RESUMEN
BACKGROUND: Medicare requires that hospitals report on their adherence to the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1). OBJECTIVE: To evaluate the effect of SEP-1 on treatment patterns and patient outcomes. DESIGN: Longitudinal study of hospitals using repeated cross-sectional cohorts of patients. SETTING: 11 hospitals within an integrated health system. PATIENTS: 54 225 encounters between January 2013 and December 2017 for adults with sepsis who were hospitalized through the emergency department. INTERVENTION: Onset of the SEP-1 reporting requirement in October 2015. MEASUREMENTS: Changes in SEP-1-targeted processes, including antibiotic administration, lactate measurement, and fluid administration at 3 hours from sepsis onset; repeated lactate and vasopressor administration for hypotension within 6 hours of sepsis onset; and sepsis outcomes, including risk-adjusted intensive care unit (ICU) admission, in-hospital mortality, and home discharge among survivors. RESULTS: Two years after its implementation, SEP-1 was associated with variable changes in process measures, with the greatest effect being an increase in lactate measurement within 3 hours of sepsis onset (absolute increase, 23.7 percentage points [95% CI, 20.7 to 26.7 percentage points]; P < 0.001). There were small increases in antibiotic administration (absolute increase, 4.7 percentage points [CI, 1.9 to 7.6 percentage points]; P = 0.001) and fluid administration of 30 mL/kg of body weight within 3 hours of sepsis onset (absolute increase, 3.4 percentage points [CI, 1.5 to 5.2 percentage points]; P < 0.001). There was no change in vasopressor administration. There was a small increase in ICU admissions (absolute increase, 2.0 percentage points [CI, 0 to 4.0 percentage points]; P = 0.055) and no changes in mortality (absolute change, 0.1 percentage points [CI, -0.9 to 1.1 percentage points]; P = 0.87) or discharge to home. LIMITATION: Data are from a single health system. CONCLUSION: Implementation of the SEP-1 mandatory reporting program was associated with variable changes in process measures, without improvements in clinical outcomes. Revising the measure may optimize its future effect. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.
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Medicare/organización & administración , Evaluación de Resultado en la Atención de Salud , Paquetes de Atención al Paciente/normas , Sepsis/terapia , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Estudios Transversales , Femenino , Fluidoterapia , Adhesión a Directriz , Humanos , Ácido Láctico/sangre , Estudios Longitudinales , Masculino , Notificación Obligatoria , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Mejoramiento de la Calidad , Sepsis/sangre , Estados Unidos , Vasoconstrictores/uso terapéuticoAsunto(s)
Maltrato a los Niños/diagnóstico , Atención Primaria de Salud , Niño , Maltrato a los Niños/prevención & control , Maltrato a los Niños/estadística & datos numéricos , Maltrato a los Niños/terapia , Servicios de Protección Infantil , Terapias Complementarias , Familia/psicología , Accesibilidad a los Servicios de Salud , Humanos , Notificación Obligatoria , Síndrome de Munchausen Causado por Tercero/diagnóstico , Síndrome de Munchausen Causado por Tercero/epidemiología , Síndrome de Munchausen Causado por Tercero/prevención & control , Aceptación de la Atención de Salud , Obesidad Infantil , Pediatras , Rol del Médico , Prevalencia , Religión , Negativa del Paciente al TratamientoRESUMEN
Nurses have an important role in preventing and responding to child abuse and neglect. This paper reports on nurses' perceptions of how organisational systems and hierarchies shaped their capacity to respond to child abuse and neglect. This is one of four key themes identified through an inductive analysis of data from a broader qualitative study that explored nurses' perceptions and experiences of keeping children safe. The study was guided by social constructionist theory, and data were collected through in-depth interviews with nurses working with children in Australia (n = 21). Key findings showed that nurses experienced many challenges to responding to child abuse, including difficulties sharing information, fear of making mistakes and inflexible systems of care. This was underpinned by an organisational 'rule-centred' culture of following policies at the expense of maintaining an explicit focus on children's needs. These findings demonstrate first the importance of creative and flexible thinking from individual professionals, so policies are enacted with a clear child focus. Second, they highlight the need for leadership to enact organisational and systemic cultural change that maintains a genuinely child-centred approach.
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Maltrato a los Niños , Prestación Integrada de Atención de Salud , Difusión de la Información , Notificación Obligatoria , Rol de la Enfermera , Percepción , Australia , Niño , Maltrato a los Niños/prevención & control , Maltrato a los Niños/psicología , Preescolar , Humanos , Entrevistas como Asunto , Investigación CualitativaRESUMEN
BACKGROUND: Sibling sexual abuse (SSA) is a widespread form of intrafamilial child sexual abuse frequently regarded as play or normal sexual behavior, and therefore highly underreported. Israeli law allows Child Protection Officers (CPOs) to suspend police intervention after the disclosure of SSA, and refer the family to therapy, by applying to an "exemption committee." OBJECTIVE: This study will examine the characteristics of cases referred to the exemption committee or legal procedure and the justifications provided by CPOs to support the decisions. PARTICIPANTS AND SETTING: The study was based on 40 family cases referred to the Child Advocacy Center in Jerusalem: twenty cases were referred to an exemption committee and the rest to legal procedure. METHOD: Qualitative document analysis conducted on the two groups of cases (Nâ¯=â¯40). Files were then analyzed using the thematic analysis approach. RESULTS: During the decision-making process, CPOs assess each of the cases in a broad and holistic manner, basing their decisions on various contextual factors, including the characteristics of the survivor, the perpetrator, the parents and other siblings, and the types of sexual acts involved. CONCLUSIONS: This comprehensive approach to understanding and handling the complex family story and nature of SSA underscores the need to address SSA and subsequent interventions - legal or therapeutic - not exclusively in terms of quantifiable criteria, but also in terms of a crisis involving the relationships in the entire family, past and future course of treatment, and the perceptions of family members involved.
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Abuso Sexual Infantil/legislación & jurisprudencia , Servicios de Protección Infantil/legislación & jurisprudencia , Notificación Obligatoria , Derivación y Consulta , Hermanos , Adolescente , Adulto , Niño , Familia/psicología , Femenino , Humanos , Israel , Masculino , Investigación Cualitativa , Adulto JovenRESUMEN
OBJECTIVE: To analyze the conceptions of the nursing professionals working in Basic Health Units regarding the detection and prevention of violence against the elderly. METHODS: Descriptive, exploratory, qualitative study. Performed in two BHUs in Mossoró/RN, using a semi-structured interview script, from March to August of 2013. Sample composed of four nurses and six nursing technicians. The content analysis, pre-analysis, material exploration, and treatment of results were performed. RESULTS: Four categories were identified: Strategies used to identify violence against the elderly; Types of violence against the elderly; Conduct used after finding a suspicion of violence; SUS and the problem of violence against the elderly. Many professionals recognize/distrust possible cases, however, they do not know how to proceed. The dimension of the problem requires that pragmatic interventions be performed in the clinical setting and in the social context. FINAL CONSIDERATIONS: There is a need for continuing education for professionals and greater communication between the bodies responsible for reporting and embracement.
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Abuso de Ancianos , Enfermeras y Enfermeros/psicología , Asistentes de Enfermería/psicología , Violencia , Adulto , Anciano , Anciano de 80 o más Años , Actitud del Personal de Salud , Brasil , Violencia Doméstica/legislación & jurisprudencia , Violencia Doméstica/prevención & control , Violencia Doméstica/psicología , Violencia Doméstica/estadística & datos numéricos , Abuso de Ancianos/diagnóstico , Abuso de Ancianos/legislación & jurisprudencia , Abuso de Ancianos/psicología , Abuso de Ancianos/estadística & datos numéricos , Femenino , Visita Domiciliaria , Humanos , Masculino , Notificación Obligatoria , Persona de Mediana Edad , Programas Nacionales de Salud , Relaciones Enfermero-Paciente , Relaciones Profesional-Paciente , Investigación Cualitativa , Delitos Sexuales/legislación & jurisprudencia , Delitos Sexuales/prevención & control , Delitos Sexuales/psicología , Violencia/legislación & jurisprudencia , Violencia/prevención & control , Violencia/psicología , Violencia/estadística & datos numéricosRESUMEN
Sexual assault is a traumatic event with potentially devastating lifelong effects on physical and emotional health. Sexual assault is associated with gastrointestinal, neurologic, and reproductive symptoms, as well as obesity, diabetes, and chronic pain. With 1 in 3 women and 1 in 6 men experiencing some form of unwanted sexual violence in their lifetime, sexual assault is a significant public health problem that necessitates attention in the medical community. This review discusses relevant literature on the neurobiologic changes that occur as a consequence of sexual assault, such as how the brain responds during a traumatic experience and the impact of trauma on memory. Osteopathic considerations for trauma-informed care and practice and how all physicians can better serve patients with a history of sexual assault are also discussed.
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Fenómenos Fisiológicos del Sistema Nervioso , Delitos Sexuales/psicología , Femenino , Humanos , Masculino , Notificación Obligatoria , Medicina Osteopática , Violación/psicología , Violación/rehabilitación , Acoso Sexual/psicología , Trastornos por Estrés Postraumático/fisiopatología , Trastornos por Estrés Postraumático/psicología , Heridas y Lesiones/fisiopatología , Heridas y Lesiones/psicologíaRESUMEN
Resumo OBJETIVO Analisar as concepções dos profissionais de enfermagem atuantes em Unidades Básicas de Saúde quanto à detecção e prevenção de idosos violentados. MÉTODOS Estudo descritivo, exploratório, qualitativo. Realizado em duas UBS, Mossoró/RN, utilizando roteiro de entrevista semiestruturada, em março a agosto de 2013. Amostra composta por quatro enfermeiros e seis técnicos de enfermagem. Realizada análise de conteúdo. RESULTADOS Identificaram-se 4 categorias: Estratégias utilizadas para identificar a violência contra o idoso; Tipos de violências contra o idoso; Conduta utilizada após constatação de uma suspeita de violência; SUS e a problemática da violência contra o idoso. Muitos profissionais reconhecem/desconfiam dos possíveis casos, entretanto, não sabem como proceder. A dimensão do problema exige que sejam realizadas intervenções pragmáticas no meio clínico e no contexto social. CONCLUSÕES Há necessidade de educação permanente para profissionais e maior comunicação entre as instâncias responsáveis pela denúncia e acolhimento.
Resumen OBJETIVO Analizar los conceptos de enfermeros activos en unidades básicas de la salud sobre la detección y prevención del maltrato hacia personas ancianas. MÉTODOS Estudio exploratorio, descriptivo y cualitativo, realizado en dos UBS, en Mossoro/RN, por medio de entrevistas semiestructuradas entre marzo y agosto de 2013. Se realizó el estudio con cuatro enfermeros y seis técnicos de enfermería. Se llevó a cabo el análisis de contenido. RESULTADOS El análisis se divide en 4 categorías: Estrategias utilizadas para identificar la violencia contra ancianos; Tipos de violencia contra personas mayores; Acción utilizada luego de detectarse la violencia; y SUS y el tema de la violencia contra ancianos. Muchos profesionales reconocen/desconfían de los posibles casos, sin embargo, no saben cómo proceder. La magnitud del problema requiere de intervenciones pragmáticas que se lleven a cabo en el ámbito clínico y en el contexto social. CONSIDERACIONES FINALES Existe la necesidad de una educación continua para profesionales y una mayor comunicación entre los organismos responsables de la queja y acogida.
Abstract OBJECTIVE To analyze the conceptions of the nursing professionals working in Basic Health Units regarding the detection and prevention of violence against the elderly. METHODS Descriptive, exploratory, qualitative study. Performed in two BHUs in Mossoró/RN, using a semi-structured interview script, from March to August of 2013. Sample composed of four nurses and six nursing technicians. The content analysis, pre-analysis, material exploration, and treatment of results were performed. RESULTS Four categories were identified: Strategies used to identify violence against the elderly; Types of violence against the elderly; Conduct used after finding a suspicion of violence; SUS and the problem of violence against the elderly. Many professionals recognize/distrust possible cases, however, they do not know how to proceed. The dimension of the problem requires that pragmatic interventions be performed in the clinical setting and in the social context. FINAL CONSIDERATIONS There is a need for continuing education for professionals and greater communication between the bodies responsible for reporting and embracement.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , Anciano de 80 o más Años , Enfermeras y Enfermeros/psicología , Asistentes de Enfermería/psicología , Relaciones Profesional-Paciente , Delitos Sexuales/legislación & jurisprudencia , Delitos Sexuales/prevención & control , Delitos Sexuales/psicología , Violencia/legislación & jurisprudencia , Violencia/prevención & control , Violencia/psicología , Violencia/estadística & datos numéricos , Brasil , Actitud del Personal de Salud , Violencia Doméstica/legislación & jurisprudencia , Violencia Doméstica/prevención & control , Violencia Doméstica/psicología , Violencia Doméstica/estadística & datos numéricos , Notificación Obligatoria , Investigación Cualitativa , Abuso de Ancianos/diagnóstico , Abuso de Ancianos/legislación & jurisprudencia , Abuso de Ancianos/psicología , Abuso de Ancianos/estadística & datos numéricos , Visita Domiciliaria , Persona de Mediana Edad , Programas Nacionales de Salud , Relaciones Enfermero-PacienteRESUMEN
Introdução:A violência é um fenômeno social e histórico na humanidade que acarreta impactos diretos sobre a saúde, por meio de lesões físicas ou emocionais, traumas e mortes, representando um problema de saúde pública no Brasil e no mundo. Nesse sentido exige formulação de políticas específicas e organização de práticas e de serviços peculiares ao setor de saúde integral à mulher a fim de se prestar uma assistência integral e humanizada. Objetivo:descrever os casos de violência física (VF) contra a mulher notificados ao Sistema de Informação de Agravos de Notificação (SINAN) na Bahia, nos anos de 2009 a 2014. Material e Métodos: estudo descritivo, transversal, utilizando-se dados secundários do SINAN, referentes a violência física praticada contra mulheres na Bahia, no período de 2009 à 2014. Resultados: foram notificados 9590 casos de VF contra mulheres na faixa etária entre 20 a 39 anos (56%), pertencentes às raças parda e negra (58,5%), com ensino fundamental incompleto (20,9%); o ato era praticado com maior frequência pelo cônjuge (24,2%), na residência das vítimas (52,2%), utilizando-se a força corporal e/ou espancamento (67,2%). Conclusão: A violência é um fenômeno frequente no cotidiano das mulheres e seu enfrentamento ainda é um desafio, havendo a necessidade de revisão das políticas públicas nacionais e internacionais que embora tenham avançado na garantia de punição do agressor, ainda carece de maior assistência holística e integral após as denúncias.
Introduction: Violence is a social and historical phenomenon in mankind that has a direct impact on health, through physical or emotional injuries, trauma and death, representing a public health problem in Brazil and in the world, requiring the formulation of specific policies and organization of practices and services peculiar to the integral health sector for women in order to provide comprehensive and humanized assistance. Objective: To describe the cases of physical violence (FV) against women notified to the Notification of Invalidity Information System (SINAN) in Bahia from 2009 to 2014. Material and methods: a descriptive, cross-sectional study using secondary data of SINAN, referring to the physical violence practiced against women in Bahia from 2009 to 2014. Results: 9,590 cases of FV were reported against women in the age group between 20 and 39 years old (56%), belonging to the brown and black races (58.5%), with incomplete elementary education (20.9%); (52.2%), using corporal force and / or beating (67.2%), was the most frequently practiced by the spouse (24.2%). Conclusion: Violence is a frequent phenomenon in women's daily lives and their confrontation is still a challenge, and there is a need to review national and international public policies that, although they have advanced the guarantee of punishment of the aggressor, still require greater holistic and integral assistance after the denunciations.
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Humanos , Femenino , Adulto , Persona de Mediana Edad , Notificación Obligatoria , Violencia de Pareja/estadística & datos numéricos , Abuso Físico/estadística & datos numéricos , NotificaciónRESUMEN
BACKGROUND: Illnesses caused by exposure to extracorporeal artificial substances play a major role in emergency medicine, family medicine, and environmental medicine. OBJECTIVE: The current situation of medical poisoning management and national reporting of poisonings in Germany are described. MATERIALS UND METHODS: The information and data presented here are derived from a literature review and from stakeholder interviews. RESULTS AND CONCLUSION: Eight poison centres (PCs) offer consultation supporting the diagnosis and treatment of poisoning cases in Germany today. Furthermore, those affected, their relatives and first aiders contact these German PCs, mainly because of a suspected poisoning. German PCs are also contacted by those affected and by institutions in other situations when expert toxicological judgement is needed, especially in cases with an environmental background. Often, interpretation of analytical laboratory results of body fluid samples or environmental samples are requested, or reference to environmental medicine treatment facilities is made. The PCs and the German Federal Institute for Risk Assessment (BfR) cooperate on the national reporting of the risks of poisoning for the population. In addition, the BfR collects and evaluates poisoning reports from German medical doctors that have been directly submitted. A pilot project on a national monitoring of poisonings should collate future case reports. An extensive and current overview of poisonings in Germany is a prerequisite for the identification of unsafe products and to fully comply with the international reporting needs of the German Federal Government in the case of chemical outbreaks and the resulting suspected cases.
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Monitoreo del Ambiente/estadística & datos numéricos , Centros de Control de Intoxicaciones/estadística & datos numéricos , Intoxicación/diagnóstico , Intoxicación/epidemiología , Vigilancia de la Población/métodos , Derivación y Consulta/estadística & datos numéricos , Sistema de Registros , Alemania , Sustancias Peligrosas , Líneas Directas/estadística & datos numéricos , Humanos , Notificación Obligatoria , Intoxicación/prevención & controlRESUMEN
The reporting of suspected CSA cases to authorities in a timely manner is important in preventing continued abuse and protecting abused children at early ages. The current study seeks to explore parents' intentions of reporting their own children's CSA experiences to authorities as well as their reporting willingness when they become aware of possible CSA cases happening to children in other families. Two rounds of semi-structured interviews were conducted among a sample of 26 parents in Beijing; these parents were purposefully selected so as to be diverse in terms of gender, age, and socioeconomic status. The data were analyzed thematically. The findings showed that the reporting of suspected CSA to authorities was a choice made by only a few Chinese parents; it was often even a last resort. By using a holistic-interactionistic approach, the interaction between Chinese parents' intentions of reporting CSA and the Chinese socio-cultural context was analyzed as a dynamic and continuously ongoing process. The impacts of the definition and perceptions of CSA on reporting, the balance of children's rights and parents' power, and the double effect of informal social control are discussed. The implications, both locally and globally, are also discussed.
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Pueblo Asiatico/psicología , Abuso Sexual Infantil/etnología , Abuso Sexual Infantil/prevención & control , Intención , Notificación Obligatoria , Padres/psicología , Adolescente , Adulto , Niño , Abuso Sexual Infantil/legislación & jurisprudencia , Abuso Sexual Infantil/psicología , Servicios de Protección Infantil/legislación & jurisprudencia , Servicios de Protección Infantil/estadística & datos numéricos , Preescolar , China , Características Culturales , Femenino , Humanos , Lactante , Entrevista Psicológica , Masculino , Persona de Mediana Edad , Violación/legislación & jurisprudencia , Violación/psicología , Violación/estadística & datos numéricos , Revisión de Utilización de RecursosRESUMEN
Though it has been illegal in the UK since 1985, no one has ever been prosecuted for FGM. Under laws rolled out last year in England and Wales, nurses, midwives, doctors and teachers have a mandatory duty to report FGM cases in under-18s to police.
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Protección a la Infancia/legislación & jurisprudencia , Circuncisión Femenina/legislación & jurisprudencia , Notificación Obligatoria , Niño , Circuncisión Femenina/estadística & datos numéricos , Crimen , Femenino , Humanos , Partería , Enfermeras y Enfermeros , Policia , Reino UnidoAsunto(s)
Antituberculosos/uso terapéutico , Salud Holística , Atención Dirigida al Paciente , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Adulto , Humanos , Masculino , Notificación Obligatoria , Nueva Zelanda , Tuberculosis Resistente a Múltiples Medicamentos/diagnóstico , Tuberculosis Resistente a Múltiples Medicamentos/fisiopatología , Tuberculosis Resistente a Múltiples Medicamentos/psicologíaRESUMEN
Quality management information systems for safety as a whole or for specific vigilances share the same information types but are not interoperable. An international initiative tries to develop an integrated information model for patient safety and vigilance reporting to support a global approach of heath care quality.
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Prestación Integrada de Atención de Salud/organización & administración , Registros Electrónicos de Salud/organización & administración , Errores Médicos/clasificación , Errores Médicos/estadística & datos numéricos , Seguridad del Paciente/estadística & datos numéricos , Gestión de Riesgos/organización & administración , Europa (Continente) , Almacenamiento y Recuperación de la Información/métodos , Notificación Obligatoria , Errores Médicos/prevención & control , Registro Médico Coordinado/métodosRESUMEN
In Sweden, pertussis was excluded from the national vaccination programme in 1979 until acellular vaccination was introduced in a highly endemic setting in 1996. The general incidence dropped 10-fold within a decade, less in infants. Infant pertussis reached 40-45 cases per 100,000 in 2008 to 2012; few of these cases were older than five months. We present an observational 15-year study on the severity of infant pertussis based on 1,443 laboratory-confirmed cases prospectively identified from 1998 to 2012 in the national mandatory reporting system and followed up by telephone contact. Analyses were made in relation to age at onset of symptoms and vaccination history. Pertussis decreased in non-vaccinated infants (2003 to 2012, p<0.001), indicating herd immunity, both in those too young to be vaccinated and those older than three months. The hospitalisation rates also decreased (last five-year period vs the previous five-year periods, p <0.001), but 70% of all cases in under three month-old infants and 99% of cases with apnoea due to pertussis were admitted to hospital in 1998 to 2012. Median duration of hospitalisation was seven days for unvaccinated vs four days for vaccinated infants aged 3-5 months. Nine unvaccinated infants died during the study period.
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Hospitalización/estadística & datos numéricos , Vacuna contra la Tos Ferina/inmunología , Tos Ferina/epidemiología , Tos Ferina/prevención & control , Niño , Preescolar , Hospitalización/tendencias , Humanos , Programas de Inmunización , Incidencia , Lactante , Recién Nacido , Notificación Obligatoria , Programas Nacionales de Salud , Vacuna contra la Tos Ferina/administración & dosificación , Vigilancia de la Población , Índice de Severidad de la Enfermedad , Suecia/epidemiología , Vacunación/métodos , Tos Ferina/patologíaRESUMEN
The development of an animal health barometer, an instrument to measure the general health of the Belgian livestock population on a yearly basis and to monitor its evolution over time, is described. The elaboration of a set of 13 animal health indicators (AHIs) as the basis for the animal health barometer is discussed. These indicators were weighted by experts - including scientists, policy makers and agro-industrial representatives - to determine their relative weight in the barometer. The result of the barometer is expressed as a comparison with a previous year. Based on the results of the 13 AHIs, it is concluded that general animal health in Belgium shows a positive evolution since 2008. The animal health barometer provides a composite view of the status of livestock health in Belgium and is a tool to communicate in an intelligible, comprehensible manner on aspects of animal health to consumers and professional stakeholders in the animal production and food chain. Together with the food safety barometer (Baert et al., 2011. Food Res. Int. 44, 940) and the plant health barometer (Wilmart et al., 2014. Eur. J. Plant Pathol. doi: 10.1007/s10658-014-0547-x), the animal health barometer is one of the three instruments to provide a holistic view on the overall status of the safety of the food chain in Belgium.
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Enfermedades de los Animales , Indicadores de Salud , Ganado , Enfermedades de los Animales/epidemiología , Enfermedades de los Animales/prevención & control , Enfermedades de los Animales/transmisión , Animales , Bélgica , Inocuidad de los Alimentos , Estado de Salud , Humanos , Relaciones Interprofesionales , Notificación Obligatoria , Práctica de Salud PúblicaRESUMEN
Dentists are likely to treat patients who have experienced a wide range of traumatic life events, including child abuse and neglect, domestic violence, sexual assault, elder abuse, and exposure to combat. In order to effectively treat survivors of traumatic events, dentists must understand how these patients may present in oral health settings, the basic mandated reporting requirements related to abuse and neglect, and communication strategies to help engage trauma survivors in dental treatment. A traditional lecture-format educational module on trauma-informed care was developed and implemented for second-year dental students (N=92) at one U.S. dental school, after which a needs assessment was performed (all 92 students participated). This assessment then informed development of an enhanced module for the subsequent group of second-year dental students (N=102) at the same school. The revised (final) module was more interactive in nature, expanded to multiple sessions, and included more discussion of mandated reporting and appropriate dentist-patient communication in relation to traumatic events. All 102 students participated in assessments of the revised module. Comparison of pre and post tests and needs assessments between the initial and final modules indicated that the extended, more interactive final module was more effective in meeting the educational objectives. Results showed that the final module increased the students' knowledge in the health-related manifestations of traumatic events and slightly improved their confidence levels in treating survivors of trauma. Dentists who are prepared to deliver trauma-informed care may help individual patients feel more at ease and increase engagement in regular preventive care. Suggestions for future educational efforts in this area are discussed.