PTSD Screening for Adults with Substance Use Disorder in an Integrated Setting

Abstract

Purpose: The purpose of this quality improvement (QI) project was to motivate family nurse practitioners (FNPs) at Psychiatric Associates LLC to add post-traumatic stress disorder (PTSD) screening in their adult patients with substance use disorder (SUD). This was done by providing an educational intervention about the co-occurrence of PTSD and SUD and the PC-PTSD-5 screener.Background: PTSD is a prevalent condition causing significant distress and functional impairment. SUD is also a chronic debilitating disorder that is highly associated with PTSD. Almost 90% of the SUD population have at least one trauma exposure in their lifetime, yet PTSD screening is underutilized. The PC-PTSD-5 is a robust screening tool to aid in the identification of potential PTSD. Methods: The Model of Improvement and Plan-Do-Study-Act cycle guided this QI project. The pretest/posttest design was used to ascertain the FNP’s knowledge, attitude, and intent to adopt the PC-PTSD-5 before and after the educational intervention. Conclusion: The two FNP participants who participated in the QI project did not lack knowledge of PTSD-SUD co-morbidity, however, did have a deficit in familiarity and confidence in using trauma screening tools. Providing an educational intervention about the PC-PTSD-5 increased their familiarity and confidence in utilizing the screener. It was not clear whether the intervention promoted a change in intent to screen. One participant presented evidence of adding use of the screener to his practice and showed most of his adult patients with SUD had possible PTSD. The preliminary data indicate the benefit of PTSD screening for improving patient care in patients with SUD as fostered by an educational intervention.