Prostate cancer is the most common malignancy encountered in corrections. While screening guidelines are well standardized, therapy options have become increasingly more complicated. The role of new therapeutics, including hormonal options and novel radiopharmaceuticals, will be discussed, along with their effect on physicians' treatment decisions and patient outcomes.

Educational Objectives

• Define patients appropriate for PSA screening
• Review treatment options for patients with low, intermediate, and high-risk prostate cancer
• Discuss the role of new hormonal and theranostic agents in diagnosis and treatment of prostate cancer

Level Intermediate

Prior to COVID, little thought was given to the dangers that nurses encounter on a daily basis during the delivery of healthcare. The purpose of this presentation is to increase the awareness of the emotional, psychological and physical stressors encountered by nurses during the delivery of care and to encourage organizational support of nurses and the unique challenges they face on a daily basis.

Educational Objectives

• Recognize the prevalence of burnout, compassion fatigue, and suicide among nurses
• Identify risk factors associated with burnout, compassion fatigue, and suicide among nurses
• Discuss self-care interventions nurses can take to prevent burnout and compassion fatigue

Level Intermediate

Cancelled

Transgender people are incarcerated and arrested at disproportionate rates leading to interaction with the criminal legal system raising multiple legal issues concerning their healthcare and housing. This workshop will discuss current and historical cases concerning constitutional and statutory rights for this special population, policies and operating procedures, and what prison and jail systems can and should do to provide care and keep those in their custody safe.

Educational Objectives

• Discuss constitutional and statutory rights of incarcerated transgender people
• Review statistics on transgender people and the criminal legal system
• Debate policies adopted by different states that address the needs of transgender people in their custody

Level Intermediate

How can you tell if your facility's suicide prevention program is exceptional, good enough, or in need of major improvement? Outside correctional suicide experts reviewing key components of your suicide prevention program, including facility/housing design, can reveal its strengths and weaknesses. This session focuses on lessons learned (and potential downsides) from systemic reviews at several jails to highlight effective suicide prevention strategies in an interactive, individualized manner with audience participation..

Educational Objectives

• Describe four ways a system-level review of a suicide prevention program can help decrease suicide attempts and deaths
• Articulate four lessons learned from the system-level suicide prevention reviews of two very different jails
• Discuss three potential downsides of having outside experts review a correctional suicide prevention program

Level Basic

Youth in the justice system experience disproportionately high rates of unplanned pregnancy and STDs/STIs, yet the field suffers from a concerning gap in tailored evidence-based preventive programming. This session will provide a reason for optimism. The national Juvenile Justice Innovation and Impact Network is co-designing and testing seven engaging theory-based interventions in direct partnership with young people and correctional partners. Workshop participants will learn more about their unique strategy and results-oriented partnerships with justice systems around the country and gain a deeper knowledge of collective approaches, emerging theories, and promising interventions.

Educational Objectives

• Describe the need for innovative partnerships to develop effective adolescent sexual health prevention education
• Define motivational interviewing - social network theory, education entertainment, and human-centered design theories
• Explain the promise of new interventions for promoting positive adolescent sexual health outcomes

Level Basic

Prior to the COVID-19 pandemic, use of telehealth in corrections was hampered by security concerns and aged infrastructure that was not designed to support the evolving technology. Numerous, rapidly developing pressures came to a head during the pandemic: staff shortages, the shutdown of nonessential outside appointments, and supply chain issues. Join in this interactive conversation about the explosive growth of telehealth services and technology in correction, including an in-depth exploration of what to expect in the near future.

Educational Objectives

• Discuss the expansion of telehealth service before, during, and after the pandemic
• Describe why legal guardrails have struggled to keep up with the technological advancements in telehealth
• Explore the exciting possibilities in telehealth and how corrections can become the leader instead of a follower in this field

Level Intermediate

The Washington State Department of Corrections Health Services Division has developed a systemwide continuity-of-care process to ensure that individuals who are leaving prison have access to needed medical, mental health, and substance use treatment in the community. This process has increased the focus on collaboration with internal and external stakeholders to assist with identification of reentry needs and facilitation of warm hand-offs at release. This presentation will discuss the current and future state of health services reentry to include patient identification, initial assessment of need, approach to reentry planning, and community supports.

Educational Objectives

• Describe the goals of the health services reentry programs
• Discuss the need for cross-agency coordination to improve continuity of care during transition
• Identify gaps, barriers, and next steps to improving continuity of care planning

Level Intermediate

Correctional medicine is arguably a subspecialty due to the uniqueness of the settings, the patients, and the administrations. There are also clinical conditions that are more common in the correctional setting than in the community. This talk will go over a few of these, including "jailhouse rash," pseudoseizures, and weightlifter chest pain. Presentation, diagnosis, and treatment of these conundrums will be reviewed.

Educational Objectives

• List several medical conditions that are uncommon in the nonincarcerated population
• Describe how to use history and physical skills to diagnose "jailhouse rash," tinea versicolor, and other conditions
• Discuss ways to manage these clinical conundrums

Level Basic

Pain and inflammation significantly slow healing. Health care professionals may not be familiar with the validated tools for pain assessment and the wide variety of choices for pain management. Inflammation may be overlooked, or mistaken for infection. An understanding of the pathophysiology of pain and inflammation forms the basis for interventions. Attendees will learn how to conduct an efficient, thorough assessment of pain and inflammation, leading to management that is evidence-based, individualized, creative, and effective.

Educational Objectives

• Describe how pain and inflammation interact to slow wound healing
• Identify appropriate tools for assessing pain and interpret the results
• Design a care plan using a nonprescription intervention to help a patient manage wound pain and inflammation

Level Advanced

Supporting individuals while they work to change dangerous and risky behaviors is challenging. Working with individuals who cannot see the risks associated with their actions is even more difficult. Both require an understanding of how behaviors are supported by the environment as well as the individual's internal experiences. In this session, we will move beyond behavior theory to theories of motivation and change in order to understand how we can support transformation in others. It is about more than education and consequences; it is about appreciating the struggle within the individual and working with ambivalence to set the stage for contemplating change. Practical strategies and the role of each individual provider within the larger health care team will be discussed.

Educational Objectives

• Examine how behavior is supported by triggers and rewards
• Explore theories of motivation and change
• Describe practical strategies for supporting individuals in appreciating the need to change and taking steps toward change

Level Basic

Some lectures address tips for testifying at deposition while others are about how trials proceed; this mock trial explores both and demonstrates how the two are interrelated. Real-life health care defense attorneys play the roles of the lawyers, and health care providers serve as the witnesses to provide an interactive experience of deposition and trial testimony. The moderator will walk you, the mock jurors, through the jury deliberation process and how those with no medical training are expected to render these important decisions.

Educational Objectives

• Describe the purpose and key characteristics of a deposition of a defendant
• Examine problematic testimony and its effects on a trial
• Discuss the role of the jury in deciding liability and damages

Level Intermediate

This presentation provides an overview of gender-responsive and trauma-informed treatment approaches being used through the Washington State Department of Corrections Sex Offender Treatment and Assessment Program with female individuals, including those who identify as transgender and nonconforming, who have committed sexually motivated offenses. The presenters will share an overview of current research and examples of how treatment delivery is being adjusted to meet the needs of this population, including treatment approaches based on Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and Acceptance and Commitment Therapy. They also will review current literature and research recommendations regarding treatment approaches, interventions, and future areas of study.

Educational Objectives

• Describe current evidence-based treatment models for working with individuals who identify as female and have committed sexually motivated crimes
• Identify current gender-responsive treatment approach adjustments being made to respond to the needs of this population
• Cite recent research about treatment of this population

Level Intermediate

This session guides participants through strategies to improve health care utilization through cultural responsiveness and models for shared decision making. Learn how first impressions impact patient engagement and follow up, approaches to improving utilization and engagement, the importance of humanizing language, and the five steps of cultural formulation.

Educational Objectives

• Describe three frameworks for analyzing how cultural factors affect clinical encounters
• Review strategies for improving engagement in and utilization of correctional health services
• Discuss considerations for engagement in care and benefits of cultural responsiveness

Level Basic

Delaware is ranked among the highest in the nation for overdose deaths. To improve outcomes for those with substance use disorder, the Delaware Department of Correction became a licensed opioid treatment program. Learn about the process of becoming licensed to offer all forms of medication assisted treatment through this discussion. Participants will gain an understanding of the process from prelicensure to licensure and identify challenges and opportunities.

Educational Objectives

• Explore challenges and opportunities of the OTP licensure process
• Describe the steps to becoming licensed, from provisional licensure to NCCHC accreditation
• Discuss what lessons can be learned from Delaware's OTP experience

Level Basic

Crisis management is an essential skill for mental health providers. This is especially true for the youth in the juvenile justice system, since the prevalence of mental disorders is estimated to be as high as 60%, with a 3 to 4 times higher risk of suicide than peers not involved in the justice system. As a general therapeutic framework, DBT addresses maladaptive behaviors by teaching emotional regulation, interpersonal effectiveness, distress tolerance, core mindfulness, and self-management skills. This session will explain how dialectical behavior therapy can be used as a culturally relevant evidence-based intervention to address crises within juvenile detention.

Educational Objectives

• Describe the main components of dialectical behavior therapy
• Explain how dialectical behavior therapy addresses crisis behaviors
• Identify specific dialectical behavior therapy strategies that can be used within crisis management

Level Intermediate

In the United States, cardiovascular diseases, which include coronary heart disease, stroke, heart failure, and peripheral artery disease, are leading causes of morbidity and mortality in the adult population. Major risk factors such as hypertension, high cholesterol, diabetes mellitus, obesity, and cigarette smoking have been established as the leading causes for atherosclerotic cardiovascular disease. When these cardiovascular risk factors accumulate, the probability of having a cardiovascular event increases. Implementing steps to evaluate and initiate preventive measures to control modifiable risk factors is very beneficial in reducing the risk of developing cardiovascular events. This presentation will review these cardiovascular risk factors, explain how to assess and manage them, and summarize the European Society of Cardiology (ESC) guidelines on cardiovascular disease prevention.

Educational Objectives

• Review processes for assessing cardiovascular risk factors
• List preventive measures that reduce the risk of cardiovascular events
• Summarize treatment options for patients with cardiovascular risk factors

Level Basic

Do you use the Ottawa Ankle Criteria before getting an x-ray for trauma? Do you auscultate lungs for egophony? Do you measure the pulsus paradoxus when evaluating an asthmatic patient? Do you calculate pulse pressure from a blood pressure to evaluate dehydration? During this two-part session, participants will learn (or relearn) 15 simple but valuable bedside diagnostic techniques for pulmonary, cardiac, abdominal, and other organ system evaluations which can be useful in daily correctional nursing practice. This session will run through two one-hour consecutive time blocks. 

Educational Objectives

• Describe the theory of 15 bedside nursing assessment maneuvers that are not commonly used but are very relevant to correctional nursing
• Review the nursing skills involved in applying these maneuvers
• Discuss the usefulness of these skills at the bedside or in the clinic

Level Intermediate

Self-injurious behaviors are common but quite challenging events for both health care and security staff in the correctional setting. Distinguishing self-injurious behaviors from suicidality is difficult but possible. Evaluations of self-injury that incorporate classifying the type of self-injurious behavior and identifying the underlying psychiatric diagnosis can significantly aid in effective management and treatment. Learn more about assessment and management of self-injurious behavior in the correctional setting.

Educational Objectives

• Distinguish self-injurious behaviors from suicidal behaviors
• Compare types of self-injurious behaviors and their underlying psychiatric diagnoses
• Describe management and treatment of self-injurious behaviors in corrections

Level Intermediate

Many doctors, nurses, and mental health professionals struggle with creating adequate and thorough charting. By the time the case reaches an attorney's desk, there are often omissions, misspellings, inconsistencies, or failures in following up. This presentation is designed to address these issues and many others. Examples of medical charting will be used to help instruct and guide practitioners to understand charting's impact in the judicial setting, and how to avoid common pitfalls associated with poor charting.

Educational Objectives

• Review proper medical charting procedures and techniques
• Identify common mistakes in medical charting
• Explain the legal impact of medical documentation errors

Level Basic

Cancelled

The security of dental sharps such as needles and scalpels as well as anesthetic carpules and other instruments is essential in the dental clinic. These items must be rigorously monitored, tracked, and documented to ensure the safety of staff and patients. This talk will provide a practical example of a way to ensure that dental sharps are managed and accounted for.

Educational Objectives

• State the importance of reaching consensus on what constitutes dental sharps
• Examine ways to track the inventory and document the usage and disposal of sharps
• Discuss use of reports, schedules, and corrective action plans to ensure sharps are properly reconciled

Level Intermediate

This session will highlight best practices for building a robust and responsive cross-disciplinary infection control program that has the buy-in and support of all key stakeholders within a correctional system. Additionally, it will highlight the importance of applying quality assurance frameworks to infection prevention and control.

Educational Objectives

• Identify the security challenges posed by infection prevention and control protocols in correctional settings
• Discuss creative approaches to overcoming the health and safety challenges posed by security procedures
• Describe how a multidisciplinary team can work cross-functionally to prevent and control the spread of infectious disease

Level Intermediate

A standardized medical diet program helps maintain optimal health status of incarcerated people, ensures compliance, and eliminates diet issues that can increase costs. Communication between medical and the food service department is the key to the success of a standardized medical diet program. This presentation will identify the key points in a medical diet program, explaining the process from the diet order to the meal served and incorporating compliance guidelines.

Educational Objectives

• Review how standardization improves compliance and controls cost
• Summarize the medical diet process from prescription to consumption
• Describe valid diets and their rationale associated with disease states

Level Basic

Diabetes, hypertension, and heart disease are common among patients in correctional settings. As these systemic diseases progress, the eyes are often adversely affected. This presentation will address the ocular manifestations of these diseases, using visual content to describe common symptoms and findings as well as current treatments. A better understanding of the ocular effects of these conditions will aid in practical, appropriate, and effective patient management.

Educational Objectives

• Discuss the ocular effects of diabetes, hypertension, and heart disease
• Describe the clinically visible signs of the ocular manifestations of diabetes, hypertension, and heart disease
• Examine the current treatment modalities of diabetic eye disease, hypertensive retinopathy, and heart disease-related ocular pathology

Level Basic

Do you use the Ottawa Ankle Criteria before getting an x-ray for trauma? Do you auscultate lungs for egophony? Do you measure the pulsus paradoxus when evaluating an asthmatic patient? Do you calculate pulse pressure from a blood pressure to evaluate dehydration? During this session, participants will learn (or re-learn) these and several other simple but valuable bedside diagnostic techniques for pulmonary, cardiac, abdominal, and other organ system evaluations which can be useful in daily correctional nursing practice. This is the second hour of a continuing session. 

Educational Objectives

• Describe the theory of 15 bedside nursing assessment maneuvers that are not commonly used but are very relevant to correctional nursing
• Review the nursing skills involved in applying these maneuvers
• Discuss the usefulness of these skills at the bedside or in the clinic

Level Intermediate

Presenters from the Illinois DOC will describe how the START NOW skills program has reduced disciplinary infractions by 27% and self-reported aggression by 9%. This evidence-informed treatment model is designed to treat incarcerated individuals with mental health issues, behavioral disorders, and associated behavioral problems. START NOW integrates research, theory, and clinical experience, focusing on an accepting and collaborative clinical style. Find out if this approach could work in your facility.

Educational Objectives

• Explain the successes and challenges of implementing the START NOW skills program in Illinois
• Name the key components of the START NOW skills program
• Analyze the data collected from 15 Illinois DOC facilities

Level Intermediate

Correctional medicine can be a litigious environment. As the first line of defense, medical records are of vital importance in shielding providers and staff from exposure to false or misleading claims. This presentation will explore how medical records can be used or misused in three stages of litigation. By illuminating the significance of a note's substance, including documentation of personal observations and patient statements, attendees will learn tools to reduce chances of a lawsuit and increase the odds of a positive legal outcome.

Educational Objectives

• Differentiate the use of medical records in preliminary injunction, depositions, and dispositive motions
• Recognize common legal pitfalls of generic or vague documentation
• Identify tools to effectively document encounters beyond the medical aspect

Level Intermediate

Prolonged operational challenges brought on by the COVID-19 pandemic highlighted a need for reevaluation of traditional correctional health care models. A marked decrease in mass movements throughout the facility necessitated development of new strategies to see patients to provide timely, high-quality health care despite rapidly changing public health guidelines, staffing challenges, and operational obstacles. This presentation describes development and implementation of several successful adaptations including acuity-based chronic care guidelines, remote behavioral health staff consultations, a provider-based urgent care model, and implementation of automated medication administration systems.

Educational Objectives

• Summarize COVID-related innovations that led to positive outcomes
• Define acuity-based clinical guidelines for chronic health conditions
• Discuss the transformation from a traditional nursing sick call process to a provider-based urgent care model

Level Intermediate

The Certified Correctional Health Professional program is the premier national certification dedicated to recognizing the special skills and knowledge necessary to provide care in the complex world of corrections. Today the program certifies over 4,000 nurses, physicians, dentists, mental health professionals, administrators, and others. This talk will present an overview of CCHP certification including eligibility, how to apply, the exam, recertification, and the benefits becoming a CCHP.

Educational objectives

• Identify the eligibility criteria and application process for CCHP certifications
• Explain how to prepare for CCHP exams
• Describe the recertification process and continuing education requirements

Level: Basic

Medication-assisted treatment is the "gold standard" and yet its evidence-based benefits are often challenged based on stigmas that create barriers to access, availability, and acceptance. Participants will explore the fears associated with use of MAT, learn how those fears limit access to the benefits of this treatment, and review MAT: Behind the Walls, a program that is built on a collaborative approach to treatment for individuals who are dealing with an opioid addiction.

Educational Objectives

• Discuss some of the fears and stigmas associated with the use of medication-assisted treatment
• Review the evidence-based benefits of MAT and services offered in opioid treatment programs
• Explore findings from the MAT: Behind the Walls program

Level Intermediate

Mindfulness is a skill that can enhance relaxation, focus, and productivity. What if mindfulness were used to assess, diagnose, and treat patients in the correctional setting? How could this change the way we view our patients? How might it lead to improved clinical outcomes for patients and increased job satisfaction for providers? This presentation will educate health care professionals on the use of mindfulness in daily practice and how to implement it in the correctional setting. Attendees will review basic mindfulness concepts and learn specific ways to incorporate those concepts into daily practice.

Educational Objectives

• Explain the concept of mindfulness
• Identify three barriers to providing the best care in correctional settings
• Describe mindfulness-based strategies to assess, diagnose, and treat patients

Level Intermediate

Family physicians are ideally suited to provide health care in correctional settings; however, correctional medicine residency training is uncommon. In an elective jail health rotation at King County Correctional Facility, residents learn about health care in an urban county jail and gain insights into the patient experience. They see how jail health care is a link in the care continuum for medically underserved people. The roundtable will provide a framework for how this program could be replicated elsewhere and how correctional health experiential education may improve the quality of health care people receive post release.   

The COVID-19 pandemic has affected lives all over the world and wreaking havoc on medical, economic, social, political, and psychological infrastructure. Nevertheless, we have withstood the impact of this storm, mourned the loss of life, labored to protect our own health and rebuild our lives. Our psychological and emotional faculties are like muscles and can likewise be strengthened through specific “exercises” and techniques.

A study identified inability to sleep as the most common mental health sick call complaint in juvenile institutions in Puerto Rico over a 12-month period. This discussion will share findings, including potential correlations with any Axis 1 diagnoses. It also will summarize a literature review of pharmacological treatments and examine how the Puerto Rican patients’ pharmacological treatment “preferences” predict effectiveness.

Correctional health care professionals are continually faced with opportunities to make both straightforward and complex clinical decisions. Providing care requires ongoing triage to risk stratify priorities. This presentation will highlight the Institute of Safe Medication Practices' nine classes of high-alert medications and seven specific high-alert medications, the drugs most often involved in harmful errors. Participants will learn about clinical decision support tools and disease registries to optimize patient safety, clinical effectiveness, and efficiency of resource utilization.

Educational Objectives

• Review the Institute for Safe Medication Practices high-alert medication classes and specific high-alert medications
• Describe the potential effects of clinical inertia and deprescribing
• Explore ways to apply clinical decision support tools and disease registries in correctional health care

Level Intermediate

Shared governance, a model of shared decision making that gives nurses autonomy over their practice, has existed in many community health care organizations for years but has rarely been practiced in the correctional setting. California Correctional Health Care Services implemented a shared governance initiative in its nursing services to support a strategic goal of structural empowerment, providing a framework in which nurses at all levels can investigate, develop, implement, and evaluate standards of practice and care. Come hear three shared governance success stories.

Educational Objectives

• Name the four principles of shared governance
• Describe the benefits of adopting a shared governance model in a correctional setting
• Analyze how shared governance supports structural empowerment

Level Intermediate

This presentation goes beyond increasing professional awareness of suicide risk factors and warning signs to highlight critical actions. Attendees will meet "John" and follow him from facility admission to discharge, as the presenters highlight opportunities to intervene and protect patients like him from suicide. The National Institute for Mental Illness's Ask Suicide-Screening Questions (ASQ) and Brief Suicide Screening Assessment tools, validated instruments tailored to this population, will be introduced. High-risk times during incarceration and the need for ongoing assessment will be discussed.

Educational Objectives

• Recognize the need for ongoing suicide screening throughout incarceration
• Identify behavioral and mood changes that can indicate increased suicide risk
• Explain the concept of suicide step-downs

Level Intermediate

Most correctional health care professionals are aware that they may face constitutional claims or lawsuits over the care they provide, but they often do not realize what statements, actions, inactions, or conduct actually constitute "deliberate indifference" under the law. The presenters will discuss real cases and use actual records and video clips to demonstrate what can get correctional health care professionals into legal hot water.

Educational Objectives

• Describe the basic legal statutes that expose correctional health care professionals to potential liability
• Recognize the differences between tort (negligence) claims and constitutional deliberate indifference actions
• Propose procedures to help avoid actions that might expose correctional health care professionals to liability

Level Intermediate

In 2018, a new NCCHC standard, Medical Surveillance of Inmate Workers, was introduced for jails and prisons. Since that time, many facilities have struggled with the development of their own surveillance programs, making this one of the most frequently missed NCCHC standards. This presentation will explore each requirement and offer practical examples on how to establish a program. Participants will also hear from an accredited facility’s administrator on the challenges and successes of their recently established program. Attendees will take away ideas on implementing or improving their own program.

Educational Objectives

• Review the components of a medical surveillance program for incarcerated workers
• Describe steps necessary to implement a medical surveillance program in prisons and jails
• List key personnel needed to implement a successful surveillance program

Level Basic

Cancelled

In 2021, the DC Jail opened the Women's Wellness Unit, an innovative and unique housing unit dedicated to supporting and treating women with substance use disorder in community with women with serious mental illness. Medical staff and custody serving the unit are all trained in trauma-informed care and cofacilitate an evidence-based curriculum designed for women with a history of trauma and addiction. This presentation will outline the development of the unit including training, programming, funding, continuity of care back into the community, and medical care delivery. It will also provide a data overview of ongoing quality improvement processes and early outcomes.

Educational Objectives

• Describe the impact of the nation's opioid epidemic on corrections
• Identify interventions for substance use disorder suited to the correctional setting
• Explain how a trauma-informed approach to treating substance use disorder improves outcomes

Level Intermediate

The Justice Health and Forensic Mental Health Network provides health care to adults and young people in contact with the forensic mental health and criminal justice systems in New South Wales. Each year, the Network's staff cares for more than 30,000 patients. This presentation shares the virtual care innovation journey the Network is taking toward digital transformation to increase the utilization of virtual care to improve patient access, reduce costs, and improve patient and clinician experience.

Educational Objectives

• Describe the model of care for justice-involved patients in New South Wales, Australia
• Identify the modes of virtual care provided in correctional centers in New South Wales
• Apply the learnings from the outcomes of the project to other correctional settings

Level Basic

This session will discuss the challenges of treating wound care in corrections, best practices in formulary management, product availability, collaboration with medical supply vendors and manufacturers to provide nurse education, and the use of data to make appropriate product and treatment recommendations that ensure clinical efficacy. Attendees will leave with tools in their toolbox to review their current wound care programs, partner with vendors to implement program changes, and educate nurses.

Educational Objectives

• Describe how operations, clinical, and procurement teams can work together to develop a wound care formulary
• Explain how to partner with supply and manufacturing vendors to create CE learning opportunities for clinical team members
• Describe a patient-centered wound care program

Level Intermediate

NCCHC Standard B-07 Communication on Patients' Health Needs discusses the importance of communication between custody and health staff to preserve the health and safety of individual patients, other incarcerated individuals, and staff. Correctional facilities can create challenges for handoff reporting or dissemination of patient needs due to different types and location of housing units and staff ratios. This session will focus on accurate handoff nursing reports, the dissemination of patient information, and role of the nursing leadership in ensuring that handoff reporting is a facility priority and expectation.

Educational Objectives

• List the important elements of handoff reporting
• Restate how to disseminate appropriate patient information to custody and health staff
• Recognize nursing leadership's role in handoff reporting

Level Intermediate

Are they high, mentally ill, or just obnoxious? Patients in correctional facilities frequently present with acute agitation and profound noncompliance. The etiology of the agitation can vary widely and result from acute intoxication, medical crisis, drug withdrawal, serious mental illness, and behavioral issues. This talk discusses tried and true techniques to manage these disruptive patients to keep them safe and minimize their impact on institutional operations.

Educational Objectives

• Identify ways determine the severity of a patient's agitation to help guide clinical decisions
• Review proven management techniques for treating acutely agitated patients
• List current medication management strategies for treating acutely agitated patients

Level Basic

Learn how to recognize and mitigate risk by examining the facts underlying one case study in detail. After introduction of the facts of the case, we will turn to the legal claims, alleged medical errors, and clear system failures and walk through the legal elements of both constitutional and state law claims relating to medical care. Come prepared to debate which elements of the case created the most risk and which could have been avoided with better checks and balances. We will conclude with a discussion of best practices in correctional settings.

Educational Objectives

• State the elements and varying burdens of proof for deliberate indifference and medical negligence suits
• Discuss the legal risks inherent in each human and systematic failure that led to the adverse patient outcome
• Review how other systems have tackled similar challenges

Level Intermediate

Throughout history we have seen outbreaks, epidemics, and devastating pandemics. In addition to COVID-19, in recent years we have had dengue fever, ebola, hepatitis A, and measles ... and we will continue to have infectious disease outbreaks. This presentation will explore the future of infection prevention in corrections by reviewing current programs and lessons learned from past outbreaks, epidemics, and pandemics. What have we learned from the recent experience of staffing shortages, limited supplies, and evolving, misleading information? How can we apply innovation and outside-the-box thinking in the future?

Educational Objectives

• Discuss the importance of the history of infectious diseases
• Identify how current infection prevention and control programs may adapt in the future
• Describe the role of infection prevention and control programs in corrections

Level Intermediate

The overprescribing of antibiotics is a national epidemic, leading to many unnecessary side effects and bacterial resistance. With dentists being responsible for 10% of antibiotic prescriptions in the United States, it is critical that dentists prescribe antibiotics based on sound clinical judgement. This presentation focuses on the use of the clinical/radiographic exam to determine the proper diagnosis, indications for prescribing antibiotics, and the most therapeutic antibiotics for odontogenic infections.

Educational Objectives

• Identify the clinical terminology for pulpal and periapical diagnoses
• Explain the use of clinical and radiographic evidence in diagnosing tooth pain/swelling
• Define when antibiotic therapy is indicated using the ADA guidelines and a patient's health status

Level Intermediate

This presentation describes ReConnect Us, a federally funded demonstration project to support continuity of care among people with HIV reentering the community after a period of incarceration. This project enhances collaboration and establishes data sharing among partners including the South Carolina Department of Health and Environmental Control, the South Carolina Department of Corrections, and the University of South Carolina School of Medicine. The project emphasizes postrelease HIV care engagement, adherence to treatment, and viral suppression maintenance. Attendees can expect to gain in-depth knowledge of the steps needed to initiate an enhanced discharge planning and postrelease linkage-to care-program for persons with HIV.

Educational Objectives

• Describe the benefits of public health and corrections partnerships to improve outcomes across the HIV care continuum
• Discuss how data can used to improve program development, implementation, quality of care, and participant outcomes in a collaborative reentry program
• Identify successes, challenges, and lessons learned about successful community reentry for persons with HIV

Level Intermediate

Cancelled

While there is an abundance of evidence encouraging the effectiveness of Medicated Assisted Treatment or Medicated Assisted Recovery (MAT/MAR), starting such a program can be a huge undertaking especially for a correctional facility that may not have the full support or buy in to initiate such a program. Where do we start? How can we financially pay for this? Using and interactive round table discussion platform, learn the steps firsthand from correctional facilities in Illinois and California on how they began their journey along with the challenges they faced along the way.

This roundtable discussion will engage APRNs in a conversation about the legal and clinical responsibilities associated with on-call duty. We will discuss the importance of clear, structured communication during on-call encounters and appropriate documentation of the interaction. Participants will have an opportunity to share their experiences and concerns related to being on-call and discuss strategies that promote good clinical decision-making and improved patient outcomes.

Before wide availability of COVID-19 vaccines, The National Academies of Science, Engineering and Medicine developed an equitable framework to guide vaccine allocation. Data shows that despite elevated risk, many incarcerated populations were deprioritized in the allocation of the COVID-19 vaccine. This session will explore strategies to advocate and promote the equitable and timely receipt of future doses in incarcerated populations.

This talk details medical, administrative, custodial, and legal issues that are the most common problem areas in terms of correctional health care quality, efficiency, accreditation, and litigation. The presenter will provide a comprehensive review of issues that you can use to assess your own facility, along with proven solutions for implementing change to address operational challenges.

Educational Objectives

• Review basic operational issues that frequently impact correctional health care delivery
• Identify potential areas of risk for providers and health care systems commonly seen in plaintiff cases
• Discuss effective tools, mechanisms, and policy changes to address these challenges

Level Intermediate

Preparation for obstetric emergencies can help correctional health care workers be ready an unexpected event. In a precipitous delivery, the situation may be too unstable to allow for immediate transfer off-site. Correctional nurses should be able to stabilize both mother and baby and attend to labor and delivery until EMS personnel arrive. This presentation is an overview of birthing, including practical information for correctional staff related to normal and abnormal labor, false labor, newborn resuscitation, and common birthing complications. Terms, processes, equipment, and procedures related to birthing are explained in detail.

Educational Objectives

• Review the stages of labor and emergency delivery process
• Explain the needed preparation and equipment for an unplanned birth in a correctional facility
• Describe how to assess for and respond to common obstetric complications

Level Basic

Despite experiencing high rates of mental health disorders, justice-involved adolescents rarely are able to access evidence-based assessment or evidence-based psychiatric care. In this presentation, we will discuss the components of an evidence-based assessment protocol designed and piloted with incarcerated adolescents involved in Rhode Island's juvenile justice system. We will also provide an overview of our group treatment curricula, focusing specifically on three promising new groups: sex trafficking prevention, healthy relationships, and restorative justice.

Educational Objectives

• Cite historical reasons behind the need for a standard clinical assessment within a juvenile facility
• Describe the steps necessary to implement a standard clinical assessment process
• Review the prevention-oriented groups developed for justice-involved youth in Rhode Island

Level Basic

This fast-paced panel will explore multiple topics including medical liability, medical implications of restraint, MAT, HIPAA, detox and withdrawal, suicide watch, and transgender care. It is not uncommon to see multi-million-dollar awards as well as criminal prosecution of individual correctional and health care professionals. Many of the poor decisions behind these verdicts are avoidable by understanding and training staff on foundational concepts such as deliberate indifference, practicing empathy, and providing access to needed medical and mental health care. Get an in-depth understanding of actionable steps to help you stay out of the headlines for common issues.

Educational Objectives

• Discuss the importance of infusing empathy into daily practice
• Describe how to avoid deliberate indifference
• Evaluate opportunities to enhance staff training

Level Intermediate

Managing withdrawal for individuals with substance use disorders who are in custody is a national priority. Deaths from substance withdrawal are particularly alarming due to their preventability. Recognizing the urgent need for jails to identify and appropriately manage withdrawal symptoms, the Bureau of Justice Assistance, in partnership with NCCHC, worked with Advocates for Human Potential and the American Society for Addiction Medicine to develop Guidelines for Managing Substance Withdrawal in Jails. Learn about these important guidelines, which are informed by evidence-based medical practice and account for the practical realities of medically managed withdrawal in jails. Participants will receive an overview of constitutional rights and key legislation related to substance withdrawal, and review the steps for creating a comprehensive response to SUDs, and learn where to find technical assistance to support application of the guidelines to agency policy and practice.

Educational Objectives

• Explain key legislation related to substance withdrawal and wrongful death
• Describe three components of substance withdrawal management
• Identify specific recommendations from the Guidelines for Managing Substance Withdrawal in Jails

Level Advanced

Stress is part of the unique world of corrections, and that has been exacerbated by current events such as the pandemic, socioeconomic disparities, and racial injustice. Already under tremendous stress and outside of our comfort zones, corrections professionals are experiencing the failure of time-honored ways of coping and living life. This session will explore various techniques to develop a new and healthy life balance plan. Participants will learn stress-relieving and life-balancing practices to resiliency at work and home, including taking responsibility for decisions and behaviors; supervision and support groups: and techniques such as mediation, mindfulness, yoga, exercise, and healthy eating.

Educational Objectives

• Define resiliency
• Discuss correctional stress as an occupational hazard
• Identify stress-relieving and life-harmonizing strategies for use at work and home

Level Basic

This presentation provides an overview of the experiences of individuals diagnosed with autism spectrum disorder in legal, judicial, and correctional settings. It seeks to increase identification, treatment, and protection of such patients when incarcerated, and discusses historical factors affecting mental health prior to these patients' incarcerations that affect them during incarceration. The presenter, both a researcher and the mother of two grown sons with autism spectrum disorder, will discuss diagnostic criteria, mental health treatment, behavior management, aggression, and physical plant accommodations.

Educational Objectives

• Identify behaviors that might indicate someone in a correctional facility has autism spectrum disorder
• Describe how attitudes toward individuals with ASD might affect their experiences in law enforcement, judicial, and correctional settings
• Describe three accommodations that can be used when interacting with an individual with ASD

Level Intermediate

As more and more people age and die in U.S. prisons, little thought is given to what can be done to make dying and death better for the patients, their families, and the health care and correctional staff. This presentation introduces a model that can work for all involved by training incarcerated individuals to act as hospice caregivers to their dying brothers/sisters. Attendees will view "Prison Terminal: The Last Days of Private Jack Hall," a moving cinéma vérité documentary that breaks through the walls of one of America's oldest maximum security prisons to tell the story of the final months in the life of a terminally ill man and the hospice volunteers, they themselves prisoners, who care for him. Viewers will be able to recognize the compassion, love, and respect demonstrated by hospice volunteers and staff, understand the practical and economic benefits of prison-based hospice care, and appreciate its rehabilitative nature.

Educational Objectives

• Describe the potential benefits of hospice for terminally ill incarcerated patients, hospice volunteers, and families
• Review the technical, logistical, and sociopolitical difficulties of setting up a hospice program in a maximum security prison
• Differentiate between the care provided by trained prison hospice volunteers and the alternative

Level Basic

The prevalence of epilepsy in the population is 1%; among these patients, intractable epilepsy is 20%-40%. In correctional settings, health care professionals see a lot of "seizures." Some are real, some are not. This presentation features videos of people having epileptic seizures, psychogenic seizures, and other types of "shaking episodes" to illustrate the different types of seizures and the clinical differentiation of a seizure versus a psychogenic seizure and other possibilities when a patient is shaking.

Educational Objectives

• Differentiate between seizures and shaking
• Recognize subtleties that differentiate a seizure from a psychogenic episode
• Cite a possible deadly, non-seizure-related diagnosis in a patient who is shaking

Level Basic

Nearly 37 million Americans live with a chronic lung disease such as asthma, COPD, emphysema, and chronic bronchitis. Proper nursing assessment skills are critical in determining the severity of a patient's illness, the knowledge of what medical care can be provided on-site, or the recognition that the patient needs a higher level of care for the best patient outcome. This session will focus on the best nursing practices for lung sound assessment, recognizing potentially life threatening events, provision of appropriate treatment for respiratory issues, the importance of re-evaluations, and the appropriate documentation of all findings and treatment provided.

Educational Objectives

• Describe normal and abnormal lung sounds
• Identify the components of a comprehensive nursing lung sound assessment
• Discuss appropriate treatments for common lung ailments

Level Basic

This presentation will outline the treatment and management of transgender, gender dysphoric, and intersex individuals within the Florida Department of Corrections. Case studies will be used to present methods, findings, and conclusions. Attendees can expect to gain insight into this challenging and complex patient population.

Educational Objectives

• Cite the diagnostic criteria for gender dysphoria
• Define the process of evaluation of gender dysphoria
• Describe the management of transgender, gender dysphoric, and intersex incarcerated individuals

Level Intermediate

Providing effective medical and mental health care is critical in corrections. This session will take the audience through a case study of a large jail operation that was struggling to provide care at the levels they expected. NCCHC Resources worked with the agency and medical team to identify challenges and opportunities for improvement. Learn about the collaborative effort that improved the quality of medical and mental health care and how long-term monitoring provided assurance that the new level of care would be maintained.

Educational Objectives

• Outline a case study of a large-scale quality improvement initiative at an urban jail
• Describe how to assess current operations, identify deficiencies, and implement improvement strategies
• Discuss the benefits of long-term monitoring of health services

Level Intermediate

Many correctional facilities across the country are seeking vendors to provide full-service medical, mental health, and pharmaceutical services to their incarcerated populations. This presentation will review the process of writing of a request for proposal (RFP) for a complete health services program as well as the critical elements that should be considered before selecting a vendor. The speakers - representing security, risk management, clinical, and medical administration - are excited to share the lessons they learned through writing an RFP and help prevent attendees from "reinventing the wheel."

Educational Objectives

• Examine why a diverse and multidisciplinary team is necessary in creating an effective health services program
• Discuss areas of a health services program that must be considered when writing an RFP
• Review the important lessons learned during the presenters' experience creating an RFP

Level Basic

This presentation will focus on how correctional health care programs can use Clinical Decision Support and Disease Registries to improve communication, safety, prioritization, identification of population trends, and longitudinal management of individuals who have Hepatitis C. Using CDS and DR provide increased value by improving safety, effectiveness, and efficiencies.

Educational Objectives

• Describe the advantages of using external Clinical Decision Support
• Express the benefits of customizing internal Clinical Decision Support
• Discuss the value of Disease Registries

Level Intermediate

Of the 9 million people released from jails each year, about two-thirds are rearrested within three years. In this session, participants will learn about an Indiana program that focuses on the individuals' whole health needs while incarcerated and equips patients with the tools and resources necessary to positively contribute to their families and communities upon release. To date, the recidivism rate for participants in this program is less than half the national average.

Educational Objectives

• Describe programming and approaches to treatment that are proven to reduce recidivism
• Explore ways the criminal justice system can enhance focus on treatment rather than punitive measures
• Discuss the necessity for continuity of care, or bridge services, as individuals transition back to the community

Level Intermediate

Early evaluation of patients with chest pain can be challenging. The patient’s history, presentation, chief complaint, and initial EKG interpretation must guide decisions
regarding the necessary workup. Having a low threshold for obtaining an initial EKG leads to precise and efficient decision
making. Minutes count in the treatment and timing for heart muscle recovery in the setting of acute ischemia.

Educational objectives 
• Review pathophysiology and etiology of acute ischemia
• Discuss current standards for treating acute chest pain regarding concern for acute ischemia
• Describe EKG changes that could be concerning for a patient with chest pain

Level: Intermediate

Orienting new correctional health nurses consistently across multiple facilities can be very challenging. This session will discuss a collaboration between clinical and operations departments to improve nursing orientation using a blended format of live and virtual courses, self-directed learning, and in-person training. The speakers will discuss how the program significantly improved retention, engagement, and satisfaction, and explain how education design was used to address the challenges of orienting new nurses from all levels and backgrounds.

Educational Objectives

• Discuss goals and barriers to effective nursing orientation in correctional settings
• Describe the education design process
• Differentiate between different types of educational materials and their uses

Level Intermediate

Learn about the important role of supportive psychotherapy for people who are incarcerated. The presenters will provide practical knowledge based on current evidence-based practices and share how mental health practitioners can strengthen the supportive relationship and apply supportive psychotherapeutic communication methods, educational and directive techniques in working with their patients. We will also discuss adaptations of supportive psychotherapy to special populations, such as those who are seriously mentally ill and those with post-traumatic stress conditions.

Educational Objectives

• Review the main types of psychotherapy commonly used when working with incarcerated individuals
• Define supportive psychotherapy
• Distinguish the adaptations of supportive psychotherapy to special populations found in correctional settings

Level Intermediate

Routine and invasive dental procedures can increase the risk of infection in the dental clinic and in the entire correctional environment. Dental personnel must be knowledgeable on vectors of transmission of pathogens in the clinic and how aerosolized particles and surface contaminants can cause disease. This presentation will explain modes of transmission, how to protect personnel from contracting or transmitting infections, and environmental control methods.

Educational Objectives

• Discuss the application of infection control laws, regulations, standards, and best practices
• Review the bloodborne pathogen standard in the context of prisons and jails
• Identify methods and equipment to reduce pathogenic microorganisms in the dental environment

Level Basic

The Washington State Penitentiary established a successful near miss reporting system, a method of reporting -- and correcting -- potential hazards before an adverse event occurs. Reporting is voluntary and can be confidential. Hazards reported can include unsafe acts, environment, or equipment. While major medical systems use near miss reporting systems, this is likely the first of its kind to be implemented in a large correctional facility. The result was a paradigm shift to a just culture of inclusion, initiative, communication, ownership, trust, and proactively working for safety.

Educational Objectives

• Define a near miss reporting system
• Describe the steps to implementing a near miss reporting system
• Outline the benefits of a near miss reporting system

Level Basic

This presentation takes a unique and realistic view of the potential hazards of working in corrections, while at the same time empowering correctional professionals to develop self-awareness and purpose, tapping into areas of personal resiliency. Sadly, professionals can find themselves faltering, even losing sense of self beyond their career, unable to relate to those not involved in the field, relating more to dark humor, and becoming physically and emotionally unwell. This multifaceted problem has a direct impact on mental and behavioral health. Participants will learn about behavioral changes they can engage in to improve overall wellness, as well as available supports to assist in times of crisis.

Educational Objectives

• Identify body cues and what they could mean for individual health and well-being
• Review the long-term effects of chronic and cumulative stress
• Create a personal "treatment plan" in preparation for times of stress and crisis

Level Basic

Up to one-quarter of individuals in criminal justice settings have an opioid use disorder. Medications for opioid use disorder, including buprenorphine, methadone, and naltrexone, are an effective treatment for individuals diagnosed with OUD. Previous literature has shown that such treatment is underutilized, but until now the association between specific geographical and institutional characteristics and the provision of MOUD has not been investigated in-depth. Learn about the role of geographical area, population density, facility type, and institutional characteristics in whether a facility provides MOUD based on a recent nationwide survey.

Educational Objectives

• Review current evidence in support of medications for opioid use disorder in correctional facilities
• Discuss significant associations between the provision of MOUD and demographic variables
• Explore the research findings' implications on expansion of access to MOUD in corrections

Level Intermediate

To meet the increased needs of aging and infirm incarcerated persons, the Delaware Department of Corrections implemented a Patient Companion Program, a home health aide education program to teach incarcerated persons how to provide assistance to patients within the facility. Under the watchful eyes of health care and custody staff, these trained individuals are employed in the infirmary and specialized housing units to aid those who require assistance with activities of daily living, reading, letter writing, or overall companionship. The presenters will showcase the positive aspects of the program for the patients, companions, and staff, while also discussing the challenges involved.

Educational Objectives

• Discuss the importance of NCCHC Standard C-06 Inmate Workers
• Distinguish between Certified Nursing Assistants and home health aides
• Analyze the program's positive impact on the incarcerated individuals involved, custody, and health care staff

Level Intermediate

How many nurses are told to take a "hands off" approach to care? This is contrary to nursing education and illustrates one example of an ethical dilemma correctional nurses face daily. This roundtable will focus on evidence-based actions that nursing and correctional administrators can use to address ethical issues to increase moral resilience in staff. Using ethical principles and evidence-based practices, the audience will learn practical, interdisciplinary approaches to promote moral resilience.

This discussion will provide counsel and physician perspectives in best practices to defend lawsuits. We will cover charting and documentation issues, witness and testimony concerns, as well as case valuation from two different perspectives. Attendees will see how claims and lawsuits are viewed from the different perspectives and how claims can be resolved.

As state hospital waitlists continue to grow, there is a crisis of overpopulation of mental health patients confined in the jail system with nowhere to go. For patients deemed incompetent to stand trial, their case is at a standstill until they can be restored to competency. The introduction of a jail-based competency restoration program has been a viable solution in the Harris County Jail, one of the largest detention facilities in the state. This presentation will focus on the development and implementation of Harris County's JBCR and discuss the factors contributing to its over 90% success rate.

Many musculoskeletal problems, particularly hip pain evaluation and management, can appropriately be managed in the primary care settings of correctional medicine. Improving providers' scope and confidence will give patients quicker and closer care while also improving efficiency. This session is appropriate for clinical providers and for administrative professionals who wish to learn more about musculoskeletal issues that can appropriately be managed inside the walls .

Educational Objectives

• Review the many diagnostic categories that can cause hip pain
• Describe what can be done within the primary care setting and when it is appropriate to refer
• Discuss ways to promote the advancement of musculoskeletal care in correctional facilities

Level Intermediate

A meaningful nursing preceptorship program supports nursing retention by improving the onboarding process for new hires. The program also is an opportunity for experienced nurses to give back to the nursing profession by helping new team members begin their correctional nursing journey on the right foot. The presenters' program uses a blended (virtual and live) format. Attendees will learn the essential elements for building a successful and effective preceptorship program in a correctional setting.

Educational Objectives

• Describe the role and responsibilities of a nursing preceptor
• Delineate the skills necessary to be a successful nursing preceptor
• Explain how the blended learning module enhances the learner's experience

Level Basic

While more common in correctional settings than in the community, Borderline Personality Disorder in males is underdiagnosed even in this setting. This presentation will explore the criteria for BPD and how these criteria manifest in a correctional setting; present current concepts about the biologic and genetic origins of BPD; and explore ways to adapt treatment modalities for BPD used in the community to correctional settings.

Educational Objectives

• Contrast Borderline Personality Disorder with Antisocial Personality Disorder
• Debate the neurobiologic underpinnings of Borderline Personality Disorder
• Express ways in which community paradigms for treatment of BPD can be adapted for correctional settings

Level Intermediate

In a time when lawsuits against correctional facilities abound, defensive practice is critical. The antidote to deliberate indifference is consistent, appropriate medical care from conscientious health care personnel who understand the incarcerated population as well as the resources and limitations of the facility. This presentation examines common processes that are most vulnerable to litigation, including receiving screening, responding to sick call requests, identifying and responding to medical emergencies, and the sharing of "need to know" information with custody staff, while explaining how to develop best medical decisions that can help keep correctional health care immune to litigation.

Educational Objectives

• Recognize medical issues that commonly lead to risk and liability
• Identify preventive quality control initiatives that are safe and practical
• Interpret current trends in correctional health care litigation

Level Intermediate

Workplace bullying is harmful, targeted behavior that happens at work and is more prevalent than you think. As health care providers working in correctional facilities, nurses may get bullied by patients, correctional staff, and, unfortunately, other health care providers. This session will discuss different types of bullying, the physical and psychological effects on those bullied, and strategies to manage bullying in the workplace.

Educational Objectives

• Recognize different types of bullying
• Describe how bullying can affect one's health and well-being
• Identify strategies to manage workplace bullying

Level Intermediate

Diagnostic excellence is much more than being well-trained and having extensive knowledge. This presentation will walk the audience though the process required to assist in diagnostic excellence, a skill set centered around four steps that require not only sound thinking but also a critical awareness of how you as an individual clinician think: metacognition. Case examples, specific disease entities, and metrics will be used to support these steps and six domains of the diagnostic process

Educational Objectives

• Identify the four steps of diagnostic excellence
• Define metacognition and its role in diagnostic excellence
• List the six domains of the diagnostic process

Level Advanced

Incarcerated people who are seriously mentally ill can be exceptionally disruptive to a correctional system and require tremendous institutional time and effort to manage.  In addition, the traditional custody responses to such disruptive behavior frequently puts the patient and the deputies at increased risk for harm.  This talk presents the development and the impact of an evidence-based practice of incorporating corrections-specific Crisis Intervention Team training program into a high-acuity mental health unit and the long-term benefits to the patients, the deputies, the mental health staff, and the institution. 

Educational objectives

• Describe the components of a corrections-specific Crisis Intervention Team curriculum
• Identify the steps to implement a Crisis Intervention Team program in a correctional facility
• Discuss the benefits of training deputies to use Crisis Intervention Team techniques when managing mentally ill patients

Level: I

High-quality nursing assessments and documentation skills can be difficult to maintain, especially when using electronic health records. This presentation is a refresher on what is important to document in nursing encounters, knowing you might be reading it as the only source of information three years later in court, and will include a discussion of licensure and clinical responsibility.

Educational Objectives

• Discuss the objectives of nursing documentation
• Describe appropriate documentation based on the totality of the circumstances
• Differentiate between the types of documentation required for various nursing encounters

Level Basic

Catatonia is an underdiagnosed clinical syndrome characterized by psychomotor disturbances that can range from immobility and mutism to agitation and autonomic dysfunction. It is associated not only with psychiatric illness, but also with medical and neurological conditions. In this presentation, a case report of a male with a previous diagnosis of schizophrenia who presents with catatonia on a forensic mental health unit will be used as the springboard for a discussion of catatonia's various presentations, special considerations for diagnosing this condition, and treatments including benzodiazepines and electroconvulsive therapy.

Educational Objectives

• Describe the common signs and symptoms of catatonia
• Differentiate catatonia from other conditions with similar presentations
• Discuss barriers in treatment of catatonia

Level Intermediate

Are you sure that every NCCHC standard and compliance indicator is mentioned in your policies and procedures? Do your P & P have a different numbering/naming convention than the corresponding standards numbering? Do you struggle with sometimes finding standards information in your P & P? If you answered yes to any of these questions, a P & P crosswalk would be an invaluable tool for your health services team and upcoming NCCHC surveys. This session explains why and when a P & P crosswalk with NCCHC standards is important, how to set it up, and how to maintain it going forward.

Educational objectives
• State why and when a policies and procedures vs NCCHC standards crosswalk is beneficial
• Describe how to create a policies and procedures vs NCCHC standards crosswalk
• Discuss how to maintain the crosswalk

Level: Basic

While substance use disorders among women have risen for decades, treatment and recovery services designed initially for men do not necessarily support women, especially those who are pregnant or parenting and have an opioid use disorder. Presenters will discuss research surrounding women who are pregnant, postpartum, and experiencing a substance and opioid use disorder; explore the intricacies of substance use disorders related to pregnant and postpartum women and their newborns; and present evidence-based, best-practice, and gold standard treatment, recovery, and supportive services for this vulnerable population.

Educational Objectives

• Define substance use disorder and the potential complications for infants born to women with SUD
• Identify gaps and barriers to recovery services for pregnant and postpartum women
• Analyze why this subset of people with substance use disorders requires a long-term and potentially medication-assisted approach to treatment

Level Basic

Mitigating the impact of incarceration on housing and employment after community return requires collaboration and coordination between correctional health, correction reentry, community health, and housing and employment services organizations. Learn how health IT solutions can facilitate collaboration, offer real-time access to resources, and share documentation to support a warm transition through case studies from national demonstration projects in New York, New Jersey, and Puerto Rico.

Educational Objectives

• Review how housing and employment challenges intersect with incarceration
• Discuss three evidence-based structural interventions to address community return
• Analyze an interactive functional assessment survey tool

Level Intermediate

Withdrawal from fentanyl has been characterized as more rapid and severe than from other opioids, leading to a higher risk of precipitated withdrawal during buprenorphine initiation. Grounded in the harm-reduction model, microdosing initiation protocols were developed to improve treatment retention and stabilization of patients due to frequent complications arising during conventional initiation protocols. This discussion will review the microdosing initiation protocol along with patient considerations and special populations.

The mission at ECHO (Extension for Health Outcomes) is to democratize knowledge and get best practice care to the underserved, including the incarcerated. Corrections administrators are challenged with limited health care resources, high rates of infectious diseases including hepatitis C, and the epidemic of opioid addiction. ECHO is an ideal model to improve health care and provide education for medical staff and the incarcerated. The model allows for rapid learning and best-practice dissemination. 

This session will discuss a virtual Medication Assisted Treatment (MAT) program that is used in the several jailsand is integral for jail-to-community transition programs. Attendees will learn how the program was developed inclusive of sample assessment and treatment tools, MAT determination processes for long-acting injectables, tracking and reporting systems, on-site MAT injectable/oral medication procedures, on-site medical staff training, discharge tools for tracking, referral and jail-to-community processes and referral systems for continuity of care and medication consistency.

Presenters will discuss how they implemented a trauma-informed treatment program for incarcerated individuals that had the state’s best success rates. This program was highlighted in the Fall 2022 issue of CorrectCare.

A medication room audit is a routine activity usually performed by a pharmacist to ensure that processes and the environment are optimized to allow consistency without failure. This presentation will help the audience understand medication room audits standards from multiple perspectives: surveyor, manager, and front-line staff. Better understanding of the expectations and the process will enable health professionals to use the audit to establish expectations for best medication practice in both routine and emergent situations. Common noncompliance findings will be reviewed and analyzed to determine reason for the failure, and troubleshooting tips will be shared.

Educational Objectives

• Summarize medication room audit standards
• State goals for a medication room audit
• Analyze reasons behind common noncompliance findings

Level Intermediate

Pregnant women have a host of challenges when incarcerated. Their pregnancies are frequently complicated by mental health issues, substance use disorders, poor health, poor nutrition, and lack of prenatal care. There are additional health risks while in corrections due to restraints, substance abuse management, and inadequate staff training. Focusing on obstetrical challenges in the prenatal, labor and delivery, and postpartum periods will better equip participants to improve outcomes for incarcerated mothers and their infants.

Educational Objectives

• Describe the challenges of obstetrical care in corrections during the prenatal, labor and delivery, and postpartum periods
• Identify methods to meet the challenges of obstetrical care in corrections
• Debate restraint use for pregnant and postpartum women

Level Intermediate

Treating severe behavioral problems in corrections is a critical job for correctional mental health professionals -- and one of the most daunting. Evidence-based treatment programs designed specifically for a correctional population are lacking. In this session, the presenter will review the use of a group milieu treatment for impulse control and high-risk behaviors within a correctional setting, detail a study investigating its effectiveness, and discuss strategies for establishing outcome-based studies in corrections.

Educational Objectives

• Describe the use of skills-focused treatment for behavioral and emotional dysregulation disorders
• Explain the need for evidence-based research in corrections
• Identify strategies for incorporating outcomes-based research into clinical practice

Level Intermediate

Depositions are typically described as stressful experiences, but few individuals are adequately prepared to provide testimony in a deposition. Attendees will gain an understanding of deposition basics and general guidelines to be followed by the deponent. The session will feature a deposition-simulation question-and-answer format using audience participation to demonstrate the challenges and pitfalls of attorney questioning, and will share strategies that can increase the likelihood of a successful deposition.

Educational Objectives

• List the nine basic rules to follow when you are deposed
• Name at least two goals of attorneys during a deposition
• Describe at least two common pitfall questions and a strategy to answer each

Level Basic

The presenter will discuss how the Network Palliative Care Model of Care set out to provide patients with end-of-life and palliative care based on their individual needs while also providing clinicians with the necessary skills and knowledge to provide high-quality care. Due to the unique challenges of correctional health care, the program was not able to simply adopt existing community models of care but rather developed a collaborative evidence-based model and care pathway for palliative care within correctional settings.

Educational Objectives

• Identify key actions implemented by the Network Palliative Care Model of Care
• Describe the program's palliative care patient criteria
• Discuss the Palliative Care Model of Care components and tools

Level Basic

Historically, the Indiana Department of Correction Parole Services used a compliance-based model to address violations relating to substance use disorder, mental health, and physical health concerns with their formerly incarcerated clients. The IDOC Transitional Healthcare Team under IDOC's medical division and Centurion Health implemented a holistic approach and expanded access to care in the community to reduce Parole Services' justice responses to these challenges. Current IDOC parole violation data demonstrate a significant decrease in returns to the Indiana Department of Correction by emphasizing care continuity and barriers related to social determinants of health.

Educational Objectives

• Summarize the Indiana Department of Correction's Transitional Healthcare model
• Examine the correlation between recidivism and social determinants of health
• Evaluate the benefits of Transitional Healthcare within a community supervising agency

Level Intermediate

The "Sick Call" model was developed for young healthy military personnel, not for an incarcerated population in which patients seeking help for episodic problems are generally much sicker with more complex needs. At the same time, most correctional institutions only minimally engage nurses in the treatment of chronic care. In this session, the speaker will argue that the current basic structure of medical care delivery in corrections is upside down and will challenge attendees to consider a very different, but more logical, structure for prison and jail ambulatory care.

Educational Objectives

• Verbalize how the current care delivery model in most facilities fails to make optimal use of the clinical strengths of its nurses and practitioners
• Describe the key components of a new practice model that leverages the clinical strengths of nurses and practitioners
• Explore ways to redesign the medical care delivery system in one's own facility

Level Advanced

As the largest group of health care professionals caring for individuals with complex physical and psychosocial needs, nurses play a key role in correctional settings. Research indicates that a standardized new hire orientation process is key to promoting a positive work environment and retention among correctional nurses. Participants will learn specific strategies to improve correctional nurse orientation based on a county jail process improvement project, deepen their understanding of why nurse orientation in correctional settings is critically important, and explore actions needed to implement improvements within their own agency/institution.

Educational Objectives

• Outline reasons that providing a thorough orientation is critically important for new correctional nurses
• Describe four specific strategies used to improve correctional nurse orientation
• Formulate a plan to apply least one nurse orientation improvement strategy

Level Basic

In 2015, the California Department of Corrections and Rehabilitation (CDCR) became the first agency in the country to adopt a policy for incarcerated transgender individuals to request and be evaluated for gender affirming surgery (GAS). This presentation will review legal events that influenced CDCR’s review process, GAS procedures that can be requested, and the GAS MH Evaluation template, including a depersonalized evaluation. 

Educational Objectives

• Review community and correctional standards influencing transgender care.
• Discuss CDCR’s policies for approving and processing GAS requests
• Describe CDCR’s GAS Mental Health Evaluation

Level Intermediate

NCCHC has formed an ad hoc Committee on Systemic Racism in Correctional Health Care with the goals of identifying how racism toward black, indigenous, and people of color (BIPOC) manifests in our work environments and its many negative impacts, as well as identifying ways to chip away at racism and improve our patients’ well-being. Our work will involve gathering data and developing communication and educational strategies. To better direct our activities, we are hosting a second open forum to invite input from the field and to build on our discussion from the open forum at the 2022 NCCHC Spring Conference.

Learning Objectives:

• Discuss causes of systemic racism in correctional health care
• Describe how it impacts systems and individuals, incarcerated and not
• Explore ways to reduce racism in our work settings

Level: Basic

Sexually transmitted infections are a significant health challenge within the U.S., particularly among the incarcerated, who represent a population with high rates of STIs. The Centers for Disease Control and Prevention 2019 data report revealed STIs reached a new all-time high for the sixth consecutive year with more than 2.5 million documented cases of chlamydia, gonorrhea, and syphilis. The presentation will cover updates on STI screening and management detailed in the CDC 2021 STI Treatment Guidelines, changes in STD regimens, new test of cure recommendations, retesting, and follow-up strategies.

Educational Objectives

• Discuss updated STI screening recommendations from the CDC 2021 STI Treatment Guidelines
• Outline new diagnostic and treatment regimens for STI management
• Describe updates in follow-up strategies to optimize STI monitoring

Level Advanced

Correctional systems must continue to improve their testing and treatment strategies for HCV infection to help achieve the goal of eradication in the United States. In this session, you will hear how the Virginia Department of Corrections has utilized pharmacist clinicians to expand testing and treatment of HCV. VADOC now offers opt-out testing to all patients during entry and opt-in testing for all releasing patients, and a pharmacist-led HCV treatment program uses telemedicine to treat patients statewide. Learn how instrumental pharmacists can be in advancing health care, specifically in corrections.

Educational Objectives

• Identify barriers to Hepatitis C treatment within corrections
• Review strategies for implementing a pharmacist-led HCV collaborative practice
• Assess opportunities for advancement within the treatment of HCV in corrections

Level Intermediate

Because the correctional environment is highly focused on security and professional practice, adherence to nursing standards and scope of practice are often less emphasized and receive limited attention. A nursing framework will strengthen nursing practice and support nurses and nurse leaders in in articulating the role of nursing and its relationship to patient care. The framework will guide professional nursing practice and improve the health outcomes of our patients. This presentation will inform health administrators, nurses, and correctional leaders on the benefit of a proposed correctional nursing framework.

Educational Objectives

• Discuss the importance of a framework on nursing practice and quality outcomes
• Identify four basic concepts central to the discipline of nursing
• Describe Muse's Framework for Correctional Nursing and an approach to implementation

Level Basic

Incarcerated women, who commonly have a history of trauma, are at risk for several adverse consequences. Untreated trauma can hinder a smooth transition back into the community and negatively impact mental health. By practicing trauma-informed care, a more conducive environment can be built that strengthens the clinician-doctor relationship, facilitates a safe space, provides specialized services, and prepares them for life outside the walls. Attendees will learn what the New Jersey Commission on Women's Reentry is doing to ensure trauma-informed care for women even before they leave confinement.

Educational Objectives

• Discuss the post-reentry benefits of trauma-informed care for women
• Define retraumatization
• Discuss how past trauma can affect the patient-provider relationship

Level Intermediate

Nearly 60,000 youths are incarcerated in juvenile corrections in the U.S., many with serious mental health needs. Though these numbers vary by state, what remains consistent are the significant racial, ethnic, and cultural disparities, highlighting the need for high quality culturally sensitive services and supports. In addition to skills like openness, self-awareness, egoless, and critique, the Write on Race cultural humility training includes treating identities as assets, empathy and interdependence, self-advocacy, and social activism. This presentation will explore the benefits of the Write on Race cultural humility training for mental health providers within juvenile corrections.

Educational Objectives

• Describe the main tenets of cultural humility
• Discuss the importance of cultural humility within the correctional setting
• Identify specific strategies to practice and improve cultural humility

Level Intermediate