Quality Improvement: Enhancing Post-Traumatic Stress Disorder Checklist Skill and Patient-Centered Communication Knowledge for Nurses

Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2020


Doctor of Nursing Practice (DNP)

Primary Advisor

Karen J. Whitt, PhD, RN, FNP, AGN-BC, FAANP; Catherine Wilson Cox, PhD, RN, CEN, CNE


Background: American military personnel suffer high rates of post-traumatic stress disorder (PTSD). Patient-centered communication (PCC) is an effective method for interacting with patients at risk for PTSD. Nurses often have a limited understanding of PTSD and lack training regarding PCC approaches. This quality improvement (QI) project was designed to develop, implement, and evaluate an educational program to improve nurses’ knowledge identifying PTSD signs and symptoms, as well as their confidence utilizing PCC approaches.

Methods: Nine registered nurses at the Keller Army Community Hospital in West Point, New York participated in a 60-minute educational program, including a PowerPoint presentation, role-play practice exercises regarding PTSD signs and symptoms, and education regarding the PCC approach. Participants completed pre-, post-, and 30-day follow-up surveys, based on a modified military PTSD checklist, plus items related to nurses' self-rating of confidence and intent to use PCC. SPSS software was used to generate descriptive statistics and paired t-tests to compare pre and post survey data.

Results: Nurses significantly increased self-efficacy in general knowledge of PTSD signs and symptoms, and in confidence in utilization of PCC approaches (p<0.05). The 30-day followup indicated generally high rates of PCC implementation but poor rates of discussing PTSD checklist results with patients and with electronic health record recording.

Conclusions: Findings generally supported the efficacy of the educational training intervention towards fostering nurse knowledge regarding PTSD, and confidence and intent to use PCC approaches. This QI project can be implemented with nurse groups at other facilities towards improving interactions with patients at risk for PTSD.

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