Graduation Year

2025

Degree Type

Open Access Capstone

Document Type

Capstone

Degree Name

Doctor of Nursing Practice (DNP)

Department

Baccalaureate and Graduate Nursing

First Advisor

Fontaine Sands

Department Affiliation

Baccalaureate and Graduate Nursing

Second Advisor

Wanda France

Department Affiliation

Baccalaureate and Graduate Nursing

Department Affiliation

Baccalaureate and Graduate Nursing

Abstract

This quality improvement project aimed to implement trauma screening and PTSD symptom assessment using the Life Events Checklist for DSM-5 (LEC-5) and the PTSD Checklist for DSM-5 (PCL-5) in a ketamine and transcranial magnetic stimulation (TMS) outpatient mental health setting. The goal was to improve the identification of trauma-related symptoms and streamline referrals to psychotherapy. Over a 31-day implementation period, 50 clients were screened with the LEC-5; 48 met criteria for PCL-5 screening, and 36 (75%) scored above the clinical threshold for PTSD symptoms. While all eligible clients were offered a referral, only 26.7% accepted, highlighting challenges in psychotherapy engagement. The findings suggest that standardized trauma screening is feasible and effective in specialty mental health settings and supports improved symptom identification and individualized care. However, the project also uncovered significant barriers to referral uptake, including client mistrust and prior unsatisfactory experiences with therapy. Analysis of PCL-5 responses showed that the Avoidance and Negative Alterations in Cognition and Mood (NACM) clusters had the highest average scores, aligning with current research on PTSD symptom profiles. The project contributes to the quality and safety of care by supporting early detection, guiding evidence-based referrals, and promoting trauma-informed practices. Organizational and policy-level changes are recommended to sustain these improvements, including structured workflows, staff training, and systematized follow-up protocols. This project provides a foundation for future scholarship in trauma-informed care, integrated behavioral health, and patient engagement strategies within innovative treatment environments.

IRB Approval Number (if applicable)

6187

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Nursing Commons

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