Utilising a nurse navigator model of care to improve prisoner health care and reduce prisoner presentations to a tertiary emergency department

Prisoners are a vulnerable population requiring complex care interventions in challenging environments, particularly around provision of emergency care. The aim of this study was to explore the effectiveness of a Nurse Navigator (NN) -led prisoner intervention from the perspective of the emergency department. This study undertook a retrospective analysis of the prisoner presentations to a public emergency department. It used time-series analysis of publicly available deidentified data, collected during standard care evaluation, to explore the impact of this unique care model over 24 months (12-pre and 12-post). Synthesis of documents pertaining to this NN model of care provide a summary of key initiatives and interventions. With the introduction of NN, the rate of change of yearly prisoner presentations dropped from + 32.8% to − 2.7%. Interrupted time-series analysis on emergency department presentations per 1000 prisoners in custody confirmed a postintervention level drop of 15.1% (rate ratio 0.849; 95% CI 0.755–0.954) followed by a period of downward trending of presentations resulting in an absolute drop of 31.5% in twelve months (rate ratio 0.685; 95% CI 0.556–0.843). The bundle of capacity-building initiatives instigated by the NN appear to have contributed to a reduction of prisoner presentations.