Nurses' Views and Current Practice of Trauma-Informed Pediatric Nursing Care

Kassam‐Adams, Nancy; Rzucidlo, Susan; Campbell, Marie; Good, Grace; Bonifacio, Erin; Slouf, Kimberly; Schneider, Stephanie; McKenna, Christine; Hanson, Carol A.; Grather, Donna

doi:10.1016/j.pedn.2014.11.008

Cited by 66 publications

(88 citation statements)

References 26 publications

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“…For example, a recent study found that pediatric nurses were fairly knowledgeable about and open to using a trauma-informed framework but that their current practice and self-rated competence varied most with regard to directly asking patients about traumatic events and educating parents and children about PTSS. 65 Another study found high overall acceptability for the implementation of a PTSS screening tool among both ED staff and patients. 66 These findings suggest that while providers value trauma-informed care practices, there are gaps in training, confidence, and support structures.…”

Section: Training Pediatric Healthcare Network In Trauma-informed Carementioning

confidence: 99%

Implementing a Trauma-Informed Approach in Pediatric Health Care Networks

et al. 2016

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Section: Training Pediatric Healthcare Network In Trauma-informed Carementioning

confidence: 99%

Implementing a Trauma-Informed Approach in Pediatric Health Care Networks

et al. 2016

Self Cite

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“…While results (particularly those exploring symptom‐level associations with QOL) are preliminary, current results can help direct nurses towards specific signs and symptoms to watch for in their pediatric patients (e.g., children's startle response, children blaming themselves for their injury). Pediatric nurses have the unique opportunity to help minimize these symptoms and improve QOL in children after injury by integrating trauma‐informed approaches into their clinical care (Kassam‐Adams et al, ; Marsac et al, ). For example, nurses may want to assess and monitor specific re‐experiencing symptoms such as nightmares or an obsession with a part of medical care.…”

Section: Discussionmentioning

confidence: 99%

Opportunities for nurses to support recovery after pediatric injury: Relationships among posttraumatic stress, hope, and quality of life

Weiss

Ostrowski‐Delahanty

Allen

et al. 2019

Specialist Pediatric Nursing

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Purpose Nurses are at the forefront of children's postinjury recovery; this unique role provides an opportunity for nurses to recognize and screen for symptoms that may interfere with children's quality of life (QOL). As such, aims of the present investigation were to explore selected variables (e.g., posttraumatic stress symptoms [PTSS], hope) that have the potential to impact QOL after pediatric injury, with a larger goal of contributing to recommendations for nursing practice to support children's full (physical and emotional) recovery during the peritrauma period following injury. Design and methods Sixty children (aged 7–13) completed measures of PTSS, hope, and QOL while receiving injury treatment. Results PTSS significantly predicted concurrent QOL, β = −0.42, p = 0.001. Exploratory results demonstrated that specific PTSS clusters (re‐experiencing [ β = −0.39; p = 0.003), avoidance [ β = −0.35; p = 0.009], arousal [ β = −0.34; p = .012]) all significantly predicted QOL. Specific PTSS were explored. Hope (overall, domains of pathways, general agency, goal setting) did not significantly predict concurrent QOL. Practice implications While this study is exploratory and more research is needed, current results suggest that nurses’ awareness of PTSS (including symptoms of re‐experiencing, avoidance, arousal) may help medical teams in identifying children that are at risk for impaired functional recovery (e.g., QOL) during the peritrauma period. Nurses may want to consider advocating for the integration of PTSS screeners into standard medical care. In addition, nurses have the opportunity to serve as key medical professionals in the delivery of trauma‐informed medical care (which aims to minimize further trauma or re‐traumatization). Nursing leadership may want to consider offering training in how nurses can identify and respond to children who have experienced an injury (such as trauma‐informed care).

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“…For example, among level I trauma centers that see children, only 20 percent systematically address posttraumatic stress in pediatric patients [15], and surveys of health care professionals indicate wide variation in knowledge and practice of trauma-informed pediatric care [16][17][18]. Nevertheless, practice standards are beginning to enumerate elements of trauma-informed care as key components of pediatric health care in such diverse areas as pediatric oncology [19] and pediatric trauma care [20].…”

Section: Practice Standards and The Ethical Case For Trauma-informed mentioning

confidence: 99%

What Do Clinicians Caring for Children Need to Know about Pediatric Medical Traumatic Stress and the Ethics of Trauma-Informed Approaches?

Kassam‐Adams¹,

Butler

2017

AMA Journal of Ethics

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Medical experiences can be frightening and traumatic for children. Ill and injured children can experience pediatric medical traumatic stresspsychological and physiological distress responses related to their medical event and subsequent medical treatment experiences-which can lead to symptoms of posttraumatic stress disorder (PTSD) and suboptimal health outcomes. Trauma-informed care provides a framework for acknowledging, addressing, and mitigating the risks of psychological trauma associated with medical treatment experiences and is congruent with the ethical principles of respect for autonomy, beneficence, nonmaleficence, and justice. Health care systems and professionals are encouraged to apply the principles of trauma-informed care to address the effects of pediatric medical traumatic stress. IntroductionFor the sick or injured child, being treated in the emergency department (ED) or admitted to the hospital can be a frightening and confusing experience that leads to subsequent psychological distress [1]. Experiencing pain, feeling helpless and out of control, and being separated from one's parents are all factors that contribute to the potentially traumatic nature of medical events. How does a physician's ethical obligation to "first, do no harm" square with the prospect of providing a therapeutically necessary procedure for a frightened child who does not understand what is being done and why? How do we understand the ethical issues involved when a medically beneficial course of treatment for a pediatric patient also has the potential to engender stress, fear, anxiety, pain, or discomfort for this child? In this brief review, we first describe two concepts that are key to understanding and addressing the psychological distress that can affect ill and injured children: pediatric medical traumatic stress and trauma-informed pediatric care. We then discuss four core principles of medical ethics (respect for autonomy, beneficence, nonmaleficence, and justice [2]) and explain how the application of these principles underscores the need for trauma-informed care.

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Nurses' Views and Current Practice of Trauma-Informed Pediatric Nursing Care

Cited by 66 publications

References 26 publications

Implementing a Trauma-Informed Approach in Pediatric Health Care Networks

Implementing a Trauma-Informed Approach in Pediatric Health Care Networks

Opportunities for nurses to support recovery after pediatric injury: Relationships among posttraumatic stress, hope, and quality of life

What Do Clinicians Caring for Children Need to Know about Pediatric Medical Traumatic Stress and the Ethics of Trauma-Informed Approaches?

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