Risk Factors for Recidivism in Nursing Practice: A Criminal Conviction Case Review Cohort Study

Abstract

<h3>Background</h3> Boards of nursing (BONs) investigate complaints and take disciplinary actions against the licenses of nurses in order to maintain patient safety. For nurses with prior criminal convictions, the potential risks to patient safety have not been formally evaluated. <h3>Objective</h3> This study aims to assess the impact of a nurse's prior criminal conviction(s) on the risk of recidivism in nursing practice and to investigate whether nurses who were disciplined by BONs for a crime but retained an active nursing license posed a subsequent risk to public safety. <h3>Methods</h3> We reviewed Nursys discipline data from 2008–2018 to compare the risk of recidivism for nurses sanctioned for criminal convictions between 2012–2013 and those disciplined for other violations. The type of crimes and disciplinary actions taken by BONs were recoded and analyzed. <h3>Results</h3> The 5-year recidivism rate of nurses who received disciplinary actions for criminal convictions between 2012 and 2013 was 38%, which is comparable to the recidivism rate among nurses in the control group (36%). Overall, among those who had a criminal conviction history yet retained an active license, 4% committed a practice-related violation or crime within the 5-year postdisciplinary period. Three factors correlated with recidivism: (1) committing a crime related to substance use disorder, (2) committing a crime related to nursing practice, and (3) committing multiple crimes. <h3>Conclusion</h3> The majority of nurses who were disciplined by BONs for a criminal conviction and allowed to remain in nursing practice did not receive additional disciplinary actions by BONs for committing subsequent practice-related violations or crimes during the 5-year post disciplinary period. The current study suggests that the licensure and discipline procedures used by BONs in response to criminal convictions help to reduce the risk of patient harm in nursing practice, thereby aligning with their mission of public protection.