Date of Award

2026

Document Type

Project

College/School

College of Nursing

Degree Name

Doctor of Nursing Practice (DNP)

Project Mentor

Kelly McBroom

Readers

Amanda Heffernan

Abstract

Background Many obstetric and women’s health organizations recognize trauma-informed care (TIC) as a cornerstone of clinical practice; however, training is often sporadic, inconsistent, and difficult to integrate into routine care. The Triple A Approach—Ask, Autonomy, Advocate—is a novel framework designed to facilitate the integration of TIC principles into clinical workflows. This study introduced The Triple A Approach to a hospital-based perinatal unit and evaluated its impact on nurses’ knowledge of TIC principles and application in practice. Methods This quality improvement project evaluated TIC knowledge and capacity among perinatal nurses using pre- and post-intervention electronic surveys. Baseline assessment measured participants’ understanding of TIC principles and perceived organizational support for implementation. Following an educational intervention, participants were reassessed 4–14 weeks later regarding their knowledge of TIC principles and use of The Triple A Approach in daily clinical practice. Results Of 24 nurses who participated in the training, 80% completed the pre-intervention survey (n=20). Baseline data indicated moderately positive attitudes towards TIC implementation (mean score 5.40 on a 7-point Likert scale). The follow-up survey was completed by 50% of initial respondents. Among these participants, 100% reported using The Triple A Approach most of the time in clinical practice, and 83% reported maintained or improved knowledge of TIC principles. Discussion The Triple A Approach shows promise as a practical tool for integrating TIC into clinical practice, particularly in settings with organizational support for TIC initiatives. However, low follow-up response rates limit the strength of conclusions. Future studies should incorporate longer implementation timelines and align data collection with existing staff engagement structures to improve participation and better evaluate effectiveness.

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