91 Current Practices and Beliefs Regarding Screening Burn Patients for Acute Stress Disorder and Post-Traumatic Stress Disorder: A Survey of the American Burn Association

Abstract Introduction The prevalence of Acute Stress Disorder (ASD) after burn injury may be up to 30% and the prevalence of Post-Traumatic Stress Disorder (PTSD) is as much as 40% at six months post-burn injury. The American Burn Association (ABA) published a consensus statement in 2013 recommending screening for ASD and PTSD in all patients with a burn injury. To our knowledge, the current practices of screening for ASD and PTSD in patients with burns is not known. This study aims to describe the current screening practices and provider beliefs regarding screening for stress disorders in burn patients in the US. Methods Interviews with psychologists and clinicians from our regional burn and injury center were utilized to generate a 31-question survey to assess burn center screening practices and provider beliefs regarding screening for ASD/PTSD. The Survey was approved by the ABA and distributed to its US membership in July 2020. Percentages of responses were generated, and chi-square tests were used to compare answers by profession type. Results There were 121 respondents out of 1500 recipients. The respondents were surgeons (27%), psychologists (6%), therapists or social workers (16%), nurses (31%), and advanced practice providers (13%). About half of the respondents (47%) worked at institutions that admit over 300 adult burn patients a year and had over 10 years of experience (52%). Seventy-five respondents (62%) indicated their institution formally screens for ASD and/or PTSD, 35 do not formally screen, and 11 respondents were unsure. Of the 35 centers that did not screen, the most common reason was a lack of mental healthcare providers (46%), lack of funding (26%) and lack of time (20%). The timing of screening, person administering the screening, and method of screening varied greatly across centers for pediatric and adult patients. Most respondents thought screening pediatric (83%) and adult (87%) patients with burns for ASD/PTSD was important, and 87% thought it should be standard of care. However, only 32% of respondents were comfortable screening pediatric patients and 62% were comfortable screening adults. Conclusions Whereas screening for ASD and PTSD is recommended for patients with burns, our study indicates that, despite general consensus that it should be, screening is not a current standard of care. Lack of mental health providers, funding, and time are contributing factors. Among those institutions that screen, a uniform screening protocol does not exist for pediatric or adult patients.