descriptive statistics using the 6 items in the pre- and posttest showed an average gain of 48% in knowledge compared to the pretest scores. Using the World Health Organization Well-Being Index scale, participants’ sense of well-being also improved with an average score of 21% to 40% following the intervention. Findings indicate that effective management of work-related stress could result in positive social change by improving the health of nurses, the health outcomes of inmates, their families, and the community at large. With knowledge from this project, leadership might provide support and create opportunities for nurses to improve their skills. Strategies for Nursing Staff Working in a Correctional Facility by Ima James APRN-FNP, Walden University, 2016 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University May 2019 Dedication This project is dedicated to my beloved husband who was my rock, my greatest encouragement, my loudest cheerleader, and my mentor who went to be with the Lord one year ago. Acknowledgments This project would not have been possible without the help and blessings of the Almighty God during this darkest time of my life; I owe Him my deepest respects. I also express my sincere gratitude to Dr. Barbara Gross, for all her time and advice; Dr. Janice Long for correcting my initial draft and guiding me; Dr. Courtney Nyange for her attention to detail; and Dr Edna Hull for her valuable ideas and tweaks. Dr Hull I will not forget that phone call you made on a Sunday evening, although I had a sleepless night after the call, but that phone call was a catalyst to this great achievement and my timely graduation from the program. I am especially indebted to you, thanks a lot ma'am. I also thank my dear parents, Ime and Emily Inokon, for instilling a spirit of achievement in me at a very young age. I will be ever grateful to my loving husband, who has been a pillar of strength in my life; he not only encouraged my intellectual pursuits but also offered an environment that was conducive to great accomplishments. I thank Dr. Philemon Chang, my mentor, for supporting me throughout my DNP program. Many thanks are due to all my family and friends who were with me via thoughts, spirit, and prayers. Finally, I thank my children, Ajay and Gold for their support and Bobby, Donna, and Kaykay for their encouragement. Connecticut Department of Correction (CT DOC) contracted with Health Management Associates (HMA) to assess the current inmate medical services delivery systems and make recommendations for the system and for a medical management model. Although the assessment methodology was initially designed to incorporate in‐person visits and on‐site observation, this was impossible due the nation’s pandemic. As a result, HMA worked diligently with CT DOC and its Health Services’ Unit (HSU) to utilize all other means including extensive interviewing (phone and video calls), extensive document review to perform an operational assessment and staffing analysis, and an evaluation of medical care through comprehensive review of 632 medical charts. A correctional health care system is by definition a specialty health care system. The system serves thousands of individuals with acute medical and behavioral health needs and individuals with many chronic conditions. The safety of inmates and staff must be ensured, and access to care is constrained by a wide variety of safety, communication, and transportation considerations. Many service delivery mechanisms in correctional health systems across the county are outdated and reactive and do not incorporate efficient and effective practices that are now ubiquitous in community health care. This analysis considered national accreditation standards for correctional health, nationally recognized clinical guidelines for managing chronic illness and preventive care, common practices in managed care, and models of care for addressing defined populations. The assessment identified many core strengths within CT DOC’s health care system as well as challenges and opportunities to improve its operations and outcomes. Findings from the chart audits aligned completely with the operational and staffing analyses. Strengths CT DOC health care system strengths are underpinned by the positive relationship between health care and security. There is a high level of medical autonomy; health care staff feel safe carrying out their work; and security is largely viewed as a partner in assuring that inmates have access to timely care. HSU’s response to COVID‐19 has been excellent and demonstrated proactive efforts and management of a fluid, dangerous, and complex set of circumstances. Several initiatives, such as its surveillance and management of Hepatitis C Virus (HCV), have also been proactive and demonstrate best practices. Recent plans such as hiring a podiatrist, should assist with improving chronic care management and outcomes. Across the system, intake screenings are generally on time, and necessary and critical actions are addressed quickly and efficiently. HSU has made great strides with new laboratory and pharmacy providers. Significant service improvement and cost savings ($800 K‐$1.1M per month) have been realized. HSU has