Correctional Nursing Practice

1. Correctional Nursing Practice Applying the New Scope and Standards Catherine M. Knox, MN, RN, CCHP-RN Mary V. Muse, MS, RN,CCHP-A, CCHP-RN Lorry Schoenly, PhD, RN, CCHP-RN, CCN/M

2. FacultyDisclosure We do not have any relevant financial relationships with any commercial interests.

3. Objectives • Relevance of the ANA scope and standards to actual practice • Emerging themes and important changes • Application in the correctional setting

4. For the Discussion Period • Important emerging issues • Use in various practice settings • Part of day-to-day practice

5. Recognition of the Specialty

6. Scopeof Practice • “who” • “what” • “where” • “when” • “why” • and “how” ...of nursing practice Nursing Scope & Standards of Practice (ANA,2010, p.2)

7. Definition of 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. Nursing’s Social Policy Statement: The Essence of the Profession (ANA, 2010, p. 3)

8. Correctional Nursing in the Nursing Profession Specialization is defined as nursing practice in an area that is identified from the field as a whole. ANA, Nursing’s Social Policy Statement, pg. 17 (2010) Recognized as a specialty area of practice by the ANA since 1985. ANA, Standards of Nursing Practice in Correctional Facilities (C. Bickford, personal communication 2011)

9. I am a Correctional Nurse

10. Definition of Correctional Nursing • Correctional 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, advocacy, and delivery of health care to individuals, families, communities, and populations… under the jurisdiction of the criminal justice system.

11. Correctional Nursing in the Nursing Profession What are the distinguishing features of the specialty? What characteristics define the practice? What observablepractices are unique? ANA, Recognition of a Nursing Specialty, pg. 13 (2010)

12. Correctional Nursing in the Nursing Profession Distinguishing features • Setting • Primary provider • Legal parameters • Wide spectrum of health needs Characteristics that define practice • Primary care • Care management • Autonomy Unique observablepractices • Medication administration • Patient advocacy • Balancing health needs with security concerns ANA, Corrections Nursing: Scope & Standards of Practice, pgs. 8-13,(2007)

14. Tenets Characteristic of Nursing Practice • Nursing practice is individualized. • Nurses coordinate care by establishing partnerships. • Caring is central to the practice of the registered nurse. • Registered nurses use the nursing process to plan and provide individualized care to their healthcare consumers. • A strong link exists between the professional work environment and the registered nurse’s ability to provide quality health care and achieve optimal outcomes. Nursing: Scope and Standards of Practice, 2nd Edition, pg 4-5

15. Correctional Nursing in the Nursing Profession Professional Regulation of Specialty Practice: 1. Scope and standards of practice 2. Body of knowledge • Research • Evidenced based practice • Publications 3. Certification of nursing competence

16. History of Correctional Nursing Scope and Standards of Practice • Standards of Nursing Practice in Correctional Facilities, 1985 • Scope & Standards of Nursing Practice in Correctional Facilities, 1995 • Corrections Nursing Scope & Standards of Practice, 2007 • Correctional Nursing Scope and Standards of Practice, 2013

17. The New Standards • The charge - update the 2007 standards to adequately describe the evolving development, complexity and responsibilities of correctional nursing practice in 2013. • The team - dedicated correctional nursing leaders representing a wide diversity of practice sites, experience, and education.

18. ANA Correctional Nursing Workgroup • Patricia A. Voermans MS, RN, APN, CCHP-RN, Chairperson • Patricia A. Blair, PhD, LLM, JD, MSN, CCHP • Jeannie Chesney, MSN, RN, BSN, CCHP-RN • Margaret Collatt, RN, CCHP-A/RN • Collean D'Acquisto, RN, CCNM, CCHP • Laurie Josefek, BSN, RN • JoRene Kerns, BSN, RN, CCHP • Catherine M. Knox, MN, RN, CCHP-RN • Jacqueline Moore, PhD, R.N • Mary MuseMS, RN, CCHP-A, CCHP-RN • Denise M. Panosky, DNP, RN, CCHP, FCNS • Ellyn Presley, RN, CCHP-RN • Lori E. Roscoe, PhD, MPA, BSN, CCHP-RN • Lorry Schoenly, PhD, RN, CCHP-RN • Bernardine Scott, RN • Nancy Sue Smith, MSN, RN • Deborah McCray Stewart, MSN, RN, FNP-C, CCHP

19. My Thoughts Another opportunity to give voice and visibility to correctional nursing. I’m glad to once again be part of the team, responsible for revision of the correctional standards.

20. What are the lived experiences of the correctional nurse? What does our research tell us? • The Process

21. Actual experience with the workgroup & ANA

22. Steps in the Review Process • Summer 2011 – Workgroup Convened • September 2011 – September 2013 – Section Drafts • October 2012 - Public comment • January 2013 Final review

23. Correctional Nursing in 2013 • The History of Nurses Within the Correctional Environment • Health Care in Correctional Settings: A Brief Historical Legal Perspective • Prevalence of Correctional Nurses • Population Served • Settings • Roles and Practice of the Correctional Nurse • Primary Care, acute care, chronic care • Medication Management • Health Promotion • Patient advocacy, • Care and concern for health • Preservation of Safety • Requisite Skills and Knowledge

24. Correctional Nursing in 2013 • Tenets of Correctional Nursing Practice • Principles that Guide Correctional Nursing • Ethics • Correctional Registered Nurses • Advanced Practice Registered Nurses • Executive Nurse Leadership • Educational Preparation • Specialty Certification • Trends and Issues in Correctional Nursing • Summary

25. Standards of Correctional Nursing Practice Standards of Practice • Standard 1. Assessment • Standard 2. Diagnosis • Standard 3. Outcomes Identification • Standard 4. Planning • Standard 5. Implementation • Standard 5A. Coordination of Care • Standard 5B. Health Teaching and • Health Promotion • Standard 5C. Consultation • Standard 5D. Prescriptive Authority • and Treatment • Standard 6. Evaluation

26. Standards of Correctional Nursing Practice Standards of Professional Performance Standard 7. Ethics Standard 8. Education Standard 9. Evidence-Based Practice and Research Standard 10. Quality of Practice Standard 11. Communication Standard 12. Leadership Standard 13. Collaboration Standard 14. Professional Practice Evaluation Standard 15. Resource Utilization Standard 16. Environmental Health

27. Relationship of Standards

28. NewCompetency Criteria • Each standard identifies the expected competencies to achieve that standard • “Competency is an expected level of performance that integrates knowledge, skills, abilities, and judgment”. • The expectation is that competence can be defined, measured, and evaluated in nursing practice Nursing Scope & Standards of Practice (ANA, 2010, p. 12)

29. Applying the Standards

30. Using the Scope and Standards

31. Application Practice improvement Peer review Quality improvement

32. Application Orientation Mentoring Professional development

33. Shelton, Weiskopf, & Nicholson (2010)

34. Shelton, Weiskopf, & Nicholson (2010)

35. Application Policy Procedure Position description

36. Application Professional Development Intake Screening Health Appraisal Requests for Healthcare Forensic Information Informed Consent and Refusal

39. Emerging Issues • Population changes simplicity diversity • Public policy and practice cost effectiveness • Nursing standards and practice caring outcomes • Health care delivery quality safety

40. Discussion

41. References • American Nurses Association (ANA). (2013). Correctional Nursing: Scope & Standards of Practice. Silver Springs, MD: Nursesbooks.org. • American Nurses Association. (2010) Nursing’s Social Policy Statement: The Essence of the Profession. Silver Spring, MD: Nursesbooks.org. • American Nurses Association. (2010). Nursing: Scope and Standards of Practice, Second Edition. Silver Spring, MD: Nursesbooks.org. • American Nurses Association (ANA). (2007). Corrections Nursing: Scope & Standards of Practice. Silver Springs, MD: Nursesbooks.org.. • Shelton, D. (2009). Forensic nursing in secure environments. Journal of Forensic Nursing. 5, 131-142. • Shelton, D., Weiskopf, C., Nicholson, M. (2010). Correctional Nursing Competency Development in the Connecticut Correctional Managed Health Care Program. Journal of Correctional Health Care. 16 (4). 38-47.

42. Correctional Nursing Practice Applying the New Scope and Standards Catherine M. Knox, MN, RN, CCHP-RN Lorry Schoenly, PhD, RN, CCHP-RN Mary V. Muse, MS, RN, CCHP-A, CCHP-RN