Lockdowns Causing Lock-Ins: Impact of the COVID Pandemic on Trends Observed by Forensic Nurse Examiners

This study consists of a secondary, longitudinal analysis of chart data pulled from a forensic nursing program at a large Level I Hospital in Colorado between 2018–2023 to explore trends in forensic assessments conducted during pandemic lockdown periods. Descriptive analyses and logistic regression were used to examine the number and severity of consultations performed by the forensic nursing team across COVID-19 pandemic timepoints. A total of 9,944 patients received a consult from the forensic nursing program between 2018–2023, with 2,144 seen during a COVID-19 lockdown period. The odds of forensic nurses conducting exams for traumatic brain injury, sexual assault, and intimate partner violence were significantly higher during various COVID lockdowns or timepoints. No changes in the odds of patients reporting strangulation were observed during COVID-19 lockdowns. While the odds of patients being examined for risk of intimate partner violence (IPV) increased during the second lockdown and reopening periods, the severity of reported IPV did not vary compared to other timepoints. Older adult patients were less likely to be seen during COVID-19, with significant declines in patients screened for elder abuse. This analysis provides valuable insight into the changes in patient volumes, types of assault, and severity of these patient experiences before and after the pandemic and over time. Observed trends emphasize the importance of coordinated responses and screenings in the emergency department setting as well as the value of the in-depth care that forensic nurses provide before, during, and after a time of global crisis.