Pediatric emergency nurses' knowledge, competence, and barriers in trauma-informed care: A cross-sectional study

pediatric emergency nurses play a critical role in caring for children who have experienced traumatic events in the emergency departments. Trauma-informed care (TIC) is an essential approach that considers the psychological, behavioral, and social implications of trauma. This study aims to assess pediatric emergency nurses' knowledge, perceived competence, and barriers related to TIC in emergency departments (EDs).

A cross-sectional design was conducted with 106 pediatric emergency nurses working in the pediatric emergency departments of three public hospitals in Egypt. Data was collected through an interview questionnaire with permission using the TIC Provider Survey Version 2.0 - Pediatric Survey. Descriptive statistics and multiple regression analysis were used to analyze the data.

Most pediatric emergency nurses in emergency departments were female (69.8 %). Their mean knowledge score was 39.16 (SD = 9.03), and they expressed favorable opinions about TIC with a mean score of 22.37 (SD = 4.26) (range: 9 to 28). Self-rated competence in specific TIC aspects varied, but providers demonstrated favorable views toward incorporating TIC into their practice overall. The top three significant barriers to TIC implementation were: (1) "Confusing or unclear information on TIC" (67 %), (2) "Scope of practice constraints" (46.2 %), and (3) "Lack of training" (66 %).

Although pediatric emergency nurses in emergency departments demonstrated limited knowledge, with only 4 out of 13 items answered correctly by more than 50% of participants, their overall mean score suggests moderate awareness TIC. However, their practical application emained deficient. Prioritizing enhanced education and training can improve recognition and management of psychosocial and behavioral consequences, positively impacting children's and parents' outcomes while fostering a trauma-sensitive culture among pediatric emergency nurses.