Date of Conferral

8-6-2026

Date of Award

August 2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Letha Thomas

Abstract

This evaluation of a quality improvement initiative addressed inconsistent trauma screening and electronic documentation at an outpatient site. The baseline trauma-screening completion rate was 60%, below the organization's 80% target. The gap was relevant to nursing because nurses support screening, documentation, referral, coordination, and follow-up. The practice-focused question addressed whether the Adverse Childhood Experiences (ACE) Questionnaire and the Posttraumatic Stress Disorder Checklist for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), or PCL-5, would improve documented screening completion and trauma-informed treatment planning over 10 weeks. The purpose was to incorporate both tools into care and establish procedures for administration, scoring, electronic documentation, review, referral and follow-up. Major products included educational materials, an electronic documentation workflow, a clinical-response pathway, and a deidentified aggregate data collection tool. Authorized site personnel provided deidentified aggregate electronic reports. The completion rate after implementation was calculated and compared with the baseline and target using descriptive statistics. Aggregate findings were examined to determine whether they showed documented assessment, referral, follow-up, or treatment planning. The aggregate electronic report showed a 90% postimplementation completion rate, 30 percentage points above baseline and 10 above the organization’s goal. Staff education, workflow, and a data tool improved documentation and clarified responsibilities. Continued use and refresher training support nursing practice and social change through privacy, cultural respect, equity, and the right to decline screening.

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