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Evidence-Based Practice in Forensic Mental Health Nursing

A Critical Review

Byrt, Richard, RMN, RNLD, RGN, PhD, MA, BSc (Hons)1,2,3; Spencer-Stiles, Theresa A., BA (Hons), PGCE4; Ismail, Ismail, RMN, BSc (Hons), DipHE3

doi: 10.1097/JFN.0000000000000202
Original Articles

Method Literature searches of databases, particularly CINAHL, using key phrases were undertaken.

Results Some authors argue that there is a lack of evidence in forensic mental health (FMH) nursing, with few randomized controlled trials and other methods providing definitive, generalizable evidence. However, literature searches revealed randomized controlled trials of relevance to FMH nursing, many qualitative studies by FMH nurses, and arguments for clinical experience and knowledge of service users, and the latter's views, as sources of evidence.

Discussion and Implications for Nursing Practice Research findings can be applied to practice, both directly and indirectly. Examples are given of ways that evidence can be used to inform FMH nursing interventions related to therapeutic ward environments, including communication, therapeutic relationships, preventing retraumatization, and enabling physical health. The complex nature of “evidence” is considered in relation to risk assessment and management.

Conclusions for Nursing Practice FMH nursing can be based on a wide range of sources of evidence. The types of evidence used in practice depend on individual service users' needs and views. In evaluating evidence, it is necessary to be aware of its complex, diverse nature. A distinction can be made between definitive, widely generalizable research findings and evidence with limited generalizability, requiring FMH nurses' judgments about whether it is applicable to their own area of practice. Recommendations for related education and research are made.

1School of Nursing and Midwifery, De Montfort University;

2School of Health, Sport and Professional Practice, University of South Wales;

3Arnold Lodge Medium Secure Unit, Nottinghamshire Healthcare NHS Foundation Trust; and

4MSc Student (Psychology), Online Learning, University of Derby.

The authors declare no conflict of interest.

Correspondence: Richard Byrt, RMN, RNLD, RGN, PhD, MA, BSc (Hons), The North Bridge Tavern, 1, Frog Island, Leicester LE3 5AG, United Kingdom. E-mail:

Received September 14, 2017; accepted for publication February 20, 2018.

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© 2018 by the International Association of Forensic Nurses. All rights reserved.
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