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Barriers to and facilitators of a screening procedure for PTSD risk in a level I trauma center
  1. Sacha A McBain1,2,
  2. Kevin W Sexton3,
  3. Brooke E Palmer1,
  4. Sara J Landes1,2
  1. 1Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  2. 2Mental Illness Research Education and Clinical Center (MIRECC), Central Arkansas Veterans Healthcare System, Eugene J Towbin Healthcare Center, North Little Rock, Arkansas, USA
  3. 3Department of Surgery, Division of Acute Care Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  1. Correspondence to Dr Sacha A McBain, Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA; smcbain{at}uams.edu

Abstract

Background Patients admitted to the hospital after an injury are at a greater risk for developing post-traumatic stress disorder (PTSD) due to the nature of the injury and the traumatic nature of necessary medical interventions. Many level I trauma centers have yet to implement screening protocols for PTSD risk. The goal of the study was to characterize the barriers to and facilitators of implementation of a screening procedure for PTSD risk in a level I trauma center.

Methods We conducted semistructured qualitative interviews with multidisciplinary academic medical center stakeholders (N=8) including those with clinical, research, teaching, and administrative roles within an urban academic medical center’s Department of Surgery, Division of Acute Care Surgery. We analyzed the qualitative data using summative template analysis to abstract data related to participants’ opinions about implementation of a screener for PTSD.

Results Participants’ general perception of screening for PTSD risk after injury was positive. Identified challenges to implementation included timing of screening, time burden, care coordination, addressing patients with traumatic brain injury or an altered mental status, and ensuring appropriate care after screening. Reported facilitators included existing psychosocial screening tools and protocols that would support inclusion of a PTSD screener, a patient-centered culture that would facilitate buy-in from providers, a guideline-driven culture, and a commitment to continuity of care.

Conclusions This study offers concrete preliminary information on barriers to and facilitators of PTSD screening that can be used to inform planning of implementation efforts within a trauma center.

Level of evidence Level V, qualitative.

  • psychological trauma
  • posttraumatic stress disorder
  • screening
  • barriers
  • facilitators
  • implementation

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors SAMcB is the corresponding author and contributed to the data collection. SAMcB and SJL contributed to the study concept and design. SAMcB and BEP contributed to the data analysis. SAMcB, BEP, SJL contributed to the writing of the article. KWS and SJL contributed to the critical revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.