Forensic Nursing Research: The Basics Explained.

ABSTRACT: As a growing profession, forensic nursing requires research to establish best practice guidelines leading to evidence-based practice. In addition, forensic nursing quality improvement projects are necessary to evaluate and improve practices and policies. The purpose of this article is to provide step-by-step guidelines on research and quality improvement projects to encourage all forensic nurses to actively contribute to and utilize research in practice. Research will expand our forensic nursing science and knowledge base. Ultimately, forensic nursing research will benefit our patients and communities by establishing enhanced, evidence-based care.

Locating gaps in the California Current System ocean acidification monitoring network.

Ocean acidification is a global issue with particular regional significance in the California Current System, where social, economic, and ecological impacts are already occurring. Although ocean acidification is a concern that unifies the entire West Coast region, managing for this phenomenon at a regional scale is complex and further complicated by the large scale and dynamic nature of the region. Currently, data collection relevant to ocean acidification on the West Coast is piecemeal, and cannot capture the primary sources of variability in ocean acidification through time and across the region, hindering collaboration among regional managers. We developed a tool to analyze gaps in the West Coast ocean acidification monitoring network. We describe this tool and discuss how it can enable scientists and marine managers in the California Current System to fill information gaps and better understand and thus respond to ocean acidification through the implementation of management solutions at the local level.

Infusing the Principles of Trauma-Informed Care Into Emergency Nursing: A Comprehensive Approach to Change Practice.

The emergency department is a frequent entry point into the healthcare system for victims of violence. Currently, a knowledge deficit and clinical practice gap exists among emergency nurses regarding their consistent ability to implement a trauma-informed approach in their interactions with forensic clients. Emergency nurses at all levels of professional development, senior undergraduate nursing students, new graduate nurses, and experienced nurses should be well informed regarding the prevalence of violence, basic clinical forensic nursing practice, and the principles of trauma-informed care. A comprehensive approach is required to both identify and address the trauma associated with violence. Through reflecting on Benner's Novice to Expert framework, strategies are proposed for the implementation of a comprehensive plan. An inclusive approach to the implementation of the principles of trauma-informed care into emergency nursing may ultimately lead to a transformation in culture in which nurses ask, "What has happened to you?" instead of "What is wrong with you?"

An Evidence-Based Approach to Suicide Risk Assessment After Sexual Assault.

Sexual violence occurs in all gender, socioeconomic, religious, and ethnic groups. The trauma of sexual violence negatively affects both a person's physical and mental health. Individuals often experience suicidal ideations in the aftermath of a sexually violent event. On the basis of an understanding of the causative relationship between sexual violence and increased suicidality, a quality improvement study was developed to enhance the direct nursing care provided to clients at the time of the forensic examination and the aftercare provided to clients after discharge at a single-site sexual assault clinic. The study consisted of the implementation of three interventions including (a) use of an evidence-based suicide risk assessment tool, (b) establishment of a nursing protocol to standardize the community resource referral process, and (c) education of the clinic's nursing staff. These interventions provided the nursing staff with a standardized method to identify each client's suicide risk while also referring them to appropriate aftercare services in the local community. Results indicated that it was highly beneficial to screen all clients for suicide risk as it promoted client safety and acted as a catalyst for the emotional healing process.

Infusing Social Justice in Undergraduate Nursing Education: Fostering Praxis Through Simulation.

SCOPE OF THE PROBLEM: Forensic clinical experiences are often inconsistent in undergraduate nursing education. Nursing students are not included in the process of forensic evidence collection, often because of the sensitive nature of the situation. Unfortunately, nursing students are forced to rely on theoretical knowledge provided by the nurse educator to understand the complexities of forensic nursing care. Nursing students must be able to identify and provide appropriate nursing care for individuals in all forensic situations. SOCIAL JUSTICE IN CLINICAL NURSING EDUCATION: Comprehensive clinical laboratory experiences should be provided through active teaching-learning strategies, which replicate nursing care of the forensic patient. Simulated patient experiences provide a unique opportunity to explore the sensitive nature of sexual trauma in a safe learning environment. This strategy facilitates the application of theoretical forensic principles by utilizing live actors or high-fidelity manikins in laboratory settings. CONCLUSION: The application of theory to each simulated patient infuses conceptual knowledge at the point of care. Change in social consciousness begins at the bedside. The moral imperative of nursing continues to be the preparation of socially responsible, professional nurses who strive to end social injustices.

Switching of the rotational direction of rhizoidal colonies in a newly isolated Bacillus mycoides strain Ko01.

Bacillus mycoides are known to form rhizoidal colonies on solid medium. In this study, a new strain of B. mycoides, strain Ko01, was isolated from soil. Genetic and growth patterns indicated that this strain belongs to subgroup II of the B. cereus group. Strain Ko01 forms extensive rhizoidal colonies with predictable directions of rotation. The concentration of the agar, and not the chemical composition, altered the direction of the colony rotation, switching from counterclockwise to clockwise. Agar concentration-dependent switching of rotation direction was unique to strain Ko01 and was not seen in colonies of other B. mycoides strains that were tested. Factors affecting colony chirality patterns appeared to be variable among B. mycoides strains. This feature can be used for the classification of B. mycoides strains.

Making the diagnosis of acute appendicitis: do more preoperative CT scans mean fewer negative appendectomies? A 10-year study.

PURPOSE: To determine the frequency of preoperative computed tomography (CT) in the evaluation of patients suspected of having appendicitis at one institution during the past 10 years and to determine whether changes in CT utilization were associated with changes in the negative appendectomy rate. MATERIALS AND METHODS: Institutional review board approval was obtained, and a waiver of informed consent was granted for this HIPAA-compliant study. A surgical database search yielded medical record numbers of 925 patients (526 [ 56.9%] men and 399 [43.1%] women; mean age, 38 years (range, 18-95 years]) who underwent urgent appendectomy between January 1998 and September 2007. Patients who were younger than 18 years of age at the time of surgery were excluded. CT, pathology, and surgery reports were reviewed. By using logistic regression, changes in the proportion of patients undergoing CT and in the proportion of patients undergoing each year appendectomy in which the appendix was healthy were evaluated. Subgroup analyses based on patient age ( 45 years) and sex also were performed. RESULTS: Prior to urgent appendectomy, 18.5% of patients underwent preoperative CT in 1998 compared with 93.2% of patients in 2007. The negative appendectomy rate for women 45 years of age and younger decreased from 42.9% in 1998% to 7.1% in 2007. However, the timing of the decline in negative appendectomy rates for women 45 years and younger could not be proved to be associated with the increase in CT use. There was no significant trend toward a lower negative appendectomy rate for men regardless of age or for women older than 45 years of age with increased use of preoperative CT. The shift from single-detector CT to multidetector CT and the use of decreasing section thickness also correlated with a reduction in false-positive diagnoses. CONCLUSION: Rising utilization of preoperative CT and advances in technology coincided with a decrease in the negative appendectomy rate for women 45 years and younger but not in men of any age or women older than 45 years.