Doctor of Nursing Practice (DNP) Projects

Implementation of Trauma Informed Care In a Primary Care Setting Using the Adverse Childhood Experiences As a Screening Tool

Adedoyin Adepoju


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Background: The prevalence of trauma is widely unacknowledged in the primary care setting. Unfortunately, the trauma that individuals sustained as children may continue to adversely affect their health as adults in various ways, including risky health behaviors, early death, chronic health conditions and low life potential. Prevention of trauma is key and can be achieved with consistent public health education. Further, there are available treatments for childhood trauma and the inclusion of primary care as a starting point is imperative.

Purpose: Screening for trauma is a component that has been established in behavioral health services and is starting to be introduced into the primary care setting. The Adverse Childhood Experience (ACEs) is a screening tool that can be used to assess patients for childhood trauma.

Methods: This quality improvement project, was conducted at a primary care clinic, assessed all staff member’s current level of understanding of trauma informed care. Based on the results of the pre assessment, training sessions were tailored to the learning needs of the staff. Then, trauma informed care was implemented and patients with at least three visits to the clinic were screened using the ACEs. After screening, patients that score four or more were offered higher level of care with a mental health provider.

Results: Pre-survey analysis indicated that training was needed for staff members. Post survey analysis displayed that the training was successful based on response by staff and implementation of TIC. The intent of the project was met with the adequate addition of ACE as a screening tool in this primary care clinic.