Implementation of standardized trauma and resiliency screening in a youth therapeutic residential setting: a quality-improvement project
Bugni, Katherine Tabije
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The purpose of this DNP project was to establish standardized trauma and resiliency screening for patients within the youth therapeutic residential setting. A lack of standardized screening and documentation of trauma exposure and resiliency factors was identified internally by the organization. The establishment of routine screening for traumatic experiences provides valuable data, which will inform and be incorporated into the patient's treatment plan. Additionally, routine screening of the patient's resiliency measures complements the trauma information that was collected. This information is important as resiliency plays a critical role in countering the downward trajectory that is set by a child's experience of trauma. Resilience can act as a safeguard from the negative outcomes that are linked with experiencing early trauma. The major objectives for this project were (1) for staff to implement trauma screening and (2) resiliency screening with youth in a therapeutic setting. Not only does the trauma score provide key information about the patient, but it can also guide treatment and serves to establish a baseline for the continued tracking of trauma and resiliency experiences. Additionally, continued data tracking beyond discharge is a requirement of the recent Family First Prevention Services Act of 2018. This project's aim was for participants to utilize the organization's electronic health record to collect and house the screening data. At a later date, the information can be utilized for advocacy of funding, vitals tracking, and for future quality-improvement processes. The results include that staff obtained screenings for 100% of the organization's residential population, with screenings for trauma (ACEs) and resiliency (CYRM-R), incorporating the new process into routine practice within the short PDSA cycle. The results of staff success in incorporating the new screening process for trauma and resiliency with youth residents during weekly routine visits indicate that this practice change is not only achievable, but can be applied during already established weekly visit time between existing trained staff and the patients within the two communities' residential therapeutic group homes.