Quality improvement project: Implementing a screening tool for acute stress disorder in pediatric trauma patients

Pediatric patients who have suffered an acute traumatic injury are at an increased risk for developing mental health disorders, such as acute stress disorder (ASD). With traumatic injuries as the leading cause of emergency room visits and deaths in the pediatric population, ASD is expected to continue rising. The American College of Surgeons recently mandated screening for traumatic stress symptoms in pediatric Level I and Level II trauma centers.

The purpose of this quality improvement project was to achieve an 80% adherence rate for administration of a validated screening tool to pediatric patients admitted for a traumatic injury in an 18-month period.

The trauma social worker and trauma nurse practitioner administered the screening tool to eligible patients who suffered an acute traumatic injury. A patient's score was calculated from their questionnaire responses, determining the level of risk for developing mental health disorders. The percentage of eligible patients that received a screening tool, the patient's level of risk for developing acute stress symptoms, the mechanism of injury sustained, and the resources given to patients were collected and analyzed during the QI project (January 1, 2024 - June 30, 2025).

Over an 18-month period, 118 patients completed screenings for ASD by receiving the Acute Stress Checklist for Kids-6. 25% of the patients who completed a screening tool showed symptoms for developing acute stress disorder. Of these 118 participants, 50 patients (42.3%) suffered an interpersonal injury, with 39 patients (33%) of the patients sustaining a firearm injury.

The results of this project suggest that implementing a process to ensure this hospital was identifying patients at risk for developing mental health problems, such as acute stress disorder, through administration of a validated screening tool allowed for goal adherence of screening tool administration.