The Role of Pediatric Patient Education on Nurse-Perceived Medical Traumatic Stress on a Surgical Unit

Background: Pediatric medical traumatic stress (PMTS) describes a set of symptoms that commonly occur in children undergoing procedures and hospitalizations. PMTS may result in costly complications and place patients and caregivers at risk for developing post-traumatic stress (Kassam-Adams & Butler, 2017). Research suggests patient education has a lasting positive impact on PMTS (Ari, Margalit, Roth, et al., 2019). Methods: This quality improvement (QI) project implemented educational intervention on PMTS and how to provide developmentally appropriate patient education for surgical procedures. Using a pre- and post-study design, four key components were analyzed: 1) knowledge level, 2) frequency of measures taken, 3) changes in practice, and 4) barriers to implementing PMTS-sensitive care. Nurses were recruited voluntarily through email. A total of 34 emails were sent, and 11 nurses were recruited. All 11 nurses provided pre-intervention and demographic data, and eight provided post-intervention data. Data were collected via the Qualtrics[R] tool (2020) and analyzed using SPSS[R] version 27.0. This QI project qualified for exempt Institutional Review Board status. Results: Most participants (87.5%) reported their practice had improved after the intervention. A paired t test demonstrated a significant increase (p = 0.006) in self-reported knowledge level, supporting that this intervention may effectively increase staff awareness; half reported an increase in the measures they take to prevent or alleviate PMTS. Time constraints and inadequate staffing were cited as barriers. Conclusion: Staff training on patient education resulted in a significant increase in provider knowledge of PMTS. Nurses demonstrated an understanding of the role of hospitalization in PMTS and an interest in addressing this concern. Organizational support is required to sustain these interventions. Keywords: Pediatric medical traumatic stress, pediatric stress, pediatric surgery, post-traumatic stress, pediatric nursing, quality improvement.