Bakgrund: Elever upplever traumatiska barndomsupplevelser (TBU) som påverkar förmågan att hantera livet som barn och vuxen. Det är angeläget att upptäcka och identifiera elever med TBU eftersom de har rätt till skydd, rehabilitering och social återanpassning. Uppgiften är central i skolsköterskans hälsofrämjande roll. Syfte: Undersöka hur skolsköterskor arbetar med att upptäcka och identifiera traumatiska barndomsupplevelser hos elever. Metod: En retrospektiv enkätstudie användes och 100 skolsköterskor lämnade sina svar mellan 20 februari och 21 mars. Nästan alla hade specialistsjuksköterskeutbildning. Resultat: Frågor om TBU ställdes av 66 % och 34 % gjorde det inte. Majoriteten frågade muntligt. Frågan om TBU fanns i skolans hälsoenkät hos 38 % och en använde validerade formulär för att upptäcka och identifiera TBU. Av samtliga respondenter ville 78 % lära sig använda Barnafrids validerade formulär för att upptäcka och identifiera TBU. Konklusion: Många frågar om TBU men en tredjedel gör det inte. Mindre än hälften hade frågor i skolans hälsoenkät. Få kände till att validerade formulär kunde hjälpa till i arbetet med TBU och användes av en. Skolsköterskor, vårdgivare, lärosäten och forskare kan tillsammans utveckla systematisk screening av TBU. Det främjar elevers hälsa, välbefinnande och möjlighet att nå utbildningens mål. / Background: Students experience adverse childhood experiences (ACE) that affect the ability to cope with life as a child and as an adult. It's important to detect and identify ACE because students have the right to protection, rehabilitation and social reintegration. This task is central for school nurse’s health promoting role.  Aim: To investigate how school nurses’ work to detect and identify ACE in students.  Method: A retrospective survey study was used and 100 school nurses provided their responses between 20 February and 21 March. Almost all had specialist nursing training.  Findings: Questions about ACE were asked by 66% and 34% did not. A majority asked verbally. ACE questions was present in 38 % of the school health questionnaire. One used validated form and of all 78% wanted to learn how to use validated form to detect and identify ACE.  Conclusion: School nurses ask about ACE but a third do not. Less than half had questions in the school health questionnaire and few knew that validated forms could help in the work with ACE. School nurses, healthcare providers, universities and researchers can together develop systematic screening for ACE. It promotes students' health, wellbeing and the opportunity to reach the goals of the education.

Trauma-informed care is a relatively new construct in K-12 education, and districts across the United States are seeking avenues to meet the needs of their students. The COVID-19 pandemic elevated the need for districts to develop appropriate supports to address student and adult trauma. Traumatic events can affect a child’s mental, physical, social-emotional, and/or spiritual well-being (Substance Abuse and Mental Health Service Administration, 2011). Furthermore, children with an elevated risk of trauma may not be able to access these supports outside of the school setting (Baweja et al., 2015). Therefore, educational systems need to develop trauma-informed care models for schools that furnish a sense of safety and community so that students receive the necessary support. This evaluation aimed to identify how the moderating factors of district administrators, site administrators, climate and culture, and teacher capacity affect trauma-informed care via a multi-tiered system of support (MTSS) framework. It included a specific focus on Tier 1, universal access, to improve timely support for students. This formative program evaluation explored the impact of the moderating factors through the viewpoint of a newly created conceptual framework. I used qualitative and quantitative data sources to explore the multiple aspects of the phenomenon. The ARTIC-45 provided descriptive statistics about educators’ attitudes toward trauma-informed care. The observational data and analysis of the Panorama Education social-emotional learning (SEL) survey that assessed 3rd-12th students social-emotional well-being provided character to the evaluation. The data analysis yielded inconsistent results. The observational data strongly indicated a trauma-informed environment in which students were given clear expectations and engaged in positive reciprocal interactions with peers and adults. The ARTIC-45 data showed that administrators, teachers, and support staff responded favorably to trauma-informed care approaches. Though statistical significance could not be obtained due to the sample size constraint of being too small, the data provided context to the other data sources. For example, teacher capacity could not be quantified, but the data provided context to the overall staff capacity. The review of the archival and current SEL survey data showed that favorability among domains varied by site and grade level. The variations in students' social-emotional favorability can be related to their lived experiences and it is important to track over time to monitor how experiences, expressions, and feelings change over time. Students' perspectives regarding themselves and their environment differed from the observational data. This indicates that educators should not solely rely on observational data to determine students’ social-emotional well-being. Furthermore, an SEL survey can be used as a tool to understand students’ well-being and thus provide them with timely support. The evaluation determined that district administration, site administration, climate and culture and staff capacity can positively impact a multi-tiered, trauma-informed care environment. In these settings, student behavior and social-emotional well-being is viewed in a healing-centered manner. Districts can create a multi-tiered, trauma-sensitive culture and provide support to enhance teachers’ capacity to implement trauma-informed care, take advantage of administrative influence, develop community partnerships, and create a culture that is open to systematic change.