Measurement of Patient-Level Outcomes After Implementation of Trauma-Informed Care Training in the Emergency Department: A Pilot Study

• Published in: Journal of emergency nursing 2024-11, Vol.50 (6), p.780-785
• Main Authors: Pulcini, Christian D., Lamberson, Miles, Collins, Samantha C., Axtmayer, Caitlin, Mathon, Cecelia J., Della Grotta, Kay, Bisanzo, Mark, Fleisher, Courtney, Marsac, Meghan L.
• Format: Article
• Language: English
• Subjects: Adult; Anxiety; Clinical outcomes; Emergency department; Emergency medical care; Emergency Nursing - education; Emergency Nursing - methods; Emergency Service, Hospital; Emergency services; Female; Health care; Humans; Intervention; Likert scale; Male; Measurement; Medical education; Middle Aged; Nursing; Patient Reported Outcome Measures; Patient-centered care; Patients; Pilot Projects; Polls & surveys; Prospective Studies; Quality Improvement; Quality management; Response rates; Staff training; Stress; Surveys and Questionnaires; Trauma; Trauma care; Trauma-informed care; Wounds and Injuries - therapy
• ISSN: 0099-1767; 1527-2966; 1527-2966
• DOI: 10.1016/j.jen.2024.06.008

Trauma-informed care has been posited as a framework to optimize patient care and engagement, but there is a paucity of data on patient-level outcomes after trauma-informed care training in health care settings. We sought to measure patient-level outcomes after a painful procedure after implementation of trauma-informed care training for ED staff. As part of a quality improvement initiative, we trained 110 ED providers in trauma-informed care. Next, we prospectively recruited patients who had undergone a painful procedure to complete a survey to assess several patient-level outcomes, such as anxiety reduction and overall experience of care. We compared differences in patient outcomes for those who were treated by providers in the trauma-informed care intervention group with those who were treated by providers who did not complete the training (usual care). One-hundred forty-seven adult patients completed survey measures (n = 76 trauma-informed care intervention group; n = 71 usual care group) over a 1-month period. Most patients offered the highest rating for all ED staff-related questions. We found no significant differences in assessment of patient-reported outcomes based on intervention versus usual care. Our trauma-informed care training did not seem to have a significant effect on our selected patient outcomes. This may be caused by the training itself or the challenges in measurement of the patient-level impact of trauma-informed care training owing to the study design, setting, and lack of standardized tools. Recommendations for future study of trauma-informed care training and measuring its direct impact on patients in the ED setting are discussed.