Implementation of a Traumatic Stress Risk Screening Protocol: Data From a Decade

Abstract

Background: Calls for standardized screening of children traumatic stress risk following a nonfatal injury have been met with high enthusiasm, but implementation has been slow. This paper presents a retrospective, single-center examination of a trauma screening protocol. Methods: Medical and psychology teams collaborated to identify a screening tool, establish follow-up procedures, and integrate the protocol into routine care. Feasibility was assessed through patient data over ten years. Yearly data compared rates of screening and psychology consults. Chi-square and independent sample t-tests assessed whether patient demographic or medical characteristics were associated with differences in screening. Results: 76.82% of eligible patients successfully completed screening. Injury severity, duration of admission, and injury type were each associated with differences in screening completion and psychology consultation. Patient age, race/ethnicity, insurance status, and residential child opportunity index score were associated with differences in screening completion and/or psychology consult completion. Conclusions: Overall, the established protocol presents a promising approach to screening pediatric patients for traumatic stress in inpatient settings. Other centers may benefit from modeling their own screening protocols with collaboration between medical/psychology teams.

Implications for Impact

Children admitted to the hospital for treatment of injuries are at risk for traumatic stress, but medical teams have struggled to implement systemic strategies to identify and support these patients. This paper presents the efforts of a pediatric medical center to develop a screening protocol for traumatic stress risk. Areas for improvement were identified based upon differences in screening associated with patient characteristics.