Nursing Research: Analyzing Articles on Prison Healthcare Issues

This report presents an analysis of two nursing research articles focusing on healthcare within prison settings. The first article explores the challenges of HCV screening and treatment in Irish prisons, highlighting the impact of security measures and resource limitations. The second article examines the improvements and ongoing challenges within mental health services in a South London male remand prison, emphasizing issues related to staffing shortages and funding constraints. The report utilizes a PICOT framework to define the problem, intervention, comparison, outcome, and timeframe related to nursing interventions. It compares the methodologies of the studies, including data collection methods and ethical considerations. The key findings of each study are presented, along with their implications for nursing practice, emphasizing the ethical responsibilities of nurses to advocate for improved patient care. The report concludes with a comparison of anticipated outcomes based on the PICOT question and the actual outcomes presented in the selected articles, underscoring the importance of funding and staffing in delivering effective healthcare within correctional facilities.

Running head: NURSING
Research Article Analysis and Nursing Purpose Issue
Name of the Student
Name of the University
Author’s Note

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Table of Contents
1.Background.............................................................................................................................2
1.1. PICOT Question..........................................................................................................2
2.Nursing practice issue and the articles’ purpose.....................................................................3
3.1 Comparing the methods of the articles.............................................................................4
3.2 Limitation and benifits of above method.........................................................................4
4.Results of study.......................................................................................................................5
4.1 Key findings of each study...............................................................................................5
4.2 Implications of these studies in nursing practice.............................................................6
5. Outcomes of Comparison.......................................................................................................6
5.1 Anticipated Outcomes of PICOT question......................................................................6
5.2 Outcomes of the chosen article with anticipated outcomes.............................................7
References..................................................................................................................................8

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1.Background
According to Crowley et al., (2019) the authors suggested that Irish prisons provide
poor healthcare facilities to the inmates that also include Hepatitis C virus (HCV) screening
procedure and treatment. They performed a qualitative study comprising nurse group
managers following a focus group methodology to identify the obstacles of facilities in the
process of HCV treatment. The research question focused on why HCV infection is widely
prevalent in Irish prisons. They identified that the high range of security and obstacles in
healthcare delivery in prisons is the main problem. Nursing personnels on duty can intervene
here significantly, by urging the higher authority to improve facilities and funding. Samele et
al. (2016) focused in their study about the challanges and improvement in the mental health
service in urban male remand prisons of South London.The research question provided
emphasis on how mental health related issues have improved in such prisons and also
identified the challenges. The problems included the shortage in staff and closure of inpatient
units, leading to poor availability of facility. As a nurse of prison healthcare facility, it is a
very relevant problem to provide quality care to patients in need, due to low availability of
funding and shortage of staffs. A nurse cannot intervene without proper resources and help
from colleagues (Brouchad & Swan, 2016).
1.1. PICOT Question
P (Problem or patient or Population) Nursing personnels on duty can intervene here
significantly, by urging the higher authority to
improve facilities and funding.

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I (Intervention / Indicator) Nurse can involve higher authority attention
highlighting the issue and make intelligent use of
available resources.
C (Comparison) Reaching to each patient and manage the situation
single-handedly
O (Outcome) Implementation of policies and funds and
recruiting new staff can improve quality of
individualistic care of patients.
T (Time) The nursing intervention can happen instantly,
but the implementation time can take from
months to years.
2.Nursing practice issue and the articles’ purpose
Samele et al., (2016) interviewed healthcare experts including nurses from prisons in South
London to incur information about the problems in mental health care facilities there. The
interviewee suggested that lack of proper inpatient facilities due to fund and other
complexities caused such issues in prisons. Crowley et al. (2019) only included nurse
managers to interview about HCV infection related issues in Irish prison. The nurses were of
the opinion that staffing and rostering issue, and safety of prison resulted in poor access of
patients to healthcare. Hence, both these articles highlight my nursing purpose issue of
funding and lack of staffs.
3. Method of Study

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3.1 Comparing the methods of the articles
Samele et al., (2016) recruited healthcare professionals from the prison for
interviewing. Sampling of the health experts were done based on the longetivity of their
period of work, and included the ones in duty of mental health care of the inmates. It also
included external staffs like forensic staffs of psychiatry. One interview continued for 1 hr or
30 mins.Thematic analysis of the results were done emphasizing on prior themes. Some other
important themes were also deliniated. Nvivo Version 9 (2010) was used to deliniate the data
and the indices and the study was ethically approved.Crowley et al., (2019) used a focus
group methodology and only included nurses(n=12) in the study, which is unlike from the
previous study.The questionnare contained questions like experience of the nurses regarding
HCV infection in prison, obstacles, variation in facilities within prisons, and role of security
personnel and peers in HCV management. Consents were taken from the interviewee as well
as from ethical committee, unlike the previous study. Audio recordings along with written
interview was conducted. The thematic coding method was renewed with individual
interview, unlike the previous study.The focus group included 12 of 13 participants and was
moderated and observed by the interviewer.
3.2 Limitation and benifits of above method
Samele et al., (2016) conducted the interview containing all healthcare experts and
this will facilitate to get a better idea about the problems of the facility. One limitation of the
study was that the study conducted in a time when the prison was changing from category B
to category C and a major change in employee status was going on, so some of the answers of
the interview can be affected by that. Crowley et al., (2019) received ethical permission from
the commitee and the interviewees. One limitation of their study includes the fact that only
nurse mangers were considered in their study, violating the views of other health care experts.

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The views of them was also important because, everyone can share unique in formation for
improving the patient-care.
4.Results of study
4.1 Key findings of each study
According to Samele et al. (2019), various internal and external matters control the
mental health care facility of South London male remand centre.It was the main challenge
because the healthcare facility was undermined by such attempts. The course of the treatment
could not be decided effectively in primary health care facility, because of lack of expert
staffs and funding in the area. Rousan et al.(2017) suggested that delay in diagnosis and
proper treatment dispairs the health care facility in mental health patients. Some positive
points in the facility include easily accesable service, a mental health-care nurse in the
reception, open referral systems and the zoning facility to consider emergent or general.
Crowley et al.(2019) revealed that the criteria for safety, security leads to
possible difficulties in health outcomes in prison, along with shortage of staffs and rostering
issues. They also emphasized that there was variation in resources availability in prisons,
along with shortage of persons to deliver the proper care. It lead to outspread of HCV
infections in prisons, without proper screening and treatment. Skarupski et al., (2018) insisted
that the intervention of authority and healthcare experts in prison facility, because there is a
prevalnce of widespread diseases that include infectious diseases, diabetes, liver disorders
and mental health problems among others, especially in aged population. So, immediate steps
by higher authority is absolutely necessary in this case.

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4.2 Implications of these studies in nursing practice
The code of ethics for nurses suggest that nurses have inevitable commitment in need
of the society. It clearly states that there should be no dicrimination in the level of care
between any inhabitant of the society, irrespective of their status (American Nurses
Association, 2019).So, as a prison and rehab nurse it is absolutely important for nurses to
look after the proper care and provision of prisoners. Nurses identified that governmental and
oragnisational shifts affects their role as a caregiver. Inappropriate recruitment of staffs
produced immense pressure on a single nurse, resulting in difficulty to provide effective
service (Turner & Peacock 2017). Shortage of fundings and resources result in improper
delivery of healthcare to the inmates resulting in widespread range of diseases
(Kouyoumdjian et al., 2017). The above articles deliniated in the study also emphasize on the
issues of funding and lack of staffs.
5. Outcomes of Comparison
5.1 Anticipated Outcomes of PICOT question
Khursid, Armstrong and Alexandru (2017) suggested that a nurse working in a prison
faces extreme challenging situation due to poor development of facility. The PICOT question
suggested here emphasizes the lack of appropriate health care workers along with shortage of
funding in the prison. South et al., (2016) emphasized that these facilities needs to be
improved in prison settings. A nurse can intervene in this matter by divulging the details to
higher authority and must urge them to bring efficient changes. They can involve the
concerned personnel of the prison and request them to bring amendments in healthcare
system, and bring proper fundings to procure medicines. If the authority takes steps, then
division of labour among staff can improve personalized care. With increased funding and

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resources, the nurse can intervene medically in any disease control of the patients, decreasing
the rate of infectious and other diseases in near future.
5.2 Outcomes of the chosen article with anticipated outcomes
Samele et al., (2016) suggested that policies helped in improving the health
care facility that included open-referral system, seperate nurse for mental heathcare in
reception, and zonation of urgent and non-urgent cases to prioritise service. These helped in
dealing with the staffing issue. Crowley et al., (2019) revealed that difficulties prevailed in
the system that ranges from lack of healthcare workers to provide treatment, lack of facility,
improper access of patients to medicines, due to funding. So, anticipated outcome corelates
with the study of Samele et al., (2016).

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References
Al-Rousan, T., Rubenstein, L., Sieleni, B., Deol, H., & Wallace, R. B. (2017). Inside the nation’s
largest mental health institution: A prevalence study in a state prison system. BMC public
health, 17(1), 342.
American Nurses Association. (2019). ANA Standards for Excellence. Access Date: 30th July, 2019.
[Online]. Retrieved from: https://www.nursingworld.org/ana/about-ana/standards/
Bouchaud, M. T., & Swan, B. A. (2017, January). Integrating correctional and community health care:
an innovative approach for clinical learning in a baccalaureate nursing program. In Nursing
forum (Vol. 52, No. 1, pp. 38-49).
Choudhry, K., Armstrong, D., & Dregan, A. (2017). Prison nursing: Formation of a stable professional
identity. Journal of forensic nursing, 13(1), 20-25.
Crowley, D., Van Hout, M. C., Murphy, C., Kelly, E., Lambert, J. S., & Cullen, W. (2019). Hepatitis C
virus screening and treatment in Irish prisons from nurse managers’ perspectives-a qualitative
exploration. BMC nursing, 18(1), 23.
Kouyoumdjian, F. G., McIsaac, K. E., Foran, J. E., & Matheson, F. I. (2017). Canadian Institutes of
Health Research funding of prison health research: a descriptive study. CMAJ open, 5(1),
E14.
Samele, C., Forrester, A., Urquía, N., & Hopkin, G. (2016). Key successes and challenges in
providing mental health care in an urban male remand prison: a qualitative study. Social
psychiatry and psychiatric epidemiology, 51(4), 589-596
Skarupski, K. A., Gross, A., Schrack, J. A., Deal, J. A., & Eber, G. B. (2018). The health of America’s
aging prison population. Epidemiologic reviews, 40(1), 157-165.
South, J., Woodall, J., Kinsella, K., & Bagnall, A. M. (2016). A qualitative synthesis of the positive and
negative impacts related to delivery of peer-based health interventions in prison
settings. BMC health services research, 16(1), 525.

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Turner, M., & Peacock, M. (2017). Palliative care in UK prisons: Practical and emotional challenges
for staff and fellow prisoners. Journal of Correctional Health Care, 23(1), 56-65.