Other Titles
PechaKucha Presentation
Abstract
Violence is a sustained global public health issue.1 Forensic nurses (FNs) receive specialized education to apply nursing knowledge and skills within the intersection of the healthcare and legal systems, focusing on people who experience or perpetrate violence, trauma, abuse, and maltreatment.2 Positive Deviance (PD) in nursing is intentional and honorable behavior that departs or differs from an established norm and contains elements of innovation, creativity, and/or adaptability; it also involves risk.3 These nurses practice differently and more effectively to provide patient-centered care.4 Although professional standards guide care and lay the groundwork for best practices, they are not enough to guide decisions that involve multiple levels of uncertainty and risk; therefore, nurses employ PD.3,4 This aligns with standards that require a nurse to go against guidelines that compromise safety.5 Nurses must also follow guidance on appropriate behaviors and ethical practices. FNs may experience role conflict when lines blur between advocacy and duty.6 Thus, it is hypothesized that FNs use PD to provide person-centered care and may work around ineffective or outdated policies.
An initial project phase showed a lack of literature evidence specific to PD in FN that assisted in developing this phase of PD inquiry into FNs experiences while providing person-centered, trauma-informed patient care. A PD inquiry is an innovative approach used to improve healthcare quality7 as assumptions are that solutions to problems are already available within the community, and identifying and sharing those solutions may help others to resolve existing issues.3,4,7 A PD inquiry is surveying FNs for accounts of care experiences to identify if, and what PD behaviors and strategies are in use. This presentation will be discuss the innovative approaches discovered to improve care for those who have experienced violence.
Narratives will be examined with content analysis by immersion, coding, gathering impressions, generating themes8, and then evaluation in relation to the Model of PD in Nursing.4 Anticipated results are policy implications and lessons learned for further understanding issues that led to PD behaviors and strategies. Lifelong health sequelae may be extensive for those who experience sexual assault.9 Next steps would investigate policy implications and care issues that led to PD.
Notes
This is a PechaKucha presentation, and the slide deck contains images instead of text. To compensate for this, the presenter notes are available in the attached slide deck. To see the notes in Adobe Acrobat, go to Tools > Comment or look at your Layers Panel. If the notes were saved as comments or layers, you can toggle them visible.
This presentation is part of a project funded by the Texas A&M University College of Nursing Dean’s Faculty Seedling Award (2025).
References:
1. World Health Organization. Violence against women. Updated March 25, 2024. Accessed November 12, 2025. https://www.who.int/news-room/fact-sheets/detail/violence-against-women
2. Academy of Forensic Nursing. (2025). What is a forensic nurse? Academy of Forensic Nursing. https://goafn.org
3. Gary, J. C. (2013). Exploring the concept and use of positive deviance in nursing. American Journal of Nursing, 113(8), 26-34. DOI: 10.1097/01.NAJ.0000432960.95762.5f
4. Gary, J. C. (2014). The wicked question answered: Positive deviance delivers patient-centered care. Dimensions of Critical Care Nursing, 33(3), 142-150. DOI: 10.1097/DCC.0000000000000038
5. American Nurses Association. Nursing: Scope and Standards of Practice. 4th ed. Silver Spring, MD: American Nurses Association; 2021.
6. Cole J, Lindhorst T, Strout TD. Defining the boundaries: How sexual assault nurse examiners (SANEs) balance patient care and law enforcement collaboration. J Interprof Care. 2024;38(4):618-626. doi:10.1080/13561820.2023.2300000
7. Kassie AM, Eakin E, Abate BB, et al. The use of positive deviance approach to improve health service delivery and quality of care: A scoping review. BMC Health Serv Res. 2024;24(1):438. doi:10.1186/s12913-024-10850-2
8. Braun V, Clarke V, Hayfield N, Hanlon H. Thematic analysis. In: Handbook of Research Methods in Health Social Sciences. Singapore: Springer; 2019:843-860.
9. Lindbak T, Lerdal A, Hjelde J, Heir T. Sexual Assault and the Association With Health, Quality of Life, and Self-Efficacy in the General Norwegian Population. J Interpers Violence. 2022;37(19-20):NP17849-NP17872. doi:10.1177/08862605211046401
Sigma Membership
Phi Iota
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Ethics, Policy and Advocacy, Positive Deviance, Positive Psychology, Forensic Nursing
Recommended Citation
Gary, Jodie C.; Charles, Laurie; and Onyemobi, Jaeda, "Identification of Positive Deviance in Forensic Nursing Practice" (2026). International Nursing Research Congress (INRC). 137.
https://www.sigmarepository.org/inrc/2026/presentations_2026/137
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-06
Identification of Positive Deviance in Forensic Nursing Practice
Toronto, Ontario, Canada
Violence is a sustained global public health issue.1 Forensic nurses (FNs) receive specialized education to apply nursing knowledge and skills within the intersection of the healthcare and legal systems, focusing on people who experience or perpetrate violence, trauma, abuse, and maltreatment.2 Positive Deviance (PD) in nursing is intentional and honorable behavior that departs or differs from an established norm and contains elements of innovation, creativity, and/or adaptability; it also involves risk.3 These nurses practice differently and more effectively to provide patient-centered care.4 Although professional standards guide care and lay the groundwork for best practices, they are not enough to guide decisions that involve multiple levels of uncertainty and risk; therefore, nurses employ PD.3,4 This aligns with standards that require a nurse to go against guidelines that compromise safety.5 Nurses must also follow guidance on appropriate behaviors and ethical practices. FNs may experience role conflict when lines blur between advocacy and duty.6 Thus, it is hypothesized that FNs use PD to provide person-centered care and may work around ineffective or outdated policies.
An initial project phase showed a lack of literature evidence specific to PD in FN that assisted in developing this phase of PD inquiry into FNs experiences while providing person-centered, trauma-informed patient care. A PD inquiry is an innovative approach used to improve healthcare quality7 as assumptions are that solutions to problems are already available within the community, and identifying and sharing those solutions may help others to resolve existing issues.3,4,7 A PD inquiry is surveying FNs for accounts of care experiences to identify if, and what PD behaviors and strategies are in use. This presentation will be discuss the innovative approaches discovered to improve care for those who have experienced violence.
Narratives will be examined with content analysis by immersion, coding, gathering impressions, generating themes8, and then evaluation in relation to the Model of PD in Nursing.4 Anticipated results are policy implications and lessons learned for further understanding issues that led to PD behaviors and strategies. Lifelong health sequelae may be extensive for those who experience sexual assault.9 Next steps would investigate policy implications and care issues that led to PD.
Description
A positive deviance inquiry explores exceptional practices and implementation strategies to provide patient-centered care in forensic nursing. The aim is to amplify discovered assets to enhance quality, reduce errors, and improve outcomes for those experiencing violence.