ArticleJournal of trauma nursing : the official journal of the Society of Trauma Nurses
Mental Health Screening in a Rural Trauma Center: Feasibility and Impact.
Article in Journal of trauma nursing : the official journal of the Society of Trauma Nurses. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTrauma survivors often develop psychological sequelae, namely depression and post-traumatic stress disorder. Identifying and treating at-risk patients in rural trauma centers is challenging due to resource limitations, a gap not previously addressed in the literature.
objectiveTo assess the feasibility and impact of a mental health screening initiative in a rural trauma center.
methodsThis quality improvement study used a quasi-experimental design to evaluate the feasibility and impact of a mental health screening initiative over 2 years (2022-2024) in a rural Northwestern U.S. Level II trauma center. We compared screening compliance, resource provision, and psychiatric consultation rates between the implementation (August 2022-July 2023) and post-implementation years (August 2023-July 2024). The inclusion criteria included trauma patients aged ≥18 years, with a Glasgow Coma Scale > 14, and who were admitted ≥ 2 days. The target screening compliance rate was set at ≥ 80%.
resultsOf the 1,114 eligible patients, 938 (84.2%) were screened, with 314 (33.5%) screening positive for psychological sequelae. All positive screen patients received a resource pamphlet and psychiatric consultation offers, resulting in 34 (10.8%) receiving formal evaluations. Missed screening opportunities decreased from 20.5% (95% CI [16.7, 24.4]) in the implementation year to 13.6% (95% CI [9.0, 18.2]) (p = .022) in the post-implementation year.
conclusionMental health screening proved feasible in a rural trauma center, achieving 84.2% screening compliance. Despite barriers of limited staff availability and manual documentation, missed screening opportunities decreased. However, with only 10.8% of positively screened patients receiving psychiatric consultations, substantial systemic barriers remain to be addressed.
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