Acute Stress Disorder and Post-Traumatic Stress Disorder Screening in Pediatric Trauma Patients

BACKGROUND: Two-thirds of U.S. children and adolescents report experiencing one or more potentially traumatic events by age seventeen. 13.4% of the North Carolina pediatric population ages 0-17 have undergone two or more traumatic adverse childhood experiences, compared to 14% of the U.S. population. Early identification reduces the by-products of underdiagnosis of ASD and PTSD, such as mental illness, developmental delays, poor academic performance, and challenges with social interactions.

LOCAL PROBLEM: The project site is a level-one pediatric trauma hospital in Charlotte, North Carolina, seeing more than 130,000 patients annually. Before project implementation, there was an absence of ASD and PTSD screening and referral protocol for pediatric trauma patients. The project aimed to implement ASD and PTSD screening at the project site for pediatric trauma patients and increase the number of pediatric trauma patients with referrals ordered.

METHODS: The Evidence-Based Practice Improvement model was the framework used for this project. The pilot study was compared to the data pre/post-intervention implementation.

INTERVENTIONS: All pediatric patients ages 7-17 years old who were admitted for unintentional traumatic injuries for a minimum of 24 hours were screened for ASD and PTSD. If the patient screened positive, a referral was placed. Screening for PTSD was conducted at 30, 60, and 90 days.

RESULTS: The project data analysis and pilot study statistical analysis were compared via Chi-Square and Pearson R analysis; however, without the original data set, the comparison left a margin for error. The data collected expanded demographics, trauma types, and referrals placed. Data was used to determine the permanent selection of screening tools used for ASD and PTSD screening.

CONCLUSIONS: The use of standardized screening tools increased the number of referrals placed for pediatric trauma patients at risk for ASD and PTSD. The implementation of ASD and PTSD screening tools will be integrated into the standard practice at the project site.