Improving the Forensic Documentation of Injuries through Alternate Light: A Researcher- Practitioner Partnership, Maryland, 2021-2023 (ICPSR 39024)

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Data Collection Notes View help for Data Collection Notes

Study Purpose View help for Study Purpose

The purpose of this study was to develop and evaluate the programmatic implementation of alternate light source (ALS) use during medical forensic examinations of injuries among adult victims of sexual and intimate partner violence.

Study Design View help for Study Design

This study proceeded in the following phases:

Assessment - Researchers collected qualitative and quantitative data to assess current forensic documentation practices at both sites. Qualitative data collection included direct observation at both sites, reviewing policies and procedures, and interviewing relevant stakeholders (administrators, local law enforcement, prosecutors) as well as nurses in the form of semi-structured focus-groups. Qualitative data from these focus groups are not available through ICPSR at this time. Nurses were recruited for focus groups using an anonymous survey about existing knowledge of alternate light sources (ALS), team dynamics, etc. The quantitative data collected through this survey are included in this release as the Nurse Survey Data. Finally, six months of de-identified patient data were collected from each site and are included in this release as Medical Records Data.

Development, Implementation, and Maintenance - Information obtained during the Assessment Phase was used to develop an ALS implementation program. Researchers presented individualized recommendations for implementing evidence-based guidelines for ALS use and provided didactic education and hands-on training to staff. After implementing ALS per program guidelines, each site entered a four month maintenance phase with ongoing support from trained facilitators.

Evaluation - The study team collected additional Medical Records Data during the 4-month maintenance phase, conducted an additional focus-group at Site A to better understand their experience implementing the ALS program, and conducted final interviews with administrators and other relevant stakeholders about the program's adoption and impact.

Sample View help for Sample

The research team recruited two forensic nursing departments in Maryland to participate in this project (Site A and Site B). Eligibility criteria included serving at least 300 adult patients annually and providing forensic medical services to diverse populations, including victims of sexual assault and intimate partner violence. Site A was a suburban, hospital-based program with no prior experience with ALS, but interest in adopting the practice. This site employed seven full-time forensic nursing staff and two nurse practitioners. Site B was a hospital-based program in an urban area with 10 years of experience with ALS, 22 on-call nursing staff, and 2 full-time employees. Of these staff and practitioners, the final sample of nurses for the Nurse Survey Data included 21 individuals: 9 from Site A and 12 from Site B.

The Medical Records Data were drawn from existing records. Six months of de-identified patient data were collected at both forensic nursing departments and then screened for the following eligibility criteria:

1. Patient must be an adult (18 years or older).

2. Patient must have received a medical forensic exam for reported or suspected sexual assault or intimate partner violence.

Time Method View help for Time Method

Universe View help for Universe

Forensic nurses and adult patients who receive acute forensic medical exams for sexual assault and/or intimate partner violence.

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Mode of Data Collection View help for Mode of Data Collection

Description of Variables View help for Description of Variables

The Nurse Survey Data include variables from 1) a Knowledge Assessment designed for the study which assessed nurses' forensic nursing knowledge, including their prior experience with alternate light sources (ALS); 2) an Evidence Assessment and Context Assessment built using the Organizational Readiness for Change Assessment (ORCA), which asked for nurses' informed opinions on the use of ALS, their organization's readiness to adopt ALS, and additional factors related to their organizations capacity for implementing new methods for forensic nursing; 3) demographic questions about age and education, including relevant certifications and nursing experience.

The Medical Records Data contain anonymous data from patients who underwent forensic examination at Sites A and B due to sexual assault or intimate partner violence. Variables include demographic information such as age, gender, and race; injury characteristics including location and size; indicators describing how the injury was photographed; photo-documentation variables describing image quality for both while-light and ALS photography.

Response Rates View help for Response Rates

The Nurse Survey Data response rate was 57 percent. Response rates for the nurse focus groups were 27 percent at baseline and 100 percent for the post-intervention focus group.

Presence of Common Scales View help for Presence of Common Scales

The Nurse Survey Data Questionnaire includes Evidence and Context subscales taken from the Organizational Readiness to Change Assessment [Helfrich, C.D., Li, YF., Sharp, N.D. et al. Organizational readiness to change assessment (ORCA): Development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework. Implementation Sci 4, 38 (2009).https://doi.org/10.1186/1748-5908-4-38]

Original Release Date View help for Original Release Date

2026-05-14

Version History View help for Version History