Decreasing Bias in the Correctional Nursing Setting in Northwest Florida Prisons: The Need for
Education on Bias and Its Impact on Patient Care
Western Governors University Leavitt School of
Health
D156: Business Case Analysis for Healthcare Improvement
Healthcare Improvement Project: Introduction and Project Initiation
Organizational Problem
The healthcare improvement project (HIP) chosen will provide education on bias and its impact
on patient care in the correctional setting in Northwest Florida Prisons. Approximately twenty-seven
thousand three hundred inmates were incarcerated in Northwest Florida prison facilities, including
Escambia, Holmes, Jackson, Okaloosa, Santa Rosa, Walton, and Washington County Prisons in Florida
in
,2023 (Prison Policy Initiative, 2023). The 8th Amendment of the United States Constitution validates an
incarcerated person's "right" to medical care. In the State of Florida, this "right" is granted through
Florida Statutes section 945.6037 (Florida Legislature, 2025).
In every aspect of healthcare, bias can be an issue; however, it can be a more significant
problem in correctional healthcare. There are many reasons this is an essential problem in the
correctional setting. Reason one is that the environment is challenging to manage since security has
control of every situation, and custody and control come ahead of anything else, including healthcare.
Reason two is the ability of nursing staff to keep their personal belief and opinions of the inmate's
reason for being incarcerated separate from the inmate's need for treatment of their medical condition.
Third, the inmate's behavior, sometimes irrational and aggressive, influences the nurses' desire, or lack
of, to treat the inmate as required by the State of Florida.
Nurses who enter the Florida prison system must undergo mandatory training before speaking
with an incarcerated individual. This training consists of boundaries, safety concerns, and the need for
security to always be in control. What is not included in this training is "bias" and how this one word
affects the population's healthcare. Many studies have shown that bias in the correctional setting is a
systemic problem in every correctional healthcare setting. The studies also agree that it is a problem
, that needs to be addressed. This HIP aims to decrease bias by nursing staff on the incarcerated by
providing mandatory training for all nursing staff on the issue, how it starts, why it is an issue, and
the consequences of bias for not only the incarcerated but also the nurse.
Stakeholders
In Florida, most correctional health care has been given to a private contractor known as
"Centurion of Florida," and this contract includes sixty-one prisons in the State. The Department of
Health Services still oversees the Florida Department of Corrections contract. Stakeholders were chosen
from both the contractor and the State responsible for the incarcerated population's well-being and
care. These individuals were selected due to their power, influence, and interest in incarcerated
persons' care. Everyone has over twenty years of experience working in the correctional environment
in the State of Florida. Everyone chosen has a unique and influential job in the correctional
environment being reviewed.
The State Director of Nursing for Centurion of Florida can discuss needed changes with
Centurion leadership and the Florida Department of Corrections leadership as required, and this is their
power. With this power, this Stakeholder can assist in changing policy and even go above and beyond
what the policy or law states to obtain appropriate patient care and provide nursing education as they
see fit. The interest of this Stakeholder is that a private contractor employs them; good practices
increase the chance of the company renewing the contract when the renewal date comes due. These
stakeholders' influence comes from their position of oversight for nursing at sixty-one prisons in the
State of Florida, so they are the direct report for everything nursing at these locations.
The Vice President of Operations (VPO) for Centurion of Florida can discuss changes needed
with Centurion leadership, the Florida Department of Corrections, and the Florida State Legislature. The
VPO's interest is in Centurion, a private contractor that can be replaced anytime. For the VPO and other
Education on Bias and Its Impact on Patient Care
Western Governors University Leavitt School of
Health
D156: Business Case Analysis for Healthcare Improvement
Healthcare Improvement Project: Introduction and Project Initiation
Organizational Problem
The healthcare improvement project (HIP) chosen will provide education on bias and its impact
on patient care in the correctional setting in Northwest Florida Prisons. Approximately twenty-seven
thousand three hundred inmates were incarcerated in Northwest Florida prison facilities, including
Escambia, Holmes, Jackson, Okaloosa, Santa Rosa, Walton, and Washington County Prisons in Florida
in
,2023 (Prison Policy Initiative, 2023). The 8th Amendment of the United States Constitution validates an
incarcerated person's "right" to medical care. In the State of Florida, this "right" is granted through
Florida Statutes section 945.6037 (Florida Legislature, 2025).
In every aspect of healthcare, bias can be an issue; however, it can be a more significant
problem in correctional healthcare. There are many reasons this is an essential problem in the
correctional setting. Reason one is that the environment is challenging to manage since security has
control of every situation, and custody and control come ahead of anything else, including healthcare.
Reason two is the ability of nursing staff to keep their personal belief and opinions of the inmate's
reason for being incarcerated separate from the inmate's need for treatment of their medical condition.
Third, the inmate's behavior, sometimes irrational and aggressive, influences the nurses' desire, or lack
of, to treat the inmate as required by the State of Florida.
Nurses who enter the Florida prison system must undergo mandatory training before speaking
with an incarcerated individual. This training consists of boundaries, safety concerns, and the need for
security to always be in control. What is not included in this training is "bias" and how this one word
affects the population's healthcare. Many studies have shown that bias in the correctional setting is a
systemic problem in every correctional healthcare setting. The studies also agree that it is a problem
, that needs to be addressed. This HIP aims to decrease bias by nursing staff on the incarcerated by
providing mandatory training for all nursing staff on the issue, how it starts, why it is an issue, and
the consequences of bias for not only the incarcerated but also the nurse.
Stakeholders
In Florida, most correctional health care has been given to a private contractor known as
"Centurion of Florida," and this contract includes sixty-one prisons in the State. The Department of
Health Services still oversees the Florida Department of Corrections contract. Stakeholders were chosen
from both the contractor and the State responsible for the incarcerated population's well-being and
care. These individuals were selected due to their power, influence, and interest in incarcerated
persons' care. Everyone has over twenty years of experience working in the correctional environment
in the State of Florida. Everyone chosen has a unique and influential job in the correctional
environment being reviewed.
The State Director of Nursing for Centurion of Florida can discuss needed changes with
Centurion leadership and the Florida Department of Corrections leadership as required, and this is their
power. With this power, this Stakeholder can assist in changing policy and even go above and beyond
what the policy or law states to obtain appropriate patient care and provide nursing education as they
see fit. The interest of this Stakeholder is that a private contractor employs them; good practices
increase the chance of the company renewing the contract when the renewal date comes due. These
stakeholders' influence comes from their position of oversight for nursing at sixty-one prisons in the
State of Florida, so they are the direct report for everything nursing at these locations.
The Vice President of Operations (VPO) for Centurion of Florida can discuss changes needed
with Centurion leadership, the Florida Department of Corrections, and the Florida State Legislature. The
VPO's interest is in Centurion, a private contractor that can be replaced anytime. For the VPO and other
