Improving Staff Outcomes Through Trauma Informed Care: A Quality Improvement Project

Background: Trauma-informed care (TIC) has emerged as a critical framework in healthcarefacilities where many patients present with complex trauma histories. Within psychiatric facilities, the need for TIC is especially important due to the prevalence of trauma-related conditions. This need becomes even more urgent in inpatient psychiatric units, where patients often require intensive care and compassionate support. Despite increasing recognition of TIC’s importance, it remains lacking in many psychiatric facilities, contributing to staff burnout, compassion fatigue, and subpar patient care. Research has shown that trauma can significantly impact emotional regulation, cognitive function, and long-term mental health outcomes, making it essential for staff to recognize trauma-related behaviors and implement sensitive and supportive interventions. Purpose: The purpose of this DNP project was to design, implement, and evaluate a TIC training program for staff in an inpatient adult psychiatric unit. Guided by the TIC framework, the goal was to increase staff knowledge, confidence, and intent to apply TIC strategies in clinical practice. Methods: This DNP project used a quantitative pre- and post-intervention design to assess the impact of TIC training on psychiatric inpatient staff. The intervention, a single 30–40 minute in-person session was delivered to 10 direct care staff consisting of registered nurses (Rns), behavioral health technicians (BHTs), peer support specialists, and supervisors at a 15-bed unit within Community Bridges (CBI), a behavioral health organization in Mesa, Arizona. Pre- and post-training surveys evaluated staff confidence and intent using Likert-scale items, while knowledge was assessed using multiple-choice questions. Open-ended post-survey questions explored common ideas and recurring patterns related to how staff anticipated applying TIC principles in their roles. The project was guided by the TIC framework and the PDSA (Plan-Do-Study-Act) cycle implementation model. Data were analyzed using unpaired t-tests. Results: A total of 16 staff members consented to participate in the TIC quality improvement project, with 12 completing the pre-training survey and 10 completing the post-training survey. Participants represented both day and night shifts with varied years of experience. Quantitative results showed that the post-training group reported higher levels of confidence, intent, and knowledge compared to the pre-training group. Qualitative responses reflected themes of awareness, empathy, and self-reflection. Conclusions: The project demonstrated that brief TIC education can promote reflection and awareness among psychiatric staff. The findings highlight the importance of continued training, clear communication, and leadership support to sustain trauma-informed practices. Ongoing evaluation and stronger assessment tools are needed to better identify learning gaps and ensure that TIC principles are consistently applied in clinical care.