Addressing Traumatic Stress in the Acute Traumatically Injured Patient

Abstract

Psychological injuries after an acute traumatic event are commonly overlooked. Currently within United States, there is no consistently utilized screening process that addresses traumatic stress within the acute trauma population. Roy's Adaptation Model guided this project, focusing on the idea that bedside nurses are at the frontline of providing early identification through nursing assessment. The purpose of this pilot study was to evaluate whether the implementation of the Primary Care-Posttraumatic Stress Disorder (PC-PTSD) screening tool by bedside nurses would result in identifying more patients at risk for traumatic stress after an acute trauma as compared with the use of no screening method. This descriptive survey study took place over a 6-week period at a Midwest Level 1 trauma hospital. The results revealed that the tool did not increase the number of health psychology consults when compared with the same 6-week period a year prior when no tool was used. Nonetheless, use of the PC-PTSD tool did trigger 28% of the patients to receive a health psychology consult. Forty-five percent of patients who received a health psychology consult were recommended outpatient therapy. Utilization of this tool by bedside nurses did not adversely increase a number of inappropriate health psychology consults. These results agree with the literature and further suggest that there are a clinically significant number of acute trauma patients who are at risk for traumatic stress. With this screening tool, nurses accurately assessed patients and connected them with timely psychological treatment.

Early Screening for Posttraumatic Stress Disorder and Depression Among Injured Emergency Department Patients: A Feasibility Study

“…Further, the TSQ only includes arousal and experiencing items; the avoidance cluster of DSM‐IV is not represented . Similarly, the brief 4‐item Primary Care‐Posttraumatic Stress Disorder screener has been used among patients hospitalized after acute injury; however, this screener is anchored solely to posttrauma symptoms, provides a binary screen (yes/no) rather than assessing the severity of symptoms, and requires additional time for processing of the event (e.g., there is an item that asks about nightmares from the event).…”

Traumatic Stress and Depression Risk Screening at an ACS Verified Trauma Center

“…Although screening for traumatic stress and depression risk is currently recommended by the ACS, less than 10% of verified trauma centers follow these guidelines (ACS Committee on Trauma, 2018). Trauma centers often lack a psychosocial component to trauma care because providers are focused on patients' physiological needs, such as establishing an airway, hemodynamic stabilization, completing trauma surgeries, and so forth (Frank et al, 2017). A Level II trauma center in Southeast Michigan has an average of 1,500 trauma activations per year.…”