Lamberson Miles, Collins Samantha C, Axtmayer Caitlin, Bisanzo Mark, Della Grotta Kay, Fleisher Courtney L, Marsac Meghan L, Mathon Cecelia J, Pulcini Christian D
J Emerg Nurs. 2025 Jan;51(1):145-157. doi: 10.1016/j.jen.2024.09.010. Epub 2024 Oct 11.
Trauma-informed care has been posited as a framework for creating ideal and safe environments for patients to participate in treatment. However, there are limited studies that demonstrate the impact of a focused trauma-informed care training on ED staff. We implemented a 4-hour trauma-informed care training in a general emergency department. We aimed to measure changes in knowledge, opinions, self-rated competency, barriers, and recent practices before and after implementing trauma-informed care training. We hypothesized that the training would result in significant self-reported improvement in all domains.
We performed a pre/post interventional study with the intervention being a trauma-informed care training adapted for ED clinical care staff. A validated, publicly available survey tool (Center for Pediatric Stress Trauma-Informed Care [TIC] Provider Survey) was used to assess knowledge, opinions, competency, and utilization of and perceived barriers to trauma-informed care. Pre- and post-training surveys were collected. Responses were stratified by role. Continuous variables were compared using analysis of variance; categorical variables compared using Pearson's chi-square.
Participants demonstrated a high level of perceived knowledge and opinions of trauma-informed care before and after training. We observed significant increases in self-reported competence for all ED staff, some increase in utilization of trauma-informed care in recent practice, and significant decreases in perceived barriers to providing trauma-informed care.
Trauma-informed care training is an effective means to improving ED staff self-perceived competence and practice of trauma-informed care even among those with high self-perceived knowledge and opinions of trauma-informed care before the training. Future study should explore the patient-level impact of trauma-informed care training, as well as how to continue to reduce barriers to system-wide implementation of trauma-informed care practices.
创伤知情护理已被视为一种为患者创造理想且安全的治疗环境的框架。然而，仅有有限的研究证明了针对急诊科工作人员的聚焦创伤知情护理培训的影响。我们在一家综合急诊科实施了为期4小时的创伤知情护理培训。我们旨在衡量在实施创伤知情护理培训前后，工作人员在知识、观点、自我评估能力、障碍及近期实践方面的变化。我们假设该培训会使所有领域的自我报告均有显著改善。
我们进行了一项干预前后研究，干预措施为针对急诊科临床护理人员的创伤知情护理培训。使用一种经过验证的、公开可用的调查工具（儿科应激创伤知情护理中心[TIC]提供者调查问卷）来评估对创伤知情护理的知识、观点、能力、利用情况以及感知到的障碍。收集培训前和培训后的调查问卷。回答按角色进行分层。连续变量使用方差分析进行比较；分类变量使用Pearson卡方检验进行比较。
参与者在培训前后对创伤知情护理的感知知识和观点水平较高。我们观察到所有急诊科工作人员自我报告的能力有显著提高，近期实践中对创伤知情护理的利用有所增加，且提供创伤知情护理的感知障碍显著减少。
创伤知情护理培训是提高急诊科工作人员自我感知能力及创伤知情护理实践的有效手段，即使是在培训前对创伤知情护理有较高自我感知知识和观点的人员中也是如此。未来的研究应探讨创伤知情护理培训对患者层面的影响，以及如何继续减少创伤知情护理实践在全系统实施的障碍。
