Practicing Upstream: Race-Based Trauma Care Training For Veteran's Health Administration Nurse Practitioners

Problem: The Advance Practice Registered Nurses (APRNs) employed by the Veterans Health Administration (VHA) lack race-based trauma training for Veterans that have experienced psychological, physiological, and emotional trauma. The VHA is responsible for the health of this culturally diverse patient population with complex health conditions. APRNs without prior military experience may have trouble obtaining an accurate history and physical exam due to their inexperience with the military's cross-cultural environment. This quality improvement pilot project aimed to incorporate race-based trauma training into a new adult geriatric acute care nurse practitioner's (AGACNP) fellowship curriculum. The study question is: In acute geriatric acute care nurse practitiioner's, what are the effects of race-based trauma training on competency and confidence in providing care to Veterans when hospitalized? Methods: A prospective descriptive design utilized a purposeful sample of senior adult-geriatric nurse practitioner (AGNP) students, due to the unforeseen circumstances of not hiring AGACNPs s for this pilot, for the first 6-weeks of a new acute care fellowship pilot program. Outcome measures included evaluating skills in identifying racial differences and confidence in applying culturally sensitive care. Results: Participant (N = 3) self-reported confidence increased by .33 (20%) in providing culturally competent and race-based trauma care, and an improvement in identifying race-based differences by .33 (17%) at completion of the pilot. Implications: Results indicated improvement in confidence and competence when providing race-based trauma care within 6 weeks. Continued training and evaluation throughout the 12-month fellowship are recommended.