Implementing a Nurse-Led Trauma-Informed Care Program to Reduce Runaway Incidents Among Adolescent Girls in a Residential Group Home Over a 6-Week Period

Implementing a Nurse-Led Trauma-Informed Care Program to Reduce Runaway Incidents Among Adolescent Girls in a Residential Group Home Over a 6-Week Period

I. Project Overview

This six-week capstone project aims to implement and evaluate a nurse-led trauma-informed care (TIC) program designed to reduce runaway incidents among adolescent girls residing at Branches of Life, a residential group home. The intervention will focus on addressing emotional and psychological triggers associated with elopement behaviors through staff education, resident coping skill development, and the establishment of a structured crisis response protocol.

II. Background and Significance

Problem Statement

Runaway incidents among adolescent girls in residential group homes are a significant safety and behavioral health concern. These incidents often stem from unmet emotional needs, unresolved trauma, and poor coping mechanisms. At Branches of Life, runaway episodes have increased over the past year, prompting the need for an evidence-based, sustainable solution.

Relevance to Advanced Nursing Practice

Advanced practice nurses (APNs) are uniquely positioned to lead trauma-informed interventions due to their expertise in mental health, patient-centered care, and systems-level change. This project aligns with the growing emphasis on integrating trauma-informed principles into behavioral health services and supports the evolving role of APNs in non-traditional clinical settings.

Organizational Alignment

The proposed project supports Branches of Life’s mission to provide individualized, compassionate care that promotes emotional healing and resilience among youth. It also reflects national priorities for child welfare reform and trauma-responsive care delivery.

III. Literature Review Summary

Research consistently demonstrates that trauma exposure is prevalent among youth in out-of-home placements, particularly adolescent girls. Key findings include:

• Up to 90% of youth in the child welfare system have experienced some form of trauma (National Child Traumatic Stress Network [NCTSN], 2020).
• Trauma-informed approaches reduce behavioral incidents and improve emotional regulation when implemented effectively (Brennan et al., 2012).
• Staff training in trauma-informed practices improves workplace morale and decreases burnout (National Association of Social Workers, 2017).

This project builds upon SAMHSA’s Six Guiding Principles of Trauma-Informed Care:

1. Safety
2. Trustworthiness & Transparency
3. Peer Support
4. Collaboration & Mutuality
5. Empowerment
6. Cultural, Historical, and Gender Sensitivity

IV. Project Objectives and Timeline

Phase 1: Baseline Assessment (Weeks 1–2)

Objective:

Establish baseline data on runaway trends, identify high-risk residents, and assess current staff knowledge and practices.

Activities:

• Conduct a retrospective chart review of runaway incidents over the past 6 months.
• Administer the Child and Adolescent Needs and Strengths (CANS) tool to assess trauma history and risk factors.
• Distribute pre-training surveys to staff using the Attitudes Related to Trauma-Informed Care (ARTIC-35) scale.
• Hold interviews and focus groups with staff to gather qualitative feedback on challenges and gaps in current practices.

Phase 2: Intervention Implementation (Weeks 3–5)

Objective:

Deliver a structured, nurse-led trauma-informed care program to address emotional triggers and enhance coping strategies.

Interventions:

1. Trauma-Informed Care Training for Staff

   • Weekly 1-hour sessions led by the DNP student and clinical nurse specialist.
   • Topics: trauma basics, de-escalation techniques, therapeutic communication, and self-care for staff.

2. Resident Coping & Emotional Regulation Sessions

   • Biweekly group sessions focusing on:
     • Emotion identification and expression
     • Mindfulness and breathing exercises
     • Conflict resolution and problem-solving
   • Use of age-appropriate tools such as emotion wheels, journaling prompts, and CBT-based activities.

3. Safe Space Development

   • Designate a sensory-friendly room with calming visuals, soft lighting, and tactile items.
   • Establish access protocols and staff supervision guidelines.

4. Crisis Response Protocol

   • Develop a stepwise approach for responding to escalating behaviors.
   • Train s