knowledge.
Situation – a set of circumstances, conditions, or events.
Stakeholders – may include patients, families, communities, corrections staff, health care providers, and others
Standard – an authoritative statement defined and promoted by the profession by which the quality of practice, service, or education can be evaluated.
Strategy – a plan of action to achieve a major overall goal.
Timeline – a chronology for the plan of action to achieve a major overall goal.
References:
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American Nurses Association. (). Nursing’s social policy statement, 2nd edition. Washington, DC: nursesbooks.org.
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Anno, B.J., “Health Behaviors in prisons and correctional facilities”, Ch. 14, David S. Goehman(Ed) Handbook of Health Behaviors Research III, New York: Plenum Press.
Anno, B. J., Graham, C., Lawrence, J. E., & Shansky, R. (). Correctional Health Care: Addressing the Needs of Elderly, Chronically Ill, and Terminally Ill Inmates. Washington, DC: Criminal Justice Institute, National Institute of Corrections. Available at http://www.nicic.org/Downloads/PDF//35.pdf
Greenfeld, L. A., & Snell, T. L. (). “Women Offenders”, Washington, D.C.:US Dept of Justice, Bureau of Justice Statistics.
Goldkuhle, U., (). “Health Service utilization by women in prison: Health needs indicators and response effects.” Journal of Correctional Health Care, 1, 63-83.
Murtha, R. (). Changes in one city's system. American Journal of Nursing, 75(3), 421-422.
National Commission on Correctional Health Care (NCCHC). (). The Health Status of Soon-To-Be-Released Inmates. Washington, DC: Author. Available at http://www.ncchc.org/pubs/pubs_stbr.vol1.html
Neeley, C. L., Addison, L., & Moreland, D.C. (). Addressing the needs of elderly offenders. Corrections Today, August.
Orr, D., & Helderstein, D. HIPPA in state correctional systems. Journal of Correctional Health Care, 9(3), p. 345-359.
Sourcebook of Criminal Justice Statistics Online, 30th Edition. (). National Criminal Justice Reference Service. Available at http://www.albany.edu/sourcebook/
U.S. Department of Health and Human Services. (). The registered nurse population: Findings from the National Sample Survey of Registered Nurses, March . Washington, DC: Health Resource and Services Administration, bureau of Health Professions, Division of Nursing.
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Source: American Nurses Association
