Implementation of the Adverse Childhood Experiences Screening Tool in an Outpatient Psychiatric Setting

Abstract

Purpose: The purpose of this project was to implement the CDC’s Adverse Childhood Experiences (ACEs) screening tool in an outpatient psychiatric setting and to determine the prevalence of ACEs assessed by the ACEs screening tool compared to previous method of screening. Methods: This project utilized a descriptive design with a retrospective chart review to compare two time points, and determine how many patients have been identified with an adverse childhood experience previously, compared to after the implementation of the ACEs screening tool. The patients age, gender, ethnicity, education and marital status were collected through a demographic questionnaire. ACES was assessed using the ACEs screening tool and by the author-developed retrospective chart review tool, based on the ACEs questions. Descriptive statistics were utilized for data analysis. The project was implemented at Utopia Psychiatric Services in Sunrise, FL. Sample: The total sample consisted of 22 patients, a majority of which were female (68%), and Caucasian (59%). Eleven (50.0%) participants were screened for ACEs using the traditional psychiatric interview in 2018 (Group1). 11 (50.0%) participants were screened for ACEs using the ACEs questionnaire in 2019 (Group 2). Results: Group 1’s mean ACE’s score was 1.73. Group 2’s mean ACE’s score was 2.73. The findings were not statistically significant in frequency of ACEs identified (t (15.920) = -.919, p = 0.372) pre and post-implementation. However more adverse events were identified by the ACEs questionnaire than by the non-standardized approach in 2018. Conclusion and Implications for Practice: The ACEs screening tool did identify an increased number of ACEs compared to previous methods. The tool provided a more comprehensive exploration of trauma, and therefore should be implemented in the outpatient setting. Providers at this facility have determined that implementation of the standardized ACEs questionnaire will become standard practice. Therefore, this DNP project resulted in quality improvement in this practice related to adverse childhood events screening.