Journal of forensic nursing最新文献

Background/aims: Human trafficking (HT) affects 25 million people globally, with Illinois ranking eleventh in U.S. cases, highlighting the need for effective health care identification systems. To evaluate an HT screening program implemented in a Chicago emergency department (ED).

Methods: The program established an HT victim screening tool into the electronic medical record, trained staff on HT red flags, and used a silent identification system to enhance victim detection at multiple patient interaction points.

Results: Two HT victims were identified shortly after implementation. However, sustainability measures proved inadequate, with screening numbers at only 15 screens 2 years after implementation. Challenges included high staff turnover, insufficient training, hidden screening locations, and poor maintenance of the silent notification system.

Discussions: Ongoing education, better screening placement, and leveraging Sexual Assault Nurse Examiners' expertise are critical for improvement. A new initiative is underway to address barriers and enhance the HT protocol in the Chicago ED.

Background: There is an identified educational gap in ED nurses regarding their comfort in screening for victims of human trafficking (HT) and intimate partner violence (IPV).

Aim: To increase nurses' knowledge about HT and IPV, legal requirements, available resources, and the use of an EHR screening tool.

Methods: A single-session 30-minute educational intervention on HT, IPV, and screening was delivered, with pre-evaluation and post-evaluation.

Results: Of the 15 participants, there was a significant increase in staff understanding of caring for victims of HT and IPV after the intervention. Specifically, nurses' knowledge increased in areas such as defining HT and IPV, identifying HT "Red Flags," and adopting a trauma-informed care approach.

Conclusions: A brief educational intervention can improve ED nurses' knowledge and confidence regarding HT and IPV identification and screening. Further longitudinal research is warranted to assess outcomes over time and the possible need for ongoing professional development on HT and IPV screening.

Background: Health professionals frequently care for individuals who have been trafficked, yet many go unrecognized. Trainings that reinforce narrow stereotypes may contribute to these missed opportunities by shaping provider perceptions and deepening bias.

Purpose: To assess whether introductory online trainings about human trafficking reflect representational biases.

Methods: Thirteen publicly available trainings were analyzed for sensationalism, racial representation, gender identity expression, and trafficking type.

Results: All trainings showed bias in at least one domain; the greatest bias was toward feminine gender expression (92%). Sensationalized imagery appeared in 46%. White-presenting survivors were overrepresented in 38%. About half lacked any transgender/nonbinary (46%) or LGBTQ+ (54%) identities. Sex trafficking was emphasized over labor trafficking in 85% of trainings.

Conclusions: Even brief trainings can shape perceptions and perpetuate bias. Educators should critically examine representation and their own positionality to support trauma-informed skills-building that helps clinicians recognize and support all survivors in clinical care.

Abstract:

Background: There is limited literature on the best strategies to prepare sexual assault nurse examiners (SANEs) for the intensity of providing testimony in court.

Aim: To explore the impact of a mock courtroom simulation-enhanced interprofessional experience on perceptions of comfort, confidence, and testimony ability in SANEs.

Methods: A mock courtroom simulation-enhanced interprofessional experience was developed to provide SANEs with multiple opportunities to practice critical skills related to providing expert testimony for a sexual assault criminal proceeding. Narrative feedback was gathered, exploring perceptions of confidence, comfort, and awareness of legal processes. A thematic analysis was conducted.

Results: Themes included (1) realism and practical exposure, (2) confidence and composure under pressure, (3) enhanced understanding of legal protocols and self-advocacy, and (4) long-term professional preparation.

Discussion: Exposure to multiple cases and styles of cross-examination from prosecutors and defense attorneys proved to be a valuable strategy for preparing SANEs for the rigor of providing testimony in court.

Introduction: Most interventions aimed at reducing mechanical restraint (MR) have not been adapted to forensic mental health settings (FMHS) and rarely consider the perspectives of service users (SUs), relatives, and staff.

Aim: To investigate the perceptions of SUs, relatives, and staff regarding the content and feasibility of seven interventions to reduce MR use in adult FMHS.

Methods: We conducted semi-structured, one-on-one, and group interviews with SUs, relatives, and staff within an FMHS and analyzed the data using content analysis.

Results: Seven categories were produced: building relationships, expanding patient-related knowledge, applying de-escalation methods, optimizing staffing levels, increasing availability, improving collaboration, and promoting professional staff attitudes.

Conclusions: Strengthening relationships is fundamental to the feasibility of most interventions aimed at reducing MR episodes. SU-staff relations depend on staff's knowledge of and genuine engagement with SUs, while staff-staff dynamics are built on trust and collaboration.

Background: Intimate partner violence (IPV) is a critical public health issue within the military. Nonfatal strangulation is a form of IPV that significantly raises the risk of future violence and increases the likelihood of homicide sevenfold.

Case reports: This article presents two case reports of women who presented to a military emergency department with the chief complaint of manual strangulation by their service member spouse. Their initial exam, injuries, and follow-up care are described.

Conclusion: IPV and nonfatal strangulation can cause severe internal damage regardless of visible external injuries. Thorough medical evaluation is essential to detect potentially life-threatening complications, including vascular, neurologic, or central nervous system damage. Enhanced prevention strategies in the military, along with adherence to evidence-based imaging and follow-up protocols, can mitigate the long-term physical and psychological effects of strangulation and improve family well-being and military readiness.

Abstract: The Runaway Intervention Program (RIP) is a strengths-based, nurse-led home visitation and case management model for runaway youth at risk of sexual exploitation, violence, and mental health challenges. RIP aims to promote healthy development, reduce trauma responses, and lower risk behaviors. This study evaluates the effectiveness of three optional psychological interventions-individual therapy, group therapy, and combined therapy-administered by licensed mental health practitioners. Using archival data from 128 RIP participants enrolled between 2015 and 2019, the study assessed pretreatment and posttreatment posttraumatic stress disorder (PTSD) symptoms using the University of California Post t raumatic Stress Disorder Index.Statistical analysis suggested a reduction in PTSD symptoms from pretreatment ( M  = 35.33, SD = 15.29) to posttreatment ( M  = 22.91, SD = 16.31), regardless of treatment type. There was no significant difference in symptom reduction between the three treatment modalities, indicating comparable effectiveness across modalities. Across all treatment modalities, clinically significant change analysis showed that 41% of participants recovered, 51% showed no change, 2% improved, and 6% deteriorated. These findings suggest that although RIP interventions effectively reduce PTSD symptoms, no single modality outperformed the others. The results underscore the value of flexible therapeutic options to address the diverse needs of runaway youth.

Introduction: Healthcare professionals play a vital role in the identification and assistance of individuals affected by trafficking who are seen in the healthcare setting. The objective of this project was to analyze a screening tool with newly added questions specifically geared at human trafficking and determine its efficacy in identifying trafficked persons who were seen in the emergency department or who were inpatients.

Methods: This retrospective cohort study occurred at a large Level 1 trauma center located in the Midwest. Nursing staff administered a mandatory Abuse Risk + Human Trafficking tool. A retrospective chart review was conducted. Data from the abuse screen were reviewed from April 1, 2021, to February 28, 2023.

Results: Of all positive screens on the Abuse Risk + Human Trafficking tool, 33% were positive for at least one human trafficking question. Among those with a positive screen on the human trafficking questions, 25 screenings (20 adults, five minors) were associated with patients who had documentation highly concerning for trafficking. There were also 11 screenings with documentation highly concerning for trafficking that did not screen positive on any human trafficking questions and were positive for the non-human-trafficking questions only.

Discussion: The addition of three human trafficking questions to create the Abuse Risk + Human Trafficking tool resulted in an increase in the identification of individuals exploited by human trafficking in this hospital setting when compared with the existing Abuse Risk tool that did not have the additional human trafficking questions.

Background: School nurses work in interprofessional teams to identify and care for youth involved in commercial sex trading. However, the school nurse role in the care of these youth is not well documented despite evidence suggesting youth who trade sex are attending U.S. public schools.

Study aim: To describe licensed school nurses' (LSNs) perspectives on interventions implemented to support youth who trade sex in Minnesota.

Methods: Twenty-one LSNs participated in an online focus group discussing their role in the support of youth who trade sex. Thematic analysis was used to identify and synthesize details about the interventions described.

Results: Four themes were identified: independent nursing interventions, collaborative interventions, barriers to intervention , and suggested support for improved intervention .

Conclusions and implications: School nurses rely on developing positive relationships with students, school staff, and community partners to intervene with youth who trade sex. Such relationships can facilitate identification of sexually exploited youth and may promote trauma-informed care when youth seek care from forensic nurses. Collaboration between forensic and school nurses is a promising yet underutilized school-based intervention for youth who trade sex.