Evidence-Based Practice in Forensic Nursing: A Collaborative Effort

Tuesday, 14 July 2009

Linda C. Pugh, PhD, RNC, FAAN
Department of Nursing, York College of Pennsylvania, York, PA
Kelli Eldredge, MS, RN, CCRN
Trauma Surgical ICU, York Hospital, York, PA
Emily S. Huggins, MHA, BSN, RN
Emergency Department, York Hospital, York, PA

Learning Objective 1: 1. discuss the collaborative Evidence-based practice (EBP) project between baccalaureate nursing students and nursing clinicians in a community hospital setting.

Learning Objective 2: 2. determine the best practice to identify trace DNA using an alternate light source (ALS) versus the Wood’s lamp in sexual assault forensic examinations.

Purpose: Teaching baccalaureate students to use evidence in practice can be a daunting task. Beginning nurses are expected to enter the profession with basic understanding of EBP. An innovative method of accomplishing EBP involved pairing interested clinicians and students with similar interests. Clinicians must address legal and medical needs of sexual assault victims to provide the best patient care. Ability to correctly identify and collect DNA evidence improves patient outcomes and prosecution rates. Current practice is inconsistent in the use of a Wood’s lamp versus other ALSs to identify potential DNA evidence.

Methods: Four class periods were scheduled to facilitate the process. These sessions were: 1) identify the problem and narrow the practice question using the PICO framework; 2) discuss the reference list and prioritize the most relevant literature; 3) develop practice recommendations based on the strength and quality of the evidence; and 4) present a poster of each project. This poster is one example between baccalaureate nursing students and forensic nurse clinicians. This project searched PubMed; CINAHL, National Clearinghouse Guidelines, Google Scholar, the National Criminal Justice Reference Service for evidence regarding best practices to identify trace DNA.

Results: Fourteen articles (from the United States, Australia, and Canada) were reviewed and evaluated for strength and quality of evidence. Using the Johns Hopkins Nursing EBP model, recommendations for practice were made.

Conclusion: Recommendations included: 1) eliminate use of the Wood’s lamp, 2) purchase an ALS that provides appropriate wave length to detect DNA, 3) educate forensic nurse clinicians on use of ALS, and 4) conduct more research. This innovative project led to a strategic plan to use best evidence to improve patient outcomes in a hospital based sexual assault forensic examiner program. This project builds skills required in their future practice while generating a renewed interest in research for practicing clinicians.