While combination antiretroviral therapy has made a huge difference in treatment of HIV, many people living with HIV are still undiagnosed or diagnosed late. This is especially true of incarcerated people, who, due to factors like poverty or homelessness, may not have access to health care. Further expansion in HIV treatment options, incorporating women-centered approaches, is essential to make individualized care a reality. With longer life expectancies, people living with HIV are at increased risk of developing non-AIDS comorbidities, such as cardiovascular diseases and cancers. Antiretroviral strategies are evolving toward a decrease in drug burden, and some two-drug combinations have proven efficacy for maintenance therapy. Investigational immune checkpoint inhibitors and broadly neutralizing antibodies with effector functions have energized the HIV cure research field as the search for an effective vaccine continues. This session will discuss the latest treatments for HIV, developing individualized care, and non-AIDS comorbidities.

Learning objectives:

• Discuss the use of combination antiretroviral therapy to treat HIV
• Explain the elements needed to develop individualized care programs and special issues faced by female patients
• Identify non-AIDS comorbidities that people living with HIV may develop

The speaker will review basic long-term monitoring of the cirrhosis patient and the new AASLD guidelines on malnutrition, frailty, and sarcopenia. Discussion will include complications seen in cirrhosis patients such as ascites, varices, encephalopathy, and hepatocellular carcinoma, as well as newer information on palliative care and nutrition.

Educational Objectives

• Describe the long-term complications associated with cirrhosis
• Review the new AASLD guidelines on malnutrition, frailty, and sarcopenia
• Discuss how to monitor and address N-stage progression to transplant criteria

Level  Advanced

The speakers will present nursing practice case studies that have the potential of becoming criminal in nature and invite the audience to identify scope-of-practice issues that were adhered to or violated. All will brainstorm on prevention strategies and mitigation strategies to keep patients out of harm's way. Legal and ethical resources available to nurses will be shared.

Educational Objectives

• Analyze two case studies for potential violations of nursing standards of care
• Identify strategies that can prevent or mitigate violations in nursing practice
• Discuss legal and ethical resources available to nurses in any practice setting

Level Intermediate

Fetal alcohol spectrum disorders are a common disability in incarcerated populations and often go unrecognized. We will review the impact of prenatal alcohol exposure on brain development and how it presents in adults and adolescents. The focus will be on identifying individuals who are likely to have an FASD and how to address their behavior problems in custody, as well as how to educate the individual about their disability.

Educational Objectives

• State the impact of prenatal alcohol exposure on brain development and how FASD is recognized
• Describe disabilities and associated behaviors related to prenatal alcohol exposure
• Explore strategies to decrease behavior issues in custody

Level Intermediate

A growing consensus within the medical community is that medication-assisted treatment is the standard of care for substance use disorders, yet MAT is not widely available in corrections settings. Courts are also trending toward acceptance of MAT as a required component of constitutionally adequate care. Thus, the legal landscape suggests that litigation liability from failure to provide MAT may soon become indefensible.

Educational Objectives

• Review the basics of medication-assisted treatment
• Describe the benefits and burdens of providing MAT
• Examine the legal liability of failing to implement MAT programs

Level Intermediate

We will discuss real-life cases concerning pregnant patients and the history of failed assessments that resulted in fatality of the mother and/or infant, with emphasis on the need to use the most appropriate screening and assessment tools and to adhere to the NCCHC standards related to care and maintenance of pregnant patients. A brief but substantive discussion will address legislation surrounding the shackling of pregnant detainees and the threat it creates for her and her unborn child.

Educational Objectives

• State the importance of using the most proper assessment for pregnant patients
• Discuss common issues associated with pregnant patients, including substandard medical and mental health care
• Determine the best methods to ensure compliance with the NCCHC accreditation standards with regard to pregnant patients

Level Intermediate

As facilities seek accreditation for juvenile or mental health services, staff may be unfamiliar with the NCCHC standards or accreditation process. This workshop will provide options for a preparation plan that meets facility needs and will also be useful for facilities that lost key staff between surveys. Topics will include how to engage staff, reviewing and cross-walking standards to ensure compliance indicators are addressed, continuous quality improvement, disaster drill planning, policy/procedure reviews, and conducting walk-throughs.

Educational Objectives

• Identify three activities focused on engaging staff, individually and as teams, in the accreditation preparation process
• Summarize a continuous quality improvement process and how to present a CQI study
• Evaluate the content and organization of health records with regard to standards' compliance indicators

Level Basic

Current treatments for schizophrenia are efficient for about only half of patients. In addition, they involve severe neurological and metabolic side effects and can lead to reduced patient cooperation and compliance. New long-acting injectable therapies can increase compliance for individuals with schizophrenia during incarceration and as they transition to community care settings. In addition, new views of the biology of schizophrenia are converging with novel drugs targeting brain mechanisms that might treat symptoms in different ways. This program will review brain science and current and future treatment options to reduce exacerbation of illness and recidivism. 

Educational objectives
• Describe current treatment strategies for patients with schizophrenia
• Discuss the future direction of schizophrenia treatment
• Explain the impact of targeted pharmacotherapy on recidivism and integration into community treatment

Made possible by an educational grant from Alkermes.

Pharmacist-managed anticoagulation clinics are critical for improving therapeutic outcomes in any health care system. We will discuss a collaborative approach that identifies patients for whom anticoagulation (warfarin) therapy is indicated. It bridges gaps in care in this vulnerable population. This initiative led to development of DVT protocol used by the medical providers. Results have shown significant optimization of anticoagulation care while reducing adverse effects, ER usage, and mortality.

Educational Objectives

• Compare and contrast anticoagulation management in the community and the correctional setting
• Describe a clinical pharmacist anticoagulation management service collaborative practice agreement
• Evaluate Warfarin dosing using current guidelines and lessons learned

Level Intermediate

Correctional nurses are often called upon to evaluate and triage dental emergencies. We will review common dental emergencies and outline appropriate management of these events, with particular attention to signs and symptoms of jaw fracture and recognition of fascial space infections of the head and neck region. We will also distinguish between true emergencies requiring immediate treatment and urgent issues that can wait until normal clinic session.

Educational Objectives

• Review clinical presentation of common dental emergencies seen in a correctional setting
• Delineate situations when the patient can wait to see the dentist and those that require a trip to the ER
• Demonstrate management of common dental emergencies

Level Intermediate

This model for managing people with severe mental illness in a mega-jail setting can work in correctional systems of any size. Key components: collaborative teamwork between custody and mental health; population management of inmates with SMI that begins with classification; segregated housing that optimizes greater freedom of movement and socialization in support of mental health treatment; conjoint suicide/crisis prevention; and programming to promote self-responsibility without impacting staff safety.

Educational Objectives

• List the key elements of collaboration between custody and mental health
• Describe the advantages of dormitory-style housing units for people with SMI
• Discuss the challenges in the effective integration of mental health, medical, and custody

Level Basic

As the first interaction between an inmate and medical staff, intake screening is critical. Appropriate intake presents an opportunity to flag both acute concerns, such as intoxication, and chronic issues like hypertension and behavioral abnormalities. Analyzing the process reveals the strengths and weaknesses of the staff and the facility and can highlight potential areas of liability.

Educational objectives:

• Recognize medical concerns at intake that require immediate intervention
• Define disabilities and chronic conditions identified at intake that require follow-up
• Identify the aspects of intake that lead to risk and liability

Level: Basic

Level: 

Throughout the COVID-19 pandemic, few things were made as clear as the importance of vaccination. While much attention was placed on COVID-19 vaccination, the vaccine landscape, as a whole, has continued to evolve with new vaccines and updated recommendations. Discussion participants will gain a better understanding of the newest vaccine approvals, updated vaccination recommendations, and how they can apply to the incarcerated population.

Educational objectives:

• Identify the various vaccine types and the basics of vaccine-induced immunity
• Discuss vaccination of incarcerated individuals from a public health perspective
• Review the ACIP vaccination recommendations as they apply to the incarcerated population

Level Intermediate

Lean Six Sigma is a process improvement methodology that can be employed to improve patient safety and quality of care. This talk will explore how to use this quality improvement method to address a correctional health care issue. Participants will learn the background of a problem related to medically supervised withdrawal patients and will review the results, methods, and outcome of a quality improvement project conducted to improve this process.

Educational Objectives

• Discuss the basis of the Lean Six Sigma quality improvement methodology
• Describe how Lean Six Sigma can be applied to health care problems
• Examine the results, outcome, and conclusion of the example quality improvement project

Level Intermediate

We will discuss the challenges and limitations faced while treating a 30-year-old male with major depressive disorder with psychotic features who severely restricted food and drink with resultant life-threatening weight loss. He refused to consent to medical and psychiatric treatments and interventions. We outline the clinical course and the care coordination among various medical, psychiatric, and correctional staff that resulted in a positive outcome for the patient.

Educational Objectives

• Discuss the important medical complications associated with prolonged starvation in a patient exhibiting psychosis
• Review the Washington state Department of Corrections policy for involuntary hydration and tube feeding
• Describe the multidisciplinary team approach to providing effective medical and mental health treatment

Level Advanced

Curable in early stages, colorectal cancer is the second leading cause of cancer mortality. While GI cancers are still a disease of aging, the increased incidence of colorectal cancers in younger patients has prompted a change in current screening age recommendations.  The session will discuss the high-risk populations that require colonoscopy and the importance of other tools like family history and physical exams. In addition, the presenter will discuss how certain patients can benefit from immunotherapy, rather than standard chemotherapy.

Educational Objectives: 

• Identify the appropriate screening methods for different patient types
• Recognize the clinical signs that support early detection
• Review therapies for GI cancer

Level: Intermediate

Many traditional interventions and even relatively recent innovations for managing wounds are inconsistent with the evidence and underlying pathophysiology. This presentation aims to guide attendees in adopting a paradigm shift to drive fundamental changes in approach. We will provide a foundation for evaluating which practices are undesirable, discuss the strength of the evidence, and describe effective alternatives.

Educational Objectives

• Distinguish between high bioburden, inflammation, and infection
• Identify at least one wound management protocols that recent research shows actually increases the risk of infection
• Summarize current best practices for wound management protocols

Level Intermediate

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, states criteria for a diagnosis of gender dysphoria. We will review these criteria and the World Professional Association for Transgender Health Standards of Care. The 5th Circuit and 9th Circuit Courts of Appeals have issued conflicting findings about gender confirmation surgery, increasing the likelihood that the Supreme Court will address the question. We will review these and other legal cases.

Educational Objectives

• Review the DSM-5 diagnostic criteria for gender dysphoria and for disorders that require consideration as alternative explanations for the patient's presentation
• Review the World Professional Association for Transgender Health Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People
• Examine the current state of litigation over gender confirmation surgery throughout the United States

Level Intermediate

When a health care surrogate is selected by the patient or appointed by a court, they have legal rights and obligations that impact your practice. Using real world examples, we will explore how interaction with a health care substitute can benefit the provider and result in the best patient outcomes and, conversely, how to handle a proxy who does not act in the patient's best interests. Learn how to recognize when your patient needs a surrogate and how to obtain one.

Educational Objectives

• Outline the legal principals underlying the right to make our own medical decisions
• Explain the differences between health care surrogates who are selected by the patient versus appointed by a court
• Discuss how to recognize when a patient needs a health care surrogate and how to obtain

Level Intermediate

Comprehensive correctional, public health, and community collaborations are essential to address the myriad health and social needs of people entering and exiting correctional facilities. Evidence-based approaches demonstrate benefits of establishing strong interdisciplinary collaborations. Teams of physicians, nurses, social workers, and case managers, based in both correctional and community settings, facilitate continuity of care and services using a collaborative, warm transition approach for people returning home after incarceration. Recommendations for a more comprehensive system are discussed.

Educational Objectives

• Identify facilitators and barriers to correction to community collaborations from the perspective of each discipline
• Apply implementation science methodology to address barriers from the perspective of each discipline
• Examine the impact of collaboration on key outcomes for people with criminal/legal histories

Level Intermediate

During this session, CDC will present current recommendations for vaccination, testing and management of HIV, viral hepatitis, STDs, and TB, highlighting their application in correctional settings. Presenters will share data on emerging epidemiologic trends in these disease areas, as well as tools and resources available to help facilities implement CDC recommendations.

Educational Objectives

• Discuss current epidemiologic trends related to HIV, viral hepatitis, STDs, and TB
• Explain how vaccination, testing, and treatment for these diseases contribute to the health of incarcerated populations and the community
• Apply CDC recommendations and tools for prevention and management of HIV, Viral Hepatitis, STDs and TB infections in correctional settings

Level Basic

Most women who are incarcerated have experienced gender violence such as intimate partner abuse, rape, sexual assault, harassment and exploitation, human trafficking, and child abuse. Evidence-based psychological interventions are most successful when they use a combination of trauma, feminist, and behavioral techniques in group format. Many women find psychoeducation useful while learning to process, make connections with their own situation, and develop new skills that help them heal.

Educational Objectives

• Assess five forms of gender violence that survivors in prison display
• Describe psychological interventions that are effective in addressing the gender-related trauma experienced by incarcerated women
• Practice cognitive behavioral skills to reduce anxiety and depression displayed by survivors of interpersonal violence

Level Advanced

Point-of-care ultrasound is an innovative tool with applications that can quickly provide diagnostic images, resulting in rapid important clinical information and quality medical management. POCUS applications can be used in the workup of multiple disease conditions including trauma, gastrointestinal emergencies, musculoskeletal complaints, and dermatological conditions. The application in initial gastrointestinal foreign body evaluation, toxicology, or infectious disease could be extremely helpful in corrections. The session includes a live demonstration of common POCUS techniques.

Educational Objectives

• Review common POCUS procedures in the correctional medicine setting
• Identify potential innovations for POCUS procedures in corrections
• Explain common high-impact POCUS procedures

Level: Intermediate

The nursing team is essential to ensure patients receive access to care for nonurgent health care requests. With the staffing shortage and current pandemic, conducting sick call is even more challenging. In this follow-up to “What’s Inside the Box? Requirements for Setting Up an Effective Sick Call System” (2021 fall conference), we will present an overview of sick call options and invite discussion on how nurses can overcome barriers in meeting NCCHC sick call requirements.

Educational objectives

• Describe various systems for conducting sick call
• Discuss at least 3 nursing scope-of-practice issues related to sick call
• Identify at least two best practices related to managing sick call

This talk discusses research that focused on understanding how adults with chronic mental illnesses perceive behavioral health treatment, as well as what adaptations can be made to mental health delivery to this vulnerable population. Major findings were that validation and collaboration are effective forms of treatment, whereas ineffective care consisted of dehumanizing patients with their diagnoses and a lack of psychoeducation around diagnoses.

Educational Objectives

• Discuss the effects of stigmatizing adults with chronic mental illnesses
• State the importance of using person-centered language
• Identify ways to improve care for this vulnerable population

Level: Basic

In corrections, health care providers can be held liable for Section 183, “deliberate indifference.” This presentation will share real-world examples from federal courts of instances of deliberate indifference and how to prevent such a finding. Using case studies, attendees will learn what they can do to document appropriate practices or change practices to avoid a determination that their care evidenced deliberate indifference.

Educational Objectives:

• Define the criteria for a finding against a correctional care health provider in a section 1983 claim
• Summarize federal court rulings on acceptable evidence of deliberate indifference in correctional health care
• Identify what providers can change in training and charting to avoid a finding of deliberate indifference

Level: Basic

The California Conditional Release Program promotes public safety and successful reintegration of patients within the community through effective, comprehensive, and standardized outpatient treatment and supervision. CONREP is a distinctive program, focused on treating unique forensic populations (i.e., people paroled with mental disorders, found not guilty by reason of insanity, or found incompetent to stand trial) while ensuring community safety through treatment and monitoring, and gradual patient reintegration.

Educational Objectives

• Review California's conditional release program, including its history and the unique population it serves
• Describe the forensic treatment and supervision provided in CONREP with consideration of community safety concerns
• Examine the programmatic design of CONREP

Level: Basic

Presenters from the Centers for Disease Control and Prevention will discuss expanded correctional health activities at CDC. This session aims to expand CDC’s connections with experts in the field through a dynamic discussion. It will be interactive, and attendees will have opportunities to highlight their own facilities’ public health priorities to help inform CDC’s areas of focus beyond COVID-19.

Educational objectives

• Differentiate between disease-based and population-based approaches to correctional health
• Describe how local jurisdictions can collaborate with their state and local health departments and CDC to advance correctional health
• Discuss health-related best practices and challenges from other facilities

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.

Learning Objectives

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

Level: Basic

The prevalence of HIV in 2015 for incarcerated individuals was markedly higher than the 0.4% HIV prevalence in the general United States population. In addition, HCV infection disproportionately affects individuals in correctional institutions. Along with these two diseases, COVID-19 has affected corrections in rates greatly exceeding those in the community. Individuals with serious underlying medical conditions are at greater risk of severe illness from COVID-19. Given these disproportionate numbers, it is critical that correctional health professionals have the best information on screening, treatment, and prevention of HIV, HCV, and COVID-19.

Educational objectives

• Explain why correctional populations have higher rates of HIV, HCV, and COVID-19
• Identify comorbidities between HIV, HCV, and COVID-19 and areas of highest concern
• Discuss screening, testing, and treatment for HIV, HCV, and COVID-

Sponsored by an independent educational grant from Gilead Sciences

1 hour of CE. Refreshments and hors d'oeuvres will be served.

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 visuals 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:

• Describe the ocular symptomatology of diabetes, hypertension, and heart disease
• Discuss 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: Intermediate

Moral distress is the negative experience that occurs when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue. Presenters will discuss moral distress and its implications for correctional nurses and highlight contributing factors and mitigating strategies for reducing moral distress. This call to action is imperative for advancing correctional nursing as a specialty.

Educational Objectives

• Define moral distress in nursing
• Describe the impact of moral distress on and its implications for correctional nursing and correctional nurse leaders
• Discuss practical approaches that correctional nurse leaders may take to mitigate the impact of moral distress on correctional nurses and promote moral resilience

Level: Intermediate

Self-injurious behaviors are common but quite challenging for both health care and security staff. Distinguishing SIB from suicidality is difficult but often possible. Evaluations of SIB that incorporate classifying the type of SIB and identifying the underlying psychiatric diagnoses can significantly aid in the management and treatment of SIB. This session will explain assessment and management of SIB 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 SIB in corrections

Level: Intermediate

Expert witness review of medical and behavioral health documentation frequently reveals critical documentation deficiencies that needlessly expose providers to liability. Clinicians often fail to realize who the audience of their notes will be and how those future readers are likely to be oblivious to the context those providers work in and take for granted. Documentation of the exercise of judgment and decision-making at critical points of care saves careers.

Educational Objectives

• Explain the medicolegal relevance of the exercise of judgment and the use of phrases to document the exercise of judgment concerning provision of care
• Review how to concisely document informed consent, risk-benefit analysis, and patient ability (or inability) to self-advocate in the clinical record
• Describe the highest liability risk encounters and the types of questions reviewers often raise regarding the care provided

Level: Intermediate

Correctional officers are essential to opioid use disorder treatment programs for escorting patients to receive care, observing medication distribution, and alerting clinical staff to medical issues. This presentation will highlight OUD trainings for New Jersey jail and prison correctional officers. Training program goals are to educate officers on the science of addiction and the benefits of medications for OUD to improve quality of life and save lives.

Educational Objectives

State why educating corrections officers on OUD and MOUD is key to successful correctional MOUD programs

List the key components of a OUD and MOUD training program for corrections officers

Explore how OUD and MOUD educational activities for corrections officers can be initiated in one's own facility or system

Level: Intermediate

Correctional outpatient clinic performance may be hampered by fragmented care that can reduce access, ineffectively address longitudinal episodes, complicate communication across providers, and reduce quality of patient outcomes. The innovative adaptation of a gender-responsive and trauma-informed patient-centered medical home model in a correctional setting resulted in improved care access, provider performance, and patient outcome metrics. This model appears replicable, scalable, and amenable to additional patient safety and satisfaction metrics.

Educational Objectives

• Summarize the elements of patient-centered medical home models
• Examine how to apply quality improvement, performance monitoring, and patient satisfaction to practice management
• Explore population health management evaluation analytics

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 an open forum to invite input from the field.

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

Level: Basic

Research indicates that incarcerated individuals have experienced high rates of childhood and adult trauma, which correlate with long-term negative outcomes. This presentation will review the research on symptom management strategies for people with a history of trauma. Attendees will learn practical skills for working with their patients to identify, monitor, and manage symptoms of trauma. These skills will be useful for patients while incarcerated and upon reentry into the community.

Educational Objectives

• Review the most recent research on symptom management for trauma
• Describe self-assessment and self-monitoring skills that may be employed with patients with a history of trauma
• Acquire concrete skills to help patients manage symptoms of trauma

Level: Intermediate

Adolescent males have a variety of unique health concerns including hair loss, breast concerns that may require workup of gynecomastia, genital and reproductive function issues, dermatology problems, chest pains, and use of performance enhancing substances. The talk will use cases to review specific issues that affect males along with diagnosis and treatment.

Educational Objectives

• Discuss medical issues related to hair loss
• Describe how to recognize and evaluate gynecomastia
• Review disorders of the male genitals

Level: Basic

A lucky few primary care clinicians have discovered the secret: Taking care of patients with chronic hepatitis B is straightforward if you have the right tools. Most CHB patients are asymptomatic and stable, there are only three medications to choose from, you can prevent cirrhosis and liver cancer, and you send the complicated ones to the specialist. These patients are easy so your workload will actually go down. We will discuss case studies of typical patients and much more.

Educational objectives

• Determine which chronic hepatitis B patients need to be started on antiviral medications by using lab values and other clinical characteristics in case studies
• Summarize an evidence-based liver cancer surveillance program for patients with chronic hepatitis B
• Differentiate between uncomplicated and complicated CHB patients, and between compensated and decompensated cirrhosis

Level: Intermediate

The prevention, diagnosis. and treatment of chronic hepatitis b is very nuanced. For the most part, it requires clinical decision support. Unless you are treating many HBV patients you should have rudimentary knowledge and know where to access reliable information to help you provide care for HBV disease. This talk will present the core knowledge base to broaden understanding, references, links, and tools to optimize your time and clinical understanding.

Educational Objectives

• Review screening, counseling, and prevention parameters
• Differentiate specialized virological and serological tests
• Describe how to monitor untreated patients

Level: Intermediate

Made possible by an independent educational grant from Gilead Sciences

Off-site specialty care is a much needed complement to the care we deliver. But it does have challenges, including services coveted by the patient, public safety risk, and cost. The speaker will deconstruct the referral writing process to get a better understanding of what we’re asking for and why. Then she will write the optimal referral that will soar through any review process and give specialists what they need to
help us take care of the patient. 
Educational objectives
• Identify appropriate and inappropriate reasons to refer out for a specialty service
• Describe components of a well written, thought out, clear, concise referral
• Discuss medical and legal obligations for following (or not following) specialist recommendations

Level: Intermediate

The presentation addresses how nurses in correctional health care settings can enhance their perceived value. It will focus on enhancing nurses? value in correctional health care, developing strategies to address upward mobility in nursing, and legislative opportunities and other initiatives that are available to assist participants in funding their educational goals.

Educational Objectives

• Appraise nurses' self-assessments of their strengths in correctional health care settings
• Explore with nurses whether their self-assessments complement the correctional health care practice setting
• Discuss current nursing legislative opportunities available to nurses

Level: Intermediate

Strategies developed in a pilot project investigating how to respond to the high prevalence of traumatic brain injury in corrections have grown into a program implemented in all facilities in the Washington State Department of Corrections. In this presentation, we describe the elements of the program and how it developed. These elements include TBI screening, cognitive skills training, peer mentoring, and referrals to mental health, health services, and ADA accommodations.

Educational Objectives

• Describe the elements of a program that addresses the high prevalence of TBI in incarcerated men and women
• Discuss the organizational change process used in implementing the TBI program
• Explore strategies for integrating a TBI program to different correctional contexts

Level: Intermediate

Correctional civil litigation is an unavoidable job hazard. Not knowing when the deed will strike, it is imperative that we maintain a focus on excellent -- and legally defensible -- health care delivery at all times and in all settings. This presentation will explore cognitive biases, charting and documentation snafus, and administrative procedural conundrums that can be detrimental to a legal defense as seen through the eyes of an expert witness.

Educational Objectives

• Define cognitive biases and how these can lead to poor outcomes in correctional health care
• List at least three charting snafus that can undermine defensibility in a lawsuit
• Describe at least two correctional health care administrative procedures or processes that can lead to legal quandaries and what can be done to mitigate negative legal impact

Level: Intermediate

This training will provide facility administrators and medical personnel with insight on the collaboration needed to comply with the PREA standards. It will cover roles and expectations, review the standards that most require collaboration, share tools, and provide working knowledge of what compliance looks like through practice to ensure residents' sexual safety.

Educational Objectives

• Review PREA standards relevant to medical personnel and facility administration
• Describe the collaboration needed between facility administrators and medical personnel to ensure compliance
• Discuss examples of practical application for each standard

Level Basic

With treatment of hepatitis C more available, management of HCV patients is more nuanced and must extend beyond the initial treatment and monitoring period. This program will discuss protocols to streamline treatment and ensure care for the greatest number of patients. Treatment and management can then extend beyond alcoholic and infectious hepatitis to liver disease of all etiologies.

Educational Objectives

• Discuss a hepatitis C universal screening and treatment program that maximizes efficiency and ensures quality outcomes
• Describe treatment of liver disease beyond antiviral treatment of infectious hepatitis
• Design protocols to safely and efficiently management liver disease

Level: Intermediate

There has been a dramatic increase in treatment of opioid use disorder among incarcerated individuals with the attendant rise in use, abuse, and mortality throughout the COVID-19 pandemic. The use of telemedicine has been a lifesaver during these tumultuous times. Telemedicine has been leveraged in community programs and jails and prisons across the country to provide safe and effective care. This presentation will intertwine the "Three T's" for optimizing care.

Educational Objectives

• Review how technology increases access and improves quality of care where MAT services are delivered
• Describe how the dynamics of a regularly scheduled multidisciplinary team meeting improves patient care
• State the reasons to champion telemedicine as an essential and permanent health care delivery modality

Level: Intermediate

As advances in technology continue to influence the medical field, the role the nurse is evolving. One of the nurse’s primary responsibilities is to focus on the care and safety of the patient. Theory and practice are the foundations of the nursing process. An integral component of this process is critical thinking. This presentation will look at the importance of the nursing process, use of evidence-based practices, and the value of critical thinking in promoting patient safety and favorable outcomes.

Educational objectives
• Describe the nursing process
• Define the concepts of critical thinking
• Discuss nursing interventions and the goals of patient care

Level: Basic

Jails and prisons are the largest mental health facilities in the nation. No matter how hard we try to defer entry, those with mental illness find their way through our doors. Implementing mental health service standards in correctional facilities can remove barriers to assisting individuals with mental illness, while also helping achieve peak organizational performance. 

Educational objectives
• Discuss challenges to providing mental health care in a correctional environment
• Review standards of care that addresses mental health care in correctional facilities
• Identify resources for assistance

Level: Basic

Several state and federal consent laws impact the provision of health care to youth confined in secure facilities. Consent for treatment, from the administration of vaccines to sexually transmitted disease treatment, is complicated by legal requirements. Parental involvement for treatment consent can also create a challenge for providing health services. This workshop will identify areas of consent laws that impact the provision of health care to youth in secure settings.

Educational Objectives

• Define consent laws by minors' status and types of health services
• Recognize legal challenges and limitations to obtaining consent for health services in juvenile justice settings
• Discuss parental and court involvement in the consent process for justice-involved youth

Level: Advanced

Medication overdoses are common occurrences in correctional settings. This presentation will review data on formulary-approved medication overdoses from North Carolina prisons over a six-month period. There were 46 overdoses requiring an emergency room visit; 17 of these required inpatient hospitalization. Acetaminophen was by far the most common substance ingested that led to an emergency room visit. We will discuss policies and procedures that may mitigate the risk of serious overdose.

Educational Objectives

Review the literature on suicide and medication overdoses in community and prison settings

List medications that have high overdose potential

Discuss prison policies and procedures that may mitigate the risk of medication overdose

Level: Intermediate

Discharge planning is a convenient way to get three wins: help a jail's residents, help the community, and generate savings in one low- or no-budget program. This workshop will discuss "Familiar Faces Action & Community Transition," a successful, evidence-based program that has been replicated by several jurisdictions. Topics include how to build a program at low cost, get stakeholder buy-in, evaluate the program, and use the results to make your community love your jail.

Educational Objectives

• Describe the benefits of a discharge planning program
• Examine the ins and outs of developing a discharge planning program
• Identify ways to get the stakeholders involved and on board

Level: Basic

In correctional medicine our role is not merely to diagnose and treat patients, but also to educate them about their chronic conditions. This discussion will focus on common occupational medicine topics including orthopedic, dermatologic, and pulmonary complaints that are likely to arise among incarcerated patients as a result of their jobs before and during incarceration. Techniques to keep patients working and enjoying their work will be emphasized.

Educational Objectives

• Review common orthopedic complaints in workers' compensation cases
• Discuss common dermatologic and pulmonary complaints in workers' compensation cases
• Examine documentation techniques that can benefit the patient and the employer

Level: Advanced

A foot and nail clinic is an innovative solution to managing diabetic foot ulcers and mitigating costs associated with lower extremity amputation. The nurse operates the clinic; performs thorough assessments; debrides calluses and nails; and manages or refers problems, thereby decreasing provider workload. This reduces facility costs, preserves patient function, and offers nurse specialization.

Educational Objectives

• Summarize three considerations for creating an RN foot and nail clinic
• Predict three functional outcomes of a successful RN foot and nail clinic
• Describe three expectations of a RN functioning as a consultant

Level: Basic

Postvention refers to activities that reduce risk and promote resilience after a suicide. When a patient dies by suicide, staff can be affected by the loss both professionally and personally. This presentation discusses common staff reactions after a suicide and the importance of including postvention in suicide prevention programs, encourages discussion on ways to apply postvention principles, and provides examples of postvention protocols and resources that emphasize self-care, supporting peers, and resiliency.

Educational Objectives

• State the rationale for focusing on postvention and common team member reactions after a patient's death by suicide
• Describe postvention protocols and resources
• Explain how postvention principles and the ACT model can be used by leaders to structure a postvention program

Level: Intermediate

This presentation reviews the entire process of transitioning completely from the use of paper medication administration records to an electronic MAR. There are many intricacies with an implementation as large scale as this. However, the focus will be on detailed project planning and management, the importance of partnerships between other vendors and our electronic MAR, staff education and training, the preparation for system outages, and lessons learned.

Educational Objectives

• Outline the planning and organization necessary to implement an eMAR at a large county jail system
• Describe safety and documentation measures needed in case of a system or network outage
• Identify what monitoring after implementation is necessary and how often

Level: Basic

The Positive Behavioral Interventions and Supports (PBIS) framework has become a national initiative for addressing behavior management in juvenile justice systems. However, PBIS is also effective in addressing executive dysfunction related to common mental health issues experienced by the youth served through juvenile justice. PBIS also supports employee care practices that create a culture for staff success.

Educational Objectives

• Demonstrate an understanding of executive dysfunction
• Discuss the connection between executive dysfunction and mental health issues common to youth in juvenile justice care
• Explore how the PBIS premise and practices correspond to best practices for dealing with executive functioning challenges

Level: Intermediate

Medical emergencies in correctional settings require rapid and competent responses. We present the substantial improvement in timeliness, coordination, and caliber of emergency response though application of a repeat cycling quality improvement process and novel debrief tool. Statistically significant and sustainable improvements, as well as qualitative measures, were observed. Debriefing offers staff beneficial postresponse stress reduction, skills development, and engagement in performance improvement.

Educational Objectives

• Identify key elements of an emergency response
• Apply quality improvement to the emergency response
• Examine the post-emergency response debrief process and identify its benefits

Level: Intermediate