Introducing trauma-informed care in an acute inpatient psychiatric unit: a quality improvement project

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Montana State University - Bozeman, College of Nursing


Traumatic experiences are common in society and are associated with an increased risk of development of adverse physical and psychological outcomes extending throughout the lifespan. Individuals accessing mental health services, such as inpatient hospitalization, are likely to have experienced interpersonal trauma at some point during their lives. Mental health professionals are well suited to provide supportive and effective trauma-informed care (TIC) to patients with trauma histories. TIC seeks to actively resist patient re-traumatization and caregiver secondary traumatic stress. An evidenced-based trauma-informed care training was presented to mental health professionals working on a psychiatric inpatient unit. The project involved a single group pre-post test design with a 1-month follow-up assessment. Staff attitudes towards trauma-informed care were evaluated by a psychometrically validated tool (ARTIC-35). Sums of the items on the ARTIC?35 for each participant were divided by the number of items, means and standard deviations for aggregate average scores for each time point were obtained, and percent change for participant average scores between time points were calculated. Additionally, participants were asked to share if they had incorporated trauma-informed care into their work with patients and if they experienced any barriers to implementing TIC since the training. Immediately following the training, ARTIC-35 scores increased on average by 11%, demonstrating that attitudes related to trauma-informed care improved as a result of the training. One month following the training, all six participants maintained their score on the ARTIC-35, representing a 12% increase from pre-training scores and 0.61% from immediately following training. Further, all participants indicated at the 1-month follow-up assessment that they changed their practice to incorporate trauma-informed care into their work with patients. A 1-hour TIC in-service training demonstrated the ability to improve psychiatric healthcare professional's attitudes toward trauma-informed care. Healthcare organizations serving patients with traumatic histories should consider TIC training for all personnel.




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