Date of Award
2024
Degree Name
Doctor of Philosophy
Schools and Centres
Nursing and Midwifery
First Supervisor
Professor Kylie Russell
Second Supervisor
Dr Tracey Coventry
Abstract
Forensic nursing encompasses a range of skills that can be utilised across healthcare services and legal services. The delivery of forensic nursing care covers a vast number of roles and practice areas that can improve patient outcome, including the care of victims of interpersonal violence who often face multiple barriers in achieving a positive medicolegal outcome. A nurse’s ability to identify a potential victim and initiate forensic nursing care in an emergency care setting can positively influence the patient’s engagement with support services and the justice system. Despite this, a review of the Australian literature has identified inconsistencies in forensic nursing practice in emergency care settings.
Interpersonal violence is a growing global concern – in particular, gender-based violence and violence against vulnerable populations. Nurses require education and support to deliver principles of forensic practice and incorporate trauma-informed care to support victims of interpersonal violence. The purpose of this study was to develop a national online forensic program for registered nurses working in an Australian emergency care setting and to determine whether these nurses perceived that the program positively influenced their patient care. This program aimed to fill the gap many health services in Australia experience as a result of the limited employment of forensic nursing roles.
The study used a multiphase mixed methods approach to collect data from stakeholders and participants working in emergency care settings across three phases and six data points. Phase one involved surveys with open ended and closed ended questions completed by stakeholders in health care and the criminal justice system from various States and Territories across Australia. Data analysis from phase one contributed to phase 2 in the development of the forensic nursing online program, which was reviewed by an expert panel. Phase 3 encompassed the distribution of the online program alongside the associated pre and post experience surveys. The surveys were distributed to nurses who work in an emergency care setting through the Australian College of Emergency Nursing (ACEN) and the College of Emergency Nursing of Australasia (CENA).
Data analysis supported the learning benefit of the program content and delivery method; additionally, across the phases, participants identified various enablers and barriers to the delivery of forensic nursing care in the emergency care setting. The internal conflict they experienced when patients refused assistance and the increased exposure to vicarious trauma was of concern to nurses’ welfare. Importantly, the study noted increased confidence in key forensic principles such as injury documentation and evidence collection. This finding is significant given that 50.7% (n = 36) of the participants stated they had received no previous education on forensic principles; however, 61.1% (n = 44) had encountered forensic patients on a daily or weekly basis.
The forensic nursing program has demonstrated its ability to provide key forensic nursing care principles to nurses through an online learning format; further, this introductory program enhanced nurses’ engagement with patient identification and their ability to deliver person-centred forensic care. The forensic nursing program, developed with stakeholder input, has provided a platform to support this extension of the registered nursing role in Australia.
Publication Details
Brown, M. (2024). The Development, Implementation, and Evaluation of an Online Program for Emergency Nurses Caring for Victims of Interpersonal Violence: A Mixed Methods Study [Doctor of Philosophy]. The University of Notre Dame Australia. https://researchonline.nd.edu.au/theses/446
