Corrections_Today_July_August_2020_Vol.82_No.4

Correctional Health Perspectives

Conclusion Providing patients with preven- tative care through chronic care clinics may help to reduce sick call complaints and emergency assess- ments. In the correctional settings, that also means less emergency travel orders to outside/commu- nity medical facilities. Facilitating telehealth in the management will further reduce travel orders and promote health while reducing cost and increase availability of specialty providers. This provides an overview of management of chronic care patients that we all face in our correctional environment. The template described worked well within our system and is by no means a comprehensive one. Each system should adapt the man- agement to their systemic strategic planning. Providing education is an im- portant part of any chronic care program. The inmate patient may need assistance to identify behav- iors that are negatively impacting his condition. By improving poor behaviors, complications may be pre- vented. Depending on the patient’s life experiences, learned helpless- ness, and education, the patient may need a step by step process to follow. Some patients may need help to break through or change their belief that they have no control to change a situation or health conditions. Examples are: for the patient needing encouragement to exercise, assign walking a specific distance within the allowed exercise area and progress from there; review and discuss the patient’s recent canteen purchases with the patient and point out which choices were poor and which were

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Health and Human Services. Retrieved from: https://www.cdc.gov/cdi/ Davis, D.M., Bello, J.K., & Rottnek, F. (2018). Care of incarcerated patients. American Family Physician , 98(10),577-583. Retrieved December 3, 2019, from https://www.aafp.org/afp/2018/1115/ p577.html# Interior Health (2019). Chronic Disease Management. Providing chronic disease care and support. Interior Health, CA. Retrieved from: https://www.interiorhealth.ca/yourcare/chronic- conditiondisease National Association of Chronic Disease Directors. (2019). Why Public Health is Necessary to Improve Healthcare. Decatur, GA. Retrieved from: https://www.chronicdisease.org/page/WhyWe- NeedPH2impHC The Pew Charitable Trusts. (2017). Prison Health Care Costs and Quality How and why states strive for high-performing systems. Retrieved from: https://www.pewtrusts.org/en/research-and- analysis/reports/2017/10/prison-health-care-costs- and-quality. Skarupski, K. A., Gross, A., Schrack, J. A., Deal, J. A., & Eber, G. B. (2018). The Health of America’s Aging Prison Population. Epidemiologic reviews , 40(1), 157–165. https://doi.org/10.1093/epirev/ mxx020 Young S. (2014). Healthy behavior change in practical settings. The Permanente journal , 18(4), 89–92. https://doi.org/10.7812/TPP/14-018. Retrieved from: https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC4206177/ Teresa I. Royer, MSN, RN is the director of nursing at Diagnostic and Evaluation Center, Nebraska Department of Correctional Services. Harbans Deol, DO, Ph.D. is the medical director for Nebraska Department of Correctional Services

better. Starting with an easy goal al- lows for success and a progression to the next step. Young (2014) encourages health care providers to help the patient find healthy choices that are fairly easy to implement into their lifestyle. If the choices are easy to implement, the patient is more likely to be suc- cessful in changing his unhealthy behaviors which in turn will help to improve his medical condition and overall health. With that thought in mind, the time and effort to implement and conduct chronic care clinics within the correctional facili- ties could not only help the patient with his health, it could help with the long term cost associated with treat- ing chronic medical conditions. Endnotes American Correctional Association (2016). American Correctional Association Standards for Adult Correctional Institutions. Retrieved from: http://www.aca.org/ Binswanger, I. A., Blatchford, P. J., Mueller, S. R., & Stern, M. F. (2013). Mortality after prison release: opioid overdose and other causes of death, risk factors, and time trends from 1999 to 2009. Annals of internal medicine , 159(9), 592–600. Retrieved from: https://doi. org/10.7326/0003-4819-159-9-201311050-00005 Centers for Disease Control and Prevention. (2019). National Center for Chronic Disease Prevention and Health Promotion’s Chronic Disease and Health Promotion Data and Indicators Open Data Portal. Atlanta, GA: US Department of

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