Mental Health Screening in a Rural Trauma Center: Feasibility and Impact.
Tessa C Savell, Alexa L Peterson, Ryan P Carroll and 4 others
PMID 40632039WHAT IT FOUND
Psychiatric consultations rose only from 1.0% to 1.4%, an increase the study could not distinguish from chance, while trauma RN screening reached 84.2% of eligible patients.
Key findings
01Psychiatric consultations rose from 14 patients (1.0%) in the implementation year to 20 patients (1.4%) in the post-implementation year, with p = .3934.
02Of 2,810 trauma patients, 1,114 met ITSS screening criteria and 938 completed screening.
03Among screened patients, 314 screened positive; all received resource pamphlets, and 34 (10.8%) underwent inpatient psychiatric evaluation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single-center quality improvement study in a rural trauma center, so the results may not apply elsewhere. It compared two years without random assignment, and patient severity, rural residence, and transfers changed between years. Screening was limited to adult patients with Glasgow Coma Scale 15 who stayed more than 2 nights, excluding patients with baseline dementia or suicide attempts. Screening was done only during weekday business hours, so weekend and holiday discharges could miss eligible patients. Results were entered manually, which can introduce data entry errors. Not every patient who screened positive received inpatient psychiatric consultation because of census, community mental health needs, and provider shortages. There was no outpatient follow-up for positive patients at 6 months.
Declared interests
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
The easy way to misread this
Do not conclude that screening improved mental health outcomes or reliably provided psychiatric care. In this quality improvement study, all positive screened patients received pamphlets, but only 34 of 314 positive patients underwent inpatient psychiatric evaluation, and psychiatric consultation rates changed from 1.0% to 1.4% with p = .3934.