Correctional Nurses on the Front Lines of the COVID-19 Pandemic: Omaha System Guidelines Documentation Case Study.

During a pandemic, basic public health precautions must be taken across settings and populations. However, confinement conditions change what can be done in correctional settings. Correctional nursing (CN) care, like all nursing care, needs to be named and encoded to be recognized and used to generate data that will advance the discipline and maintain standards of care. The Omaha System is a standardized interprofessional terminology that has been used since 1992 to guide and document care. In 2019, a collaboration between the newly formed American Correctional Nurses Association and the Omaha System Community of Practice began a joint effort with other stakeholders aimed at encoding evidence-based pandemic response interventions used in CN. The resulting guidelines are included and illustrated with examples from CN practice.

Does a Public Health Crisis Justify More Research with Incarcerated People?

Covid-19 has infected thousands and killed hundreds in prisons, jails, and immigration detention facilities across the United States. Responding to this crisis, leading medical researchers have called for expanding opportunities for people in prison to participate in vaccine trials. These calls, like current regulations, focus on individualized risk assessments around consent, coercion, and harm, while ignoring the unnaturalness of deprivation conditions in U.S. prisons. We need new frameworks of analysis that refocus on structural, rather than individual, risk assessments. Integrating structural perspectives-including skepticism of claims of scarcity, avoidance of representational distortions, and attention to institutional agency-into our existing, overly individualistic frameworks might permit the design of more ethical research projects involving people who are incarcerated. Still, the unnatural deprivations of incarceration might be so great that research subjects might need to be removed from prison entirely in order to ethically participate in research.

Developing policies for adult sexual minorities with mental health needs in secured settings.

Lesbian, Gay, Bisexual, and Transgender (LGBT) people are more likely to be disproportionally placed in a secured setting such jails, prisons, and forensic hospitals. These settings can be traumatizing, hostile, and dangerous-especially for those who are suffering from mental illness. Administrators are encouraged to develop institutional policies that undoubtedly include that LGBT residents should be free of discrimination, victimization, and abuse. LGBT residents should have equal access to safe housing, vocational programs, rehabilitation services, as well as medical and mental health treatments. Several organizations provide guidelines to ensure that LGBT residents are protected. This article provides a general roadmap for developing LGBT policies in secured settings synergizing the recommendations of some of these organizations with emphasis on policy guidelines for transgender people that are not only standards for good care but also very cost-effective interventions that can help reduce symptoms of mental illness for this population.

A Continuum of Competency Restoration Services Need Not Include Jail.

Competency restoration in jails has grown steadily over the past decade, driven primarily by cost considerations and long wait times for inpatient restoration programs. Although jail-based programs may offer an attractive temporary solution to the shortage of beds, a longer-term solution involves enhancing the continuum of competency restoration services available outside of the correctional system. Such a continuum includes inpatient, supportive residential, and outpatient services. If these services were adequately funded and managed, jail-based competency restoration services would provide no additional benefit to patients, mental health professionals, or the criminal justice system.