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  • 1.
    Åling, Maria
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Identifying nursing care needs for patients in forensic psychiatry: in search for a sustainable and co-created person centred care2018Konferansepaper (Annet vitenskapelig)
  • 2.
    Åling, Maria
    Röda Korsets Högskola, Avdelningen Teknik och Välfärd.
    Implementation of Nursing Diagnosis (i.e. NANDA) in a Forensic Psychiatric setting2016Inngår i: Abstracts: Narrative Nursing: Nordic Conference Of Mental Health Nursing: 14-16 September 2016 Börshuset – Malmö, Malmö: Psykiatriska riksföreningen för sjuksköterskor , 2016, s. 36-Konferansepaper (Fagfellevurdert)
    Abstract [en]

    The Swedish legislation indicates that patients in the forensic psychiatric setting should be re-integrated into society through rehabilitative measures including nursing care. This was recognized by the National Board of Health and Welfare (i.e. Socialstyrelsen) in 2002, but concluded that there is a vast knowledge gap regarding the aim and the content of nursing care in forensic psychiatric settings. Still nursing care in forensic psychiatry is sparsely described. Recent research confirms this description of a knowledge gap and adds that there is a lack of structured nursing care in forensic psychiatry (Hörberg, 2012). Nonetheless, the content and outcome of nursing care in the forensic psychiatric setting is hard to visualize. The actual patient needs and problems has to be identified and defined. To meet this knowledge gap, structured and categorized descriptions of the patients’ nursing care needs need to be described. Frauenfelder et al., 2014) claims that NANDA could be the tool to label problems and risk diagnoses, although they call for further research.

    The implementation of nursing diagnoses according to NANDA started in 2011, one year after Forensic Psychiatry Care Stockholm became one department, and the implementation process is still on-going. Previously, the forensic psychiatric care in Stockholm had been spread out over three different departments with dissimilar culture. The new management wanted a “unified department”, and one way to achieve this was to use NANDA as a tool for a common language in nursing care. The implementation started with a meeting with the ward managers and Registered Nurses. A project plan for the implementation was presented and discussed. The project leader met all RNs in the department in small groups to describe and motivate the use of NANDA. Up till now eleven wards have been involved and at least two meetings have been held at each ward. The project leader has participated at ward rounds and supervised the RNs in the use of NANDA. In conclusion, more RNs need to be engaged to continue the progress of the project. Another task is to find a less time consuming implementation process and to evaluate the implementation to this point. It is also important, further down the line, to introduce the tools Nursing Diagnoses Interventions (NIC) and Nursing Diagnoses Outcome (NOC) in the forensic psychiatric setting. Apart from a common nursing language, the use of standardized descriptions, actions and goals would fill the knowledge gap regarding aim and content of nursing care in forensic psychiatric settings (Escalada-Hernandez et. al., 2015).

  • 3.
    Åling, Maria
    et al.
    Röda Korsets Högskola, Avdelningen Teknik och Välfärd.
    Kasel, Daniel
    LWL-MRVK Forensic Hospital Herne, Germany.
    Peternelj-Taylor, Cindy
    University of Saskatchewan, Canada.
    What is your story?: The experiences of patients and nurses in secure forensic environments2016Inngår i: Abstracts: Narrative Nursing: Nordic Conference Of Mental Health Nursing: 14-16 September 2016 Börshuset – Malmö, Malmö: Psykiatriska riksföreningen för sjuksköterskor , 2016, s. 35-Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Nurses who work in forensic environments, practice at the shifting interface of the criminal justice system and the health care system.  How they view those in their care, and more importantly, how they engage those in their care, is a significant concern for nursing.  Forensic clients are members of a highly stigmatized and stereotyped population. The ability of forensic mental health nurses to provide competent and ethical nursing care is often compromised by personal, social, and political animosity regarding crime, criminality, and mental disorder.  Pausing to reflect on the stories of clients and nurses, within a narrative context, evokes understanding, and contributes to the creation of person centered care.

    In paper one, the coercive treatments experienced by a man who has spent many years in compulsory care in a variety of secure psychiatric settings is explored in response to his confession “I don’t dare to tell them I feel okay!” In paper two, how nurses transition to their roles as forensic nurses is considered as they straddle the custodial and therapeutic aspects of their work, often expressing concerns with their perceptions of “education of the fly” or “faking it ‘til you make it.” In paper three, the mental health contributions of nurses who practice in prisons and correctional institutions is captured in the words “that’s why I bought into this profession, to instill hope and recovery.”

    Through the examination of these vignettes that have emerged through research and practice, participants will be engaged in an interactive discussion as we consider the implications of narrative nursing vis-à-vis the vast tensions that exist between theory, practice, and research in forensic mental health nursing.  Finally, the universal nature of these issues, highlighting contributions from Sweden, Germany and Canada will be illustrated.

     

  • 4.
    Åling, Maria
    et al.
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Nilsson, Evelina R
    European Medicines Agency.
    Garpstål, Björn
    Capio S:t Görans Sjukhus.
    Strömberg, Lars
    Röda Korsets Högskola, Hälsovetenskapliga institutionen.
    Nursing Diagnoses Panorama in a Swedish Forensic Psychiatric Setting Using NANDA-International Taxonomy2018Inngår i: Journal of Forensic Nursing, ISSN 1939-3938, E-ISSN 1556-3693, Vol. 14, nr 3, s. 141-147Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    More than 1,000 Swedish hospital beds are occupied by patients in forensic psychiatric settings; their average length of hospitalization is 3-7 years. In this context, nursing diagnoses could be extremely useful to make nursing care structured, measurable, and internationally comparable. The study aimed to describe nursing diagnoses in a Swedish forensic psychiatric setting.

    METHODS: Data were collected from electronic patient records of 55 patients in a medium-secure forensic psychiatric setting in Sweden. Anonymized data were entered into a database where entries were transformed into figures. Descriptive statistics were used, and frequencies, means, and percentages were calculated. The variables employed were characteristics and related factors, according to NANDA-International (NANDA-I) and International Statistical Classification of Dieseases and Related Heatlh Problems, 10th Revision (ICD-10), diagnoses.

    RESULTS: The patients had between 1 and 13 NANDA-I diagnoses each. Forty-one of the 55 patients had psychosis as the primary ICD-10 code. The identified nursing diagnoses described the patients' status upon arrival in the forensic psychiatric setting. Of the 55 patients, entries in the patient records describing 300 signs and symptoms (i.e., characteristics and related factors) were found. From these signs and symptoms, 371 entries that fit NANDA-I diagnoses were identified, representing 20 different NANDA-I diagnoses.

    CONCLUSION: NANDA-I diagnoses individualize patient care, making care person centered. NANDA-I is used all over the world and has the potential to make nursing care structured, measurable, and internationally comparable.

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