An Evaluation of the Nursing Practice Environments in Portuguese Prisons

TL;DR

This study evaluates nursing practice environments in Portuguese prisons to identify areas needing improvement for better care and professional well-being.

Contribution

The study provides a mixed-methods analysis of nursing environments in Portuguese prisons, highlighting specific weaknesses and suggesting targeted interventions.

Findings

Low scores were found in nurses' involvement in institutional policies and professional qualification.

Participants emphasized the need for better infrastructure, equipment, and performance assessment policies.

Priority interventions include enhancing human resources and defining care quality indicators.

Abstract

Background/Objectives: The prison environment is a unique context of professional practice, characterized by specific challenges requiring conditions that ensure both the delivery of tailored care to inmates and the well-being of healthcare professionals. This study analyzes the characteristics of nursing practice environments in Portuguese prisons. Methods: A descriptive, exploratory, mixed-methods design, combining quantitative and qualitative approaches was conducted in 30 Portuguese prisons. A non-probabilistic convenience sampling method was used to select participants. Data were collected between June and July 2022 using an online self-administered questionnaire. The Statistical Package for the Social Sciences (SPSS), version 28.0, was used to analyze the quantitative data, while Bardin’s Thematic Analysis was used to examine the qualitative data. The Ethics Committee granted ethical approval for the study, and the Directorate-General for Reintegration and Prison Services provided authorization. Results: A total of 77 nurses participated in the study, representing 39.4% of the target population. The dimensions with the lowest mean scores included “Nurses’ participation and involvement in institutional policies, strategies, and management”, “Institutional policy for professional qualification”, “Interdependent practices in professional activities”, and “Systematic assessment of nurses’ performance and supervision”. Participants highlighted the need for improved strategies targeting structural, procedural, and outcome-oriented components. Conclusions: Finding fields of weakness can greatly enhance the setting for nursing practices. Priority interventions in Portuguese prisons include the following: enhancing human resources; providing adequate infrastructure and equipment; implementing policies to involve, qualify, and assess nurses’ performance; and defining indicators centered on the safety and quality of care as well as the welfare of professionals.