Archive for the ‘Health Assessment’ Category

The forensic nurses role

February 8, 2010

 Review of Forensic Nursing, by Virginia A. Lynch.

The forensic nurse’s role according to our book includes such skills as the following: -identification of trauma (assessment) -investigation (planning) -documentation (history) pertaining to the incident (intervention) -collection of evidence (specimens) -postinvestigation review (evaluation). In other words not only will the forensic nurse interact with the patient as a regular nurse would, they will have to go beyond in all aspects of crisis. Their skills of assessing, planning, intervention and evaluation must be finely honed. They must be able to look passed the obvious.

Tags: , , , , ,

Forensic Nursing Assessment

December 30, 2009

One of the many reasons why I love nursing is because it has so many fields to dive into. Being a new student, I had no clue about forensic nursing. Now that I do, I am very interested. The job is quite meaningful, requiring nurses to be able to examine the unique cases involved in the criminal justice system. Definitely nurses are better trained to deal with the whole person, instead of just the case. Everyone cannot do this efficiently and this is why we have one of the most important jobs on earth. The skin assessment, in my opinion, is the most important of all. Any type of abuse or violence can normally be revealed after a thorough skin assessment. These assessment skills should be reviewed often.

Online Forensic Nursing Course

Online Forensic Nursing Certificate Program

Online Nursing Assessment Course

Tags: , , , , , ,

Prevention of Pressure Ulcers in the Surgery Department

November 3, 2009

With the federal CMS reimbursements of October 2008, stating that nosocomial infections and development of hospital acquired pressure ulcers were no longer going to be paid for, one of the areas of concern was pressure ulcers in the operating room. Years ago, we never really thought of pressure ulcers originating in my department, we did our cases and primarily observed for post-operative complications such as respiratory failure or bleeding. The patients were on long term bed rest, the bedding was of poor materials and the only thing we as nurses did, was to turn the patients "frequently” and that was to prevent pneumonia. With research, and projects such as IHI’s 5 million lives campaign, SCIP’s studies, Joint Commission, NYS department of Health reporting requirements, pressure ulcers have been brought to the forefront. For the past year and half, I have been having in-services for my staff on prevention of pressure sores and more use of pressure relieving aids for our patients. It was amazing to find a lot of articles and hearing about the cost of and risks of pressure ulcers at our workshops and the Association for Operating Room Conferences. It was staggering to learn that 25% and as high as 66% of post-operative pressure ulcers were operating room induced, and, that they didn’t present themselves for 3-7 days post-operatively-many times the patient may have been discharged. One pressure ulcer can cost an average of $43,180.00. We always perform a pre-operative assessment on skin integrity (among other things). We obtain a baseline assessment to see if there are any pre-existing areas of concern (for example their nutritional status, whether they are on any pressers, and if they are very thin or immunocompromised). We also look at the length of time the procedure will take, and the position of the patient for the procedure. Pressure ulcers can start to occur in as few as 20 minutes and surgeries lasting for over 2 hours. My facility has been very proactive, as we have had a pressure ulcer team for quite a few years and we as educators and staff, have been updated frequently of the prevention and treatment of pressure ulcers.

Tags: , , ,

The Correlation between health assessment and forensic nursing, question

September 15, 2009

Do you offer financial aid for your online Health Assessment and Forensic Nursing courses?

Original Post
September 8, 2009
Title: The Correlation between health assessment and forensic nursing
Thank you for these great posts related to the correlation between Forensic nursing and health assessment. I am a Sexual Assault Nurse Examiner and a NP student. I never thought about the health assessment as a forensic investigation, but it is so true. Making this correlation has already helped me to complete more thorough health assessments in my graduate NP courses. Thanks!

Original Post
March 21, 2008
Title: The Correlation between health assessment and forensic nursing
I am writing in respond to the article titled “The Correlation between the Health Assessment and Forensics Nursing.” My job is performing assessments on patients for surgery, which in some way is similar to an assessment used in forensics nursing. I am not involved in forensics, but have read materials related to the assessment. I totally agree that as soon as I meet my patient, I start my assessment based on appearance, speech, skin color and facial expressions. Anesthesia assessment involves collecting all types of data that identifies the patient’s physiologic status, risk factors, knowledge and past health and anesthesia history. The most difficult challenge is keeping the patient focused and answering questions completely without omitting details, I can associate this also with a forensic assessment. 
Once the subjective data is obtained, we do gather objective data to be complete. An example would be labs, EKG and x-rays which is also used in an investigation. Subjective and objective data are the two primary components in performing a health assessment, whether it is any type. They both work together, if patient is unresponsive or unable to communicate, it does present a challenge. I than rely on family history or previous medical records. I agree with the last item in the article, “giving our clients a voice”, practicing as a nurse you must always assume the role as a patient advocate. Communication to physicians and other members of the health team is to ensure putting the patient’s best interest first. That is one reason I choice to become a nurse.

Original Post:

November 1, 2007

I think that performing a health assessment is very similar to a forensics investigation. The forensics investigator starts gathering evidence as soon as he enters the scene. The fractioned also gathers evidence as soon as she enters the examination room. Does the client answer questions appropriately, is her posture straight, is she tearful, guarding a certain area of her body. What about hygiene, is well groomed, or wearing stained, mismatched clothing. The forensics investigator uses many senses while investigating a crime scene. Smell, touch, sight, and the 6th sense about what seems to be not quite right. The fractioned doing the assessment uses the same senses. Smell can clue the fractioned into some diseases, for example some malignancies. The sense that something is not quite right is another skill that the fractioned develops. The client that says she is eating, yet losing weight leads the fractioned to follow-up with other questions. Is the client diabetic, bulimic, or an elderly patient unable to afford food? The forensics investigator uses laboratory data to support his theories. Laboratory is a tool that the fractioned also uses. Is the chest pain cardiac with elevated cardiac enzymes and EKG changes? Is weight loss due to a malignancy, diabetes, poor nutrition? Forensics investigation and health assessment share one more very important trait. Forensics investigators give the victim a voice. As health practitioners, our clients too, will often need us to give them a voice. This includes the very young, the very old, the cognitively impaired, and the victims of abuse.

Tags: , , , , , , ,

The Correlation between health assessment and forensic nursing

September 8, 2009

Thank you for these great posts related to the correlation between Forensic nursing and health assessment. I am a Sexual Assault Nurse Examiner and a NP student. I never thought about the health assessment as a forensic investigation, but it is so true. Making this correlation has already helped me to complete more thorough health assessments in my graduate NP courses. Thanks!

Original Post
March 21, 2008
Title: The Correlation between health assessment and forensic nursing
I am writing in respond to the article titled “The Correlation between the Health Assessment and Forensics Nursing.” My job is performing assessments on patients for surgery, which in some way is similar to an assessment used in forensics nursing. I am not involved in forensics, but have read materials related to the assessment. I totally agree that as soon as I meet my patient, I start my assessment based on appearance, speech, skin color and facial expressions. Anesthesia assessment involves collecting all types of data that identifies the patient’s physiologic status, risk factors, knowledge and past health and anesthesia history. The most difficult challenge is keeping the patient focused and answering questions completely without omitting details, I can associate this also with a forensic assessment. 
Once the subjective data is obtained, we do gather objective data to be complete. An example would be labs, EKG and x-rays which is also used in an investigation. Subjective and objective data are the two primary components in performing a health assessment, whether it is any type. They both work together, if patient is unresponsive or unable to communicate, it does present a challenge. I than rely on family history or previous medical records. I agree with the last item in the article, “giving our clients a voice”, practicing as a nurse you must always assume the role as a patient advocate. Communication to physicians and other members of the health team is to ensure putting the patient’s best interest first. That is one reason I choice to become a nurse.

Original Post:

November 1, 2007

I think that performing a health assessment is very similar to a forensics investigation. The forensics investigator starts gathering evidence as soon as he enters the scene. The fractioned also gathers evidence as soon as she enters the examination room. Does the client answer questions appropriately, is her posture straight, is she tearful, guarding a certain area of her body. What about hygiene, is well groomed, or wearing stained, mismatched clothing. The forensics investigator uses many senses while investigating a crime scene. Smell, touch, sight, and the 6th sense about what seems to be not quite right. The fractioned doing the assessment uses the same senses. Smell can clue the fractioned into some diseases, for example some malignancies. The sense that something is not quite right is another skill that the fractioned develops. The client that says she is eating, yet losing weight leads the fractioned to follow-up with other questions. Is the client diabetic, bulimic, or an elderly patient unable to afford food? The forensics investigator uses laboratory data to support his theories. Laboratory is a tool that the fractioned also uses. Is the chest pain cardiac with elevated cardiac enzymes and EKG changes? Is weight loss due to a malignancy, diabetes, poor nutrition? Forensics investigation and health assessment share one more very important trait. Forensics investigators give the victim a voice. As health practitioners, our clients too, will often need us to give them a voice. This includes the very young, the very old, the cognitively impaired, and the victims of abuse.

Tags: , , , , , , ,

Abdominal trauma in forensic nursing, comment

August 20, 2009

This article speaks a lot of truth for the field in which I currently work in. As a Critical Care Nurse in a Trauma 1 hospital I see a lot of abdominal issues that may or may not be trauma related. However the assessments and sequence of assessments tend to be the same (if indicated.) We see a lot of GI bleeds which may or may not be extremely painful. Auscultation of bowel sounds, palpation etc are all part of our core assessment. Using forensic assessment is almost 100% of the assessment process as well. Its funny how we do things out of instinct and training now, then read an article that reminds us of where we learned it from previously, as part of our education.

Original Post:
July 31, 2009
ABDOMINAL TRAUMA IN FORENSIC NURSING

  The primary components of health assessment are the health history and the physical examination. Since forensic nurses may need to perform specific exams related to each individual case, abdominal assessments may be indicated where there is some nature of trauma involved. Subjective and objective data are utilized in order to obtain data required for the specific case involved. Just as nursing assessment are used in hospitals, the same assessment is utilized in forensic nursing assessments.

  Forensic nursing assessment as with general nursing assessment is initiated by observing the client’s general behavior and position. The nurse assesses the client for any marked restlessness, rigid posture or knees drawn up. Facial grimacing and rapid, uneven or grunting respirations are also noted.

  The abdomen is observed to detect any erythema or bruises. The nurse also documents any signs of abdominal distention, tautness, scars, lacerations or open wounds. Auscultation is then performed to assess if bowel sounds are present or absent. Percussion of the abdomen, liver and spleen are indicated in order to assess the level of trauma sustained. Palpation of the abdomen, umbilicus, liver, gallbladder, spleen and kidneys are noted to assess any tenderness, hypersensitivity or rigidity. The client may respond to pain by using muscle guarding, facial grimaces or pulling away from the nurse. Spleen and kidney tenderness may indicate trauma.

  The nurse should use a pain scale in order to assess the degree of pain the client exhibits. Examples of pain scales can include descriptive or numeric pain intensity scale. The McGill Pain Questionnaire is another resource to indicate pain quality descriptors using 4 major groups ie: descriptive, affective, evaluative and miscellaneous which aids clients in describing their pain.  These groups are then totaled in order to indicate the description of pain the client is experiencing.

  Although all assessments of abdominal trauma are useful in determining the degree of trauma sustained, the nurse should be aware that findings detected during an exam may warrant the use of additional tests. The client may need to be transported to the nearest hospital for further evaluation.

  Abdominal assessments regardless of injury should be performed in a setting that is conducive to the client’s safety, privacy and dignity.

  Abdominal assessment techniques utilized in Chapter 20 of Health Assessment for Nursing Practice, Wilson & Giddens is an excellent resource for any nurse to familiarize themselves with the proper sequence of assessments.

Forensic Nursing Certificate Program that includes Health Assessment

Tags: , , , ,

ABDOMINAL TRAUMA IN FORENSIC NURSING

July 31, 2009

  The primary components of health assessment are the health history and the physical examination. Since forensic nurses may need to perform specific exams related to each individual case, abdominal assessments may be indicated where there is some nature of trauma involved. Subjective and objective data are utilized in order to obtain data required for the specific case involved. Just as nursing assessment are used in hospitals, the same assessment is utilized in forensic nursing assessments.

  Forensic nursing assessment as with general nursing assessment is initiated by observing the client’s general behavior and position. The nurse assesses the client for any marked restlessness, rigid posture or knees drawn up. Facial grimacing and rapid, uneven or grunting respirations are also noted.

  The abdomen is observed to detect any erythema or bruises. The nurse also documents any signs of abdominal distention, tautness, scars, lacerations or open wounds. Auscultation is then performed to assess if bowel sounds are present or absent. Percussion of the abdomen, liver and spleen are indicated in order to assess the level of trauma sustained. Palpation of the abdomen, umbilicus, liver, gallbladder, spleen and kidneys are noted to assess any tenderness, hypersensitivity or rigidity. The client may respond to pain by using muscle guarding, facial grimaces or pulling away from the nurse. Spleen and kidney tenderness may indicate trauma.

  The nurse should use a pain scale in order to assess the degree of pain the client exhibits. Examples of pain scales can include descriptive or numeric pain intensity scale. The McGill Pain Questionnaire is another resource to indicate pain quality descriptors using 4 major groups ie: descriptive, affective, evaluative and miscellaneous which aids clients in describing their pain.  These groups are then totaled in order to indicate the description of pain the client is experiencing.

  Although all assessments of abdominal trauma are useful in determining the degree of trauma sustained, the nurse should be aware that findings detected during an exam may warrant the use of additional tests. The client may need to be transported to the nearest hospital for further evaluation.

  Abdominal assessments regardless of injury should be performed in a setting that is conducive to the client’s safety, privacy and dignity.

  Abdominal assessment techniques utilized in Chapter 20 of Health Assessment for Nursing Practice, Wilson & Giddens is an excellent resource for any nurse to familiarize themselves with the proper sequence of assessments.

Forensic Nursing Certificate Program that includes Health Assessment

Tags: , , , ,

 

 

 

The Correlation Between the Health Assessment and Forensics Nursing, comment

March 21, 2008

I am writing in respond to the article titled “The Correlation between the Health Assessment and Forensics Nursing.” My job is performing assessments on patients for surgery, which in some way is similar to an assessment used in forensics nursing. I am not involved in forensics, but have read materials related to the assessment. I totally agree that as soon as I meet my patient, I start my assessment based on appearance, speech, skin color and facial expressions. Anesthesia assessment involves collecting all types of data that identifies the patient’s physiologic status, risk factors, knowledge and past health and anesthesia history. The most difficult challenge is keeping the patient focused and answering questions completely without omitting details, I can associate this also with a forensic assessment.
Once the subjective data is obtained, we do gather objective data to be complete. An example would be labs, EKG and x-rays which is also used in an investigation.

Subjective and objective data are the two primary components in performing a health assessment, whether it is any type. They both work together, if patient is unresponsive or unable to communicate, it does present a challenge. I than rely on family history or previous medical records. I agree with the last item in the article, “giving our clients a voice”, practicing as a nurse you must always assume the role as a patient advocate. Communication to physicians and other members of the health team is to ensure putting the patient’s best interest first. That is one reason I choice to become a nurse.

Original Post:
November 1, 2007
I think that performing a health assessment is very similar to a forensics investigation. The forensics investigator starts gathering evidence as soon as he enters the scene. The fractioned also gathers evidence as soon as she enters the examination room. Does the client answer questions appropriately, is her posture straight, is she tearful, guarding a certain area of her body. What about hygiene, is well groomed, or wearing stained, mismatched clothing. The forensics investigator uses many senses while investigating a crime scene. Smell, touch, sight, and the 6th sense about what seems to be not quite right. The fractioned doing the assessment uses the same senses. Smell can clue the fractioned into some diseases, for example some malignancies. The sense that something is not quite right is another skill that the fractioned develops. The client that says she is eating, yet losing weight leads the fractioned to follow-up with other questions. Is the client diabetic, bulimic, or an elderly patient unable to afford food?

The forensics investigator uses laboratory data to support his theories. Laboratory is a tool that the fractioned also uses. Is the chest pain cardiac with elevated cardiac enzymes and EKG changes? Is weight loss due to a malignancy, diabetes, poor nutrition?

Forensics investigation and health assessment share one more very important trait. Forensics investigators give the victim a voice. As health practitioners, our clients too, will often need us to give them a voice. This includes the very young, the very old, the cognitively impaired, and the victims of abuse.

tags









%d bloggers like this: