Inmates face numerous hardships which expose them to a wide range of health challenges. The lack of proper facilities and services make further compound the problems that the inmates face. It has been established that suicide is one of the outcomes of the hardships that incarcerated individuals encounter (Kaba et al., 2013). Suicide promises and end to the misery that they grapple with in prison. To prevent suicide, a number of approaches are being adopted across correctional institutions. The problem with most of these approaches is that their implementation requires huge capital investments. To effectively tackle suicide among inmates, cost-effective interventions are needed.
Geographic Population Targeted
The PICO model facilitates the adoption of interventions in nursing practice. A key element of this model is identifying the population at which the intervention is targeted. The prisoners in Rhode Island are the main targets of the intervention. These prisoners have been targeted because in 2017, Rhode Island recorded the highest number of prisoner deaths in the US (Grinberg, 2017). A significant proportion of these deaths were suicides. A number element of the PICO model is intervention. Essentially, this element concerns the development of an effective solution. Nurses have an obligation to strive to identify and implement solutions that deliver gains for populations (Curley & Vitale, 2016). Identifying offenders who are at greatest risk of suicide is one of the interventions that have proven effective (Marzano et al., 2016). The correctional facilities in Rhode Island will be advised to implement this intervention. Comparison and outcome are the other elements of the PICO model. Comparison allows one to evaluate the relative effectiveness of the selected intervention. One of the most commonly employed interventions involves limiting access to items that may be used to commit suicide (Marzano et al., 2016). While this measure is effective, it may be difficult to implement because prison offers may fail to detect the items. This intervention can be used to measure the relative effectiveness of identifying at-risk offenders. Outcomes are the end results that a particular intervention is expected to deliver. A significant decline in the number of prisoner suicides is the main outcome to be used to evaluate the effectiveness of the intervention.
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Plan for Reducing Suicide
The intervention to be applied needs to achieve two objectives. One, it should help to prevent suicides among inmates. Two, this intervention is expected to minimize the costs incurred through suicide watches. The identification of offenders who face an elevated risk of suicide promises to achieve both objectives. This intervention is both practical and based on sound research. There are various indicators that prison officials can use to identify inmates who require extra care. For example, mental illness is one of the risk factors for suicide (Marzano et al., 2016). Upon their entry into a facility, all prisoners should be screened for mental illness. Those found to be mentally ill should then be provided with appropriate health services. This is more effective than keeping an eye on the inmates and waiting for them to attempt suicide. Prisoners who appear to be enduring hardships could also be targeted as part of tackling suicide in correctional institutions. This intervention requires minimal manpower and capital investment. A facility simply needs to screen inmates upon admission and regularly during their stay at the facility.
Research Question
For a research exercise to deliver any helpful insights, it should begin with a question. The question should capture the aims of the research and the expected findings. It cannot be guaranteed that the intervention recommended above will be effective. For this reason, it may be necessary to conduct research. The following is the question that will guide the research process: is the identification of at-risk offenders an effective intervention for preventing prisoner suicide? This research question will allow for the effectiveness of the intervention to be determined.
Community Engagement
The task of attending to the needs of inmates has largely been left to prison officials. Other stakeholders have neglected their mandate. It is therefore not surprising that a worrying increase in the rate of prisoner suicide has been observed. For any intervention to be effective, community engagement is needed. This is especially true for interventions aimed at tackling suicide in correctional institutions (Pratt et al., 2010). Such community actors as families and political leadership need to join forces in responding to the plight of prisoners. To ensure the effectiveness of the intervention identified above, families of prisoners will be asked to join the effort. Families play an important role in safeguarding the welfare of inmates. In the following discussion, the particular contributions that they will make in the implementation of the intervention are outlined.
One of the important roles that families play is offering social support. This support is vital for preventing suicide (Prahbu et al., 2010). The families of the inmates could support and encourage the inmates to participate in the intervention. For example, family members could encourage the inmates to trust the prison officials and provide all the information that the officials request. Another vital function that families serve is that they provide critical information. As noted earlier, the implementation of the intervention will involve screening inmates upon admission. To facilitate this exercise, families should provide such details as the mental health history of an inmate. The contribution that the families make will go a long way in tackling suicide among prisoners.
Implementation Model
No intervention that is implemented randomly and without any clear order can deliver desired outcomes. To enhance the implementation process, nurses and other medical practitioners need to use established models and protocols. The John Hopkins Nursing Model is among the frameworks that are commonly used for implementing interventions. The key pillar of this model is evidence-based practice (Dang & Dearholt, 2017). The model challenge practitioners to rely on research evidence to guide the implementation of interventions. This model involves a three-phase process. The first stage involves the practice question (“Center for Evidence-Based”, n.d). At this stage, the practitioner determines the issue that requires an intervention. In the case of prisoner suicides, the prevention of the suicides is the practice question. Using this question, practitioners are able to wonder which interventions are most effective for preventing suicides in correctional institutions. The second stage of the model is concerned with evidence. Here, one gathers all necessary evidence needed to identify an intervention. An individual may consult scholarly literature and research for evidence. At the third stage, translation is carried out. This stage involves making sense of the evidence. The practitioner determines how the intervention developed through an examination of evidence is to be implemented.
There are a number of reasons why the John Hopkins Nursing Model is the most appropriate framework. The fact that it focuses on evidence-based practice is one of these reasons. Prisoner suicide is a serious problem that requires urgent intervention. However, caution is needed to identify the interventions that are most effective. If practitioners hurry to implement an intervention whose effectiveness has not been established, they place the lives of inmates at grave risk. Another reason for recommending the use of the John Hopkins Nursing Model lies in its simplicity. This model is fairly simple and can easily be integrated into practice (Otten, 2008).
In conclusion, every year, the US loses thousands of inmates. A worrying number of these inmates commit suicide. To prevent prisoner suicide, there is need for urgent action to be taken. Screening prisoners with the goal of identifying those who are most at risk of suicide is a promising intervention. In addition to minimizing suicides, this intervention will also enable correctional facilities to significantly reduce costs. The implementation of this intervention should be done in accordance with the John Hopkins Nursing Model. This model will ensure that there is sufficient evidence to justify the implementation of the intervention.
References
Center for Evidence-Based Practice. (n.d). Retrieved April 13, 2017 from https://www.hopkinsmedicine.org/evidence-based-practice/ijhn_2017_ebp.html
Curley, A. L. C. & Vitale, P. A., (2016). Population-Based Nursing (2nd Ed.). New York: Springer.
Dang, D., & Dearholt, S. L. (2017). John Hopkins Nursing Evidence-Based Practice. Model And Guidelines. Third Edition. Indianapolis, IN: Sigma Theta Tau.
Grinberg, E. (2017). Prison Suicides are on the Rise Nationally and it’s Pretty Bad in Massachusetts. Retrieved April 13, 2018 from https://edition.cnn.com/2017/04/19/health/prison-suicides-massachusetts-trnd/index.html
Kaba, F., Lewis, A., Glowa-Kollisch, S., Hadler, J., Lee, D., Alper, H., Selling, D., MacDonald, R., Solimo, A., Parsons, A., & Venters, H. (2013). Solitary Confinement and Risk of Self-Harm among Jail Inmates. American Journal of Public Health, 104 (3), 442-7.
Marzano, L., Hawton, K., Rivlin, A., Smith, N. E., Piper, M., & Fazel, S. (2016). Prevention of Suicidal Behavior in Prisons. An Overview of Initiatives Based on a Systematic Review Of Research on Near-Lethal Suicide Attempts. Crisis, 37 (5), 323-334.
Otten, R. A. (2008). John Hopkins Nursing Evidence-Based Practice Model and Guidelines. Nursing Education Perspectives, 29 (4), 234.
Prahbu, L. S., Molinari, V., Bowers, T., & Lomax, J. (2010). Role of the Family in Suicide Prevention: An Attachment and Family Systems Perspective. Bulletin of Menninger Clinic, 74 (4), 301-27.
Pratt, D., Appleby, L., Piper, M., & Webb, R. (2010). Suicide in Recently Released Prisoners: A Case-Control Study. Psychological Medicine, 40 (5), 827-835.
