A University of Pittsburgh researcher is developing REVIVE, a program that applies trauma-informed care to nursing practice and healthcare systems. This educational approach should help mitigate implicit bias in healthcare settings using trauma-informed care principles with all patients. It is hoped this approach will not only improve patient outcomes but also empower healthcare workers, improving morale and staff retention.
Description
Increasingly, healthcare is focusing on person-centered care, treating the whole person rather than the disease. One area of person-centered care is trauma-informed care (TIC), where people are screened for adverse childhood events and results are incorporated into health goals. This approach is not feasible in acute care settings due to lack of time and resources and could re-traumatize people seeking care. In an acute setting, TIC should have less focus on screening for previous trauma but should ensure each patient does not experience re-traumatization and feels safe during an extremely vulnerable time. Given one in three women worldwide has experienced sexual assault, TIC is particularly important in maternity care and all birthing persons should be considered as trauma survivors. In this novel approach, REVIVE, the emphasis is not on individual actions but on bringing about long-term institutional change. This approach could be introduced into many hospitals to improve outcomes in patients and increase staff retention and morale.
Applications
• Nursing education
• Maternity care improvements
• Increasing nursing staff retention
Advantages
Trauma can take many forms. Systemic racism and implicit bias in healthcare settings can make maternity care particularly traumatic for many birthing persons. The COVID-19 pandemic traumatized almost everyone, so all persons seeking medical care should be considered as being in the early stages of trauma recovery. While addressing past trauma is not feasible during childbirth, avoiding primary trauma or re-traumatization is possible.
REVIVE aims to create a culture in maternity units where healthcare workers (HCW) and birthing persons can feel safe and protected against the toxic manifestations of trauma. REVIVE aims to mitigate implicit bias through culture change without focusing the blame on individual staff. It is hoped REVIVE will promote care for both patients and HCW.
Invention Readiness
REVIVE has been designed to promote the tenets of TIC: safety, compassion, communication, collaboration, autonomy, and empowerment using intentional steps, integrating knowledge, and preventing re-traumatization. These steps can be applied in the nurse-patient interaction as well as guide interactions between peers and between leadership and staff. Work is currently ongoing to apply REVIVE in the UMPC maternity units, along with a study of the application of REVIVE by nursing students. Data will be collected on maternal, neonate, and staffing outcomes to assess the benefit of REVIVE to individuals, health care systems and on reducing health disparities.
IP Status
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