Implementation of a standardized screening program for risk of posttraumatic stress disorder among youth hospitalized with injury.

Abstract

Children with pediatric injury and their parents are at risk for developing posttraumatic stress disorder (PTSD). Although challenging to implement, standardized screening for risk of developing PTSD can identify families most at risk. The current retrospective, chart review study evaluated the implementation of a clinical program that integrated screening for risk of PTSD into standard care for youth admitted to a Level I pediatric trauma center due to injury. Advanced practice nurses administered the Screening Tool for Early Predictors of PTSD (STEPP), a brief screen that evaluates risk of developing PTSD for injured children (ages 8 -17 years) and their parents. Positive parent or child STEPPs prompted a referral to psychology for an inpatient consultation. Data were collected via review of electronic medical records and trauma program registry, including demographic, injury, and admission information, completion of and result on the STEPP, and completion of a psychology consultation. During the 2.5 year study period, 1,153 youth (birth-17 years) were admitted due to injury. Among those eligible for the STEPP (i.e., Ն8 years; N ϭ 562), 67% completed the STEPP. Among those who completed the STEPP, 25% had positive parent or child screens and 68% of these completed an inpatient psychology consultation. Standardized screening was related to significantly higher use of inpatient psychology services compared with a control sample not eligible for screening (i.e., Ͻ8 years). STEPP scores varied by demographic, admission and injury factors. Results suggest standardized screening is feasible and improves reach of trauma-informed care. Barriers and facilitators of this screening program are discussed.

Post-Traumatic Distress and Symptom Experience in Patients With Head and Neck Cancer–Related Tracheostomy and Family Caregivers

“…Early detection of post-traumatic distress warrants the delivery of prompt support by the interprofessional team. One implementation study of a standardized PTSD screening tool in the electronic health record for hospitalized youth (N = 562) found significantly higher use of psychological consultation services (Price et al, 2019). An algorithm-based PTSD screening tool based on patients' electronic health records developed by Russo et al (2013) was also a feasible approach for PTSD screening.…”

Development and pilot testing of a five item traumatic stress screener for use with adolescents in pediatric primary care

“…Low-income and BIPOC youth are disproportionately affected by traumatic and adverse events [48,49], which are at least partially downstream outcomes of structural inequities. One consequence of the disproportionate exposure to trauma and ACEs that low-income and BIPOC youth cope with is a higher rate of subsequent PTSD and associated mental health symptoms and disorders [50][51][52].…”

Development and Pilot Testing of a Five Item Traumatic Stress Screener for Use with Adolescents in Pediatric Primary Care

“…Moreover, they create conditions that increase the likelihood that low-income and BIPOC youth will be exposed to other traumas, such as violence and death (Knopov et al, 2019; Wilkins et al, 2019). One consequence of the disproportionate exposure to trauma and ACEs that low-income and BIPOC youth cope with is a higher rate of subsequent PTSD and associated mental health symptoms and disorders (Lopez et al, 2017; Price et al, 2019; Pulsifer et al, 2019).…”