Daniel J. Sheridan

Acute Injury Patterns of Intimate Partner Violence Victims

Although millions of women receive injuries from intimate partner violence (IPV) each year in the United States alone, there has been only limited research of acute injury patterns and the types, locations, and mechanisms of IPV injuries. The mechanism of being punched to the face with a fist resulting in blunt trauma—related injuries is most commonly reported. Strangulation, especially manual strangulation, is a frequently cited mechanism of injury; however, less is known about the types of injuries that result from strangulation. In general, clinicians should assess all patients who present for treatment of head, neck, and face injuries for IPV. There is little consistency between and much inaccuracy with medical terms used to describe types of injuries. To increase the accuracy and generalizability of findings from studies of acute IPV injuries, researchers need to use more standardized medical forensic terminology.

Workplace violence: prevalence and risk factors in the safe at work study.

Objective: Nurses face one of the highest rates of reported workplace violence (WPV). This research examined the prevalence of WPV and demographic, work-related, and adult and childhood abuse histories as risk factors for WPV among 2166 nurses/nursing personnel across four health care institutions in one US metropolitan area. Methods: Using data from an online cross-sectional survey, multivariate logistic regression was utilized to determine risk factors for physical and psychological WPV. Results: Almost one-third (30%) of nurses/nursing personnel experienced WPV (19.4% physical, 19.9% psychological). Risk factors included being a nurse, white, male, working in the emergency department, older age, longer employment, childhood abuse, and intimate partner violence. Conclusions: Adult and childhood abuse histories have not been considered in previous large-scale investigations, but were significant risk factors along with other previously identified risk factors for WPV.

Can one accurately date a bruise? State of the science

Abstract Forensic nursing experts and other health professionals often testify regarding the injuries women and men receive from violence. Bruise discoloration can provide an opportunity for health professionals to grossly estimate the age of impact and determine if it is consistent with a given reported history. However, there is much confusion in the literature and clinical practice as to the accuracy of dating bruises. This article will demonstrate that using the color of the bruise as the primary criteria to determine its age is not the best practice. The limited available research and related literature on the topic are flawed and inconsistent. Finally, recommendations will be made for future research and clinical practice.

Nonoccupational postexposure HIV prophylaxis in sexual assault programs: a survey of SANE and FNE program coordinators.

&NA; This cross‐sectional study describes sexual assault nurse examiner (SANE)/forensic nurse examiner (FNE) program practices related to HIV testing, nonoccupational postexposure prophylaxis (nPEP), and common barriers to offering HIV testing and nPEP. A convenience sample of 174 SANE/FNE programs in the United States and Canada was drawn from the International Association of Forensic Nurses database, and program coordinators completed Web‐based surveys. Three fourths of programs had nPEP policies, 31% provided HIV testing, and 63% offered nPEP routinely or upon request. Using χ2 and Fishers exact tests, a greater proportion of Canadian programs had an nPEP protocol (p = .010), provided HIV testing (p = .004), and offered nPEP (p = .0001) than U.S.‐based programs. Program coordinators rated providing pre‐ and/or posttest counseling and follow‐up as the most important barrier to HIV testing, and medication costs as the most important barrier to providing nPEP. Our results indicate HIV‐related services are offered inconsistently across SANE/FNE programs.

Factors Associated With Forensic Nurses Offering HIV nPEP Status Post Sexual Assault

Nonoccupational, postexposure prophylaxis (nPEP) for human immunodeficiency virus (HIV) is offered inconsistently to patients who have been sexually assaulted. This may be due to Forensic Nurse Examiner (FNE) programs utilizing diverse nPEP protocols and HIV risk assessment algorithms. This study examines factors associated with FNEs offering nPEP to patients following sexual assault at two FNE programs in urban settings. Offering nPEP is mostly driven by site-specific protocol. At Site 1, in addition to open anal or open genital wounds, the presence of injury to the head or face was associated with FNEs offering nPEP (adjusted odds ratio [AOR] 64.15, 95% confidence interval [CI] = [2.12, 1942.37]). At Site 2, patients assaulted by someone of Other race/ethnicity (non-White, non-African American) were 86% less likely to be offered nPEP (AOR 0.14, 95% CI = [.03, .72]) than patients assaulted by Whites. In addition to following site-specific protocols, future research should further explore the mechanisms influencing clinician decision making.

Influence of Intimate Partner Violence and Depression on Undergraduate Nursing Students: A Literature Review

BACKGROUND Intimate partner violence (IPV) and dating violence is a significant problem among college-age students. IPV has an associative outcome of depression and lower academic performance, but it is unknown how it relates to undergraduate nursing students. METHOD Two literature searches were performed for IPV and depression from a combination of 87 databases including EBSCO, Proquest, Nursing at OVID, Medline, PubMed, CINAHL, PsycARTICLES, JSTOR, SAGE journals, and Google Scholar. RESULTS Initial results yielded 24,675 research studies on IPV, dating violence, and depression. Forty-eight level-three studies were identified using the John Hopkins School of Nursing evidence-based practice model, including 42 nonexperimental studies, three meta-syntheses, and three governmental studies. CONCLUSION Relevant data on the prevalence rates of IPV and depression among nursing students are lacking. IPV and dating violence among college students places them at a higher risk for failure and poor academic performance. [J Nurs Educ. 2017;56(7):397-403.].

Alternate Light Source Findings of Common Topical Products.

ABSTRACT Background: One of the important roles of a forensic clinician is to perform examinations of patients who are victims and suspects of crime. Alternate light source (ALS) is a tool that can improve evidence collection and enhance visualization of injuries. The purpose of this study was to examine if commonly used topical products fluoresce or absorb when examined with an ALS. Second, we aimed to identify patient and examination variables that may impact findings. Methods: A convenience sample of 81 subjects was used. After the application of 14 over-the-counter products, researchers observed the participants’ skin with an ALS under 18 combinations of wavelengths and colored filters. Results: Of the 14 products viewed (n = 1458 observations per product), six were found to fluoresce under alternate light in more than 40% of observations, five fluoresced in 1%–10% of observations, and three fluoresced less than 1% of the time. One product (a makeup product) absorbed ALS light consistently (81%), and a second (a sunscreen product) absorbed in 7%, whereas the remaining 12 products produced absorption findings in less than 1% of observations. In generalized mixed linear models, absorption findings were more commonly identified in participants with light or medium skin tones when compared with those with dark skin tones. Discussion: These results suggest that the presence of topical products may impact ALS findings. A thorough forensic clinical assessment should include a documented history, including assessment of potential sources of findings, to aid in interpretation.