Table 2.

Major quantitative and qualitative findings for included studies.

Author and date	Specific intervention	Quantitative findings	Qualitative findings
Education
Carter-Snell 2020	Needs assessment and educational intervention (EESAS)	- Comfort providing sexual assault services significantly improved even at 6-month surveys (P <0.01) in emergency clinicians - Knowledge of consequences of sexual assault, mental health considerations, healthcare interventions, and legal considerations improved post training (P < 0.01)	- Enhanced collaboration across services and issues with ongoing turnover of personnel - Subjective quality of service ratings improved
Chandramani 2020	Needs assessment and educational intervention (SANE)	- Significant improvement in knowledge of elements of assault history 67% to 93% (P < 0.05) and comfort in ability to take history 41% to 86% (P <0.01) in ED residents. -Significant improvement in comfort performing a forensic examination 44% to 87% (P < 0.01) in ED residents.	- In pre-intervention free response, nine participants mentioned a lack of training and education as a barrier to providing better care - Post survey participants expressed that the educational intervention was very helpful to their ability to care for survivors.
Cole 2014	Educational Intervention to decrease use of restraints in ED	- Initially, 15 to 20 episodes of restraints being used per month, which decreased to no episodes by the end of the intervention. - Overall, ED behavioral health seclusion and restraint hours were reduced from 38.5 h/mo to 0 h/mo after 2 years of the program.	-Changing the culture through staff understanding of trauma-informed care was key in improving the patient outcomes. -Success of the program depended upon relationship between ED and behavior health department working together.
Hoysted 2018	Web-based training on general TIC principles for pediatric patients	- Training group had significantly greater knowledge following training and at follow-up than the control (P <.001) - Most participants (74.2%) indicated that the training would be useful in their role in the ED	- Participants liked the online format, found the training to be interesting and informative, and felt the training increased their insight and awareness - Participants stated that there should be more interactive program with the opportunity to practice learned skills
Hall 2016	Modular didactic education on TIC and mental health in ED	- ED nurses reported more confidence in their ability to talk to patients about traumatic experiences (P = 0.001, r = 0.41), respond to disclosures of family violence (P = 0.001, r = 0.41), and understand how their current nursing practice is trauma informed (P = 0.001, r = 0.53)	- Participants had an increased openness to ask questions about trauma and listen to patients’ responses - Participants found the neurobiology component of the education assisted their understanding of trauma
TIC-based programs and protocols
Corbin 2010	Assessment, case management, mentoring, psychoeducational groups, case review	N/A	Authors concluded a combination of In-hospital peer counseling starting in the ED, outpatient follow-up with home visits to address educational, employment, and behavioral health needs, leads to better all- around care and preventing of future incidents of community violence
Giles 2019	TIC assessment and intervention for suicide prevention	- Patients who received the intervention were significantly more likely to attend outpatient treatment compared with usual care; 79 families (88.8%) received at least one care linkage contact compared to zero in the non-intervention group	- Authors concluded that adding the trauma screening helped to provide trauma-informed care and to link youth directly to trauma- specific, evidenced-based treatments from the ED.
Lakatos 2014	TIC response to the Boston Marathon bombings	N/A	- A team of psychiatric advanced practice nurse using a TIC framework were able to provide comprehensive care to patients, their families, and staff after the Boston Marathon bombings starting in the ED. - Staff reported returning to baseline 3 weeks after the event
Stolbach 2017	TIC screening, support, education, and intervention	N/A	- A TIC-based clinic that first reached out in the ED helped patients recover from the mental harm caused by community violence.
Tiller 2020	TIC-based Protocol for Victims of Human Trafficking (HEAL Toolkit)	N/A	- The development of a TIC standardized protocol ensured that survivors of human trafficking and at-risk patients were treated appropriately and in a standardized manner regardless of the experience of the clinician.

TIC, trauma-informed care; EMS, emergency medical services; ED, emergency department; EESAS, Enhanced Emergency Sexual Assault Services; SANE, Sexual Assault Nurse Examiners.