Skin, Not Canvas: Playbill for harm reduction measures in use of body art by inmates in Dallas County Jail

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1 Skin, Not Canvas: Playbill for harm reduction measures in use of body art by inmates in Dallas County Jail Dr. Ja Net Nash, MS, MPH, FNP-C, ARNP, CCHP Parkland Health and Hospital Systems, Jail Health, Dallas Texas Doctors of Nursing Practice 2012 Fifth National DNP Conference, St. Louis, MO Evidence-Based DNP Education September 19-21, 2012

2 Skin, Not Canvas: Playbill

3 Current health care delivery issue Synopsis Inmates receive unsterile body art (tattoos) from other inmates while incarcerated in jails and prisons, with the use of common office supply items such as paperclips, ink pens and staples. This is an illegal, but routinely inherent part of the jail and prison cultures.

Clinical education outcome To reduce body art harm, upon release from jail to families and the communities by controlling the spread of jail- acquired

4 Clinical education outcome To reduce body art harm, upon release from jail to families and the communities by controlling the spread of jail- acquired blood borne infectious diseases, such as MRSA, syphilis, viral hepatitis, HIV and AIDS, from inmate to inmate. This is an emergent public health concern.

5 Evidence Based Skin not Canvas: Playbill is a health promotion, disease prevention fine art, jail-based and community educational program designed by a DNP to impact nursing education outcomes, enhance patient safety and improve clinical outcomes.

6 GOAL The goal of Skin not Canvas: Playbill program is to decrease the occurrences of jailacquired tattoos and improve jail-based testing and treatment of unsterile tattoo transmitted diseases/infections prior to community reentry.

7 Objectives Identify blood borne pathogens that can be transmitted through jail-based body art application Describe innovative methods of evidence-based dissemination to improve the distribution of health education in correctional and community health Identify strategies for enhancing patient safety and reducing liability and risk from jail acquired body art

8 Skin, Not Canvas Playbill

9 Cast of Characters: MRSA MRSA, (played by Staph and Staff) Bio: One-third of the United States population has the MSRA strain, and other staph bacterial strains, are present "on the skin or in the nose of a person. May appear as a spider bite. (Retrieved from http: //www. cdc.gov).

10 Cast of Characters: Syphilis Syphilis, appearing as the great imitator, is courtesy of the oldest known sexually transmitted disease guild. Bio: Syphilis is a preventable and curable sexually transmitted disease (STD) caused by the bacterium Treponema Pallidum.

11 Cast of Characters: Viral Hepatitis Viral hepatitis lead role is portrayed by Hepatitis B; understudy will be portrayed by Hepatitis C. Bio: Viral hepatitis is the leading cause of liver cancer and the most common reason for liver transplantation is viral hepatitis.

12 Cast of Characters: HIV and AIDS HIV and AIDS Appearing as Thrush (CDC Photo, 2011) Supporting each of the previously mentioned three lead characters will be HIV and AIDS.

13 Cast of Characters: AIDS Bio: AIDS has been credited in the closing moments of many influential people lives. AIDS/HIV continues to thrive at epic proportions, oftentimes appalling and unprecedented, among African American communities.

14 Harm reduction

15 Harm reduction SKIN, NOT CANVAS BODY ART IN JAILS Top 3 Things to Think about BEFORE you get that TATTOO tat IN JAIL 1. If the floor is DIRTY where you get that tat, SO IS THE TAT!!!! 2. If the person doing your tat is in jail, SO ARE YOU!!!! 3. In jail tats can shorten your life, by giving you, your family and your community, INFECTIONS THAT CAN KILL!!!!! Don t get that TAT! If you chose to not get a tattoo in jail, but decide to get one in prison instead Read above items 1 thru 3 again Why? Because you are at more risk for getting sick with MRSA, Syphilis, Viral Hepatitis, HIV and/or AIDS

Liability and risk reduction The effectiveness of any disease prevention programs is dependent on the extent to which individuals take personal responsibility for their own health by avoiding

16 Liability and risk reduction The effectiveness of any disease prevention programs is dependent on the extent to which individuals take personal responsibility for their own health by avoiding health risks such as those associated with jail -acquired tattoos. This fine art program can be utilized not only in jails, but prisons, schools and every public institution where people gather.

17 Evidence-based dissemination

18 Evidence-based dissimination

19 Strategy: Quiz Health Education SKIN, NOT CANVAS QUIZ Match the correct answers: a. Syphilis b. HIV/AIDS c. Hepatitis B/Hepatitis C d. MRSA 1. inflammation of the liver that can cause liver cancer and is the number one reason for liver transplants. 2. is the oldest known sexually transmitted disease. It may present with a rash that appears on the palms of hands and bottom of feet, then disappears. 3. occurs when the initial virus has destroyed so much of the body's defenses that immune-cell counts fall to critical levels causing the final virus. 4. is commonly mistaken as a spider bite Correct Answers: 1. c 2. a 3. b 4. d

20 SKIN, NOT CANVAS, BODY ART IN JAIL WHAT IS IT???? BODY GRAFFITI: (PRONOUNCIATION)/bod-ee gra-fee-tee Definition: Strategy: Grass root terminology Life-shortening drawing, scribbling, and scratches inked unclean and unlawful on the physical structure of a human being

21 Dallas County Sheriff Department, Doctors of Nursing Practice Organization, Parkland Health and Hospital Systems Special Thanks

22 QUESTIONS???? Contact Information: Dr. Ja Net Nash, MPH, MS, FNP-C. ARNP, CCHP Phone:

23 References Amerena, V. (2009). Syphilis. elaborate. Jan-Feb:16-7. CINAHL AN: Abiona T, Balogun J, Adefuye A. & Sloan, P. (2010). Body art practices among inmates: implications for transmission of blood borne infections. American Journal of Infection Control, 38(2). Bureau of Justice Statistics (2008). Texas. Retrieved from http/bjs.ojp.usdoj.gov Cumbie, S. A, Conley, V. M., & Burman, M. E. (2004). Advanced practice nursing model for comprehensive care with chronic illness: model for promoting process engagement. ANS Advances in Nursing Science, 27(1), Center for Disease Center Control and Prevention, Fact Sheet (2010). HIV and AIDS Center for Disease Control and Prevention, Fact Sheet (2010). MRSA Center for Disease Center Control and Prevention, Fact Sheet (2010). Syphilis Center for Disease Center Control and Prevention, Fact Sheet (2010). Viral Hepatitis Foran, A. (2009). Unlocking jail health care: Parkland sets national example. Parkland, (46)2, 19-21, HIV/AIDShttp:// Influential and famous people who died from AIDS, Retrieved from chicagonow.com/blogs/whats-aboy-to-do/2009/12/influential-and-famous-people-who-died-from-aids.html. Kelly, P., Peralez-Dieckmann, Cheng, & Collins (2010). Profile of Women in a County Jail. Journal of Psychosocial Nursing, 48(4) Kelly, P., Peralez-Dieckmann, Cheng, & Collins (2010). Profile of Women in a County Jail. Journal of Psychosocial Nursing, 48(4) Kondro, W., (2007). Report supports cost-effective prison tattoo program. Canadian Medical Association Journal, 176 (4): Mitchell I., Wolfe, M., Xu, F., Patel, P., O'Cain, M., Schillinger, J., St. Louis, M., Finelli, L. (2001). An outbreak of syphilis in Alabama prisons: Correctional health policy and communicable disease control. American Journal of Public Health. 91(8), Pew Center on the States (2010, August), One in 100: Behind Bars in America 2008, Retrieved 2/28/2011, from

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