Care of Clients in Correctional Settings Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Community.

Care of Clients in Correctional Settings

Copyright ©2008 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.Community Health Nursing, 5/eMary Jo Clark

26CHAPTER

Community Health Nursing, 5/eMary Jo Clark

Copyright ©2008 by Pearson Education, Inc.

Health Care in Correctional Settings

Between 2 and 10 million people are in correctional system



Health Needs Due to

• Vulnerability to health problems

• Potential for exploitation

• Constitutional right to health care



Risk for Transmission of Communicable Diseases

• Within the correctional setting

• To the outside community



Predisposition for Other Health Concerns

• Social isolation

• Boredomملل• Stress

• Hostility

• Depression



Basic Nursing in Correctional Settings

• Focus on care to individuals and families

• Disease prevention

• Health promotion

• Recognition and treatment of disease and injury

• Counseling



Advanced Nursing in Correctional Settings

• Focus on policy formulation and program development, implementation, and evaluation

• Supervision

• Management

• Clinical practice

• Program evaluation



Biophysical Considerations

• Age and aging

• Gender and ethnic composition

• Existing health problems

• Pregnancy

• Immunization status



Psychological Considerations

• Preexisting conditions– Drug and alcohol abuse– Mental illness

• PTSD– Women and juveniles أالحداث

• Suicide



Physical Environmental Considerations

• Confined spaces

• Poor ventilation

• Lack of temperature control

• Unsanitary conditions



Sociocultural Considerations

• Socioeconomic factors

• Homelessness

• Family relationships

• Correctional culture

• Violence and abuse

• Security issues



Behavioral Considerations

• Diet

• Substance abuse

• Exercise/recreational opportunities

• Sexual activity

• Medication use and dispensing االستغناء practices



Health System Considerations

• Funding for and organization of services

• Health promotion/illness prevention services



Health System Considerations (continued)

• Medical/dental services– Minimal screening services

• Evidence of infectious disease• Existing health problems• Current medications• Disabilities/limitations• Suicide risk



Health System Considerations (continued)

• Mental health services

• Emergency response capabilities

• Provisions for continuity of care



Primary Prevention in Correctional Settings

• Health promotion– Adequate nutrition– Rest and exercise– Health education

• Self-care• Risk factor modification

– Prenatal care and contraception



Illness Prevention

• Communicable disease prevention

• Suicide prevention

• Violence prevention



Primary Prevention: Advocacy

• Availability of health promotion services

• Availability of illness/injury prevention services



Secondary Prevention in Correctional Settings

• Screening

• Diagnostic services

• Treatment



Screening Foci

• Identify and address health needs of inmates

• Pregnancy screening• Promote early identification of key

problems• Identify and isolate potentially

communicable inmates• Pre-existing mental illness• Specialized screening



Diagnostic Services

• Medical conditions

• Mental illness



Treatment

• Medications– TB treatment– HIV therapies

• Medical treatments– Chronic health conditions– Substance abuse/Mental health



Treatment (continued)

• Emergency care

• Disaster care



Tertiary Care in Correctional Settings

• Long-term care planning

• Reentry

• End-of-life care



Long-term Care Planning

• Assistance by a personal care attendant

• Inmates السجناء with chronic conditions

• Provision of home care in general population

• Monitoring treatment compliance

• Transfer to appropriate facility as needed

• Adult day care services



Reentry Planning

• Development of systematic discharge protocols• Development of individual discharge plan and

assistance with family reintegration as needed• Provision for continuity of health care• Arrange for a supply of necessary medications

on discharge• Arrangement for health insurance coverage• Advocacy for prerelease االفراج planning,

community infrastructure البنية التحتية to support reentry, and civil rights of released inmates



End-of-life Care

• Advanced directives

• Palliative care

• Compassionate release

• Referral to hospice care

• Inmates under sentence of death

• Advocacy for medical parole إطالق سراح and arrangement for follow-up مشروطcare



Resources

• Incarcerated women HERSA website discussing the health status and health indicators of incarcerated women.

• Journal of Correctional Health Care Peer reviewed Journal addresses areas such as clinical health care, health services and support, personnel and staffing, ethical issues, clinical services, medical records, continuous quality improvement, risk management and medical-legal issues. Clinical guidelines and position statements are published in the Journal.



Resources

• Forensic Science Resource Center information center includes forensic science literature such as scientific publications, journals, magazines and articles authored by forensic professionals and those working in related disciplines; covering topics such as brain fingerprinting, condom trace evidence, forensic DNA, palynology, crime scene investigation, cyber-terrorism, forensic mapping, ballistics, voice identification, sexual assault, identity theft, digital forensics, and human trafficking.



Resources

• New York Times Examines Prison HealthA yearlong examination of Prison Health by The New York Times reveals repeated instances of medical care that has been flawed and sometimes lethal.

Care of Clients in Correctional Settings Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Community.

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