Implmentation of trauma informed care using the 'ACE-10' questionnaire: a quality improvement project

Abstract

The effects of childhood trauma, in the form of adverse childhood experiences, are detrimental to a person's mental and physical health. Education and screening are pertinent components of trauma-informed care, both assisting in the identification of those patients who are at risk for poor health outcomes. A rural, critical-access hospital in Northeast Montana has no trauma-informed care policies or screening practices. As an educational component, the inpatient nurses and providers employed at this hospital were provided with a 15-minute presentation on trauma-informed care and adverse childhood experiences. All adult behavioral health patients admitted to the inpatient medical-surgical floor at this hospital were screened using the 'ACE-10' questionnaire. Scores from the questionnaire range from 0 = no adverse experiences to 10 = 10 unique traumatic experiences during childhood. Patients scoring four or greater were referred to outpatient mental health services during these six weeks. Post-tests after presentations resulted in an average passing score of 95%. Three adult behavioral health patients were admitted during the six weeks. The average ACE score of the three patients was 6.7. All three patients were transferred to the Montana State Hospital. Thus, no referrals were sent. Trauma-informed care practices were initiated at a rural critical access hospital, providing trauma education and screening practices.