Implementation of a Trauma Screening Tool in a Pediatric Oncology Unit

Background: Pediatric oncology patients experience multiple prolonged hospitalizations, procedures, and cytotoxic chemotherapy with significant adverse effects. The American Academy of Pediatrics recommends formal trauma screening to avoid re-traumatization and identify risk factors to provide appropriate intervention. Objective: This practice improvement project aimed to implement the use of the Child Trauma Screen Tool upon admission to a pediatric oncology unit. This practice improvement project aimed to implement the use of the Child Trauma Screen Tool, educate the nursing staff, and improve their comfort level with providing trauma-informed care in the pediatric oncology unit. Methods: A pre- and postsurvey design was used to assess pediatric oncology nurses' knowledge, attitudes, and self-reported competence in trauma-informed care by utilizing the Attitudes Related to Trauma-Informed Care Scale and Trauma-Informed Care Provider Survey. An educational session was provided on trauma-informed care basics and the Child Trauma Screen tool. Results: Survey results found that nurses' attitudes towards trauma-informed care improved posteducation with a statistically significant change, p < .02. The nurse's knowledge posteducational session was significantly higher than preeducational intervention, p < .015. A Wilcoxon rank test found that the nurse's self-reported competence posteducational session was significantly higher than preeducational intervention, p < .003. An audit was conducted to monitor adherence to screening tool usage; eight screening assessments were completed of the (n = 10) screened. Conclusions: Following the educational session on trauma-informed care basics and the Child Trauma Screen tool, nurses' attitudes, knowledge, compliance, and self-reported competence on trauma-formed care and the use of the Child Trauma Screen Tool improved. The results of this practice improvement project demonstrate the feasibility of using the Child Trauma Screen Tool. Implication for Nursing: The findings of this quality improvement project highlight the importance of integrating trauma-informed care principles by implementing The Child Trauma Screening Tool upon admission. Nurses can identify patients at risk for trauma-related distress and provide appropriate interventions to avoid re-traumatization. The statistically significant improvements in nurses' attitudes, knowledge, and self-reported competence underscore the value of structured education on trauma-informed care. Additionally, the feasibility of the screening tools use suggests that routine trauma screening in the pediatric oncology units can enhance patient-centered care. Future initiatives should focus on sustaining compliance, expanding trauma-informed education, and assessing long-term patient outcomes and staff engagement.