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Improving Neonatal Adverse Childhood Experiences (ACEs) Screening in the NICU: A Quality Improvement Initiative

Journal of Perinatology (2025)Cite this article

Subjects

Abstract

Objective

Adverse Childhood Experiences (ACEs) are linked to various negative health outcomes. Although research typically focuses on ACEs during childhood and adulthood, emerging studies indicate that the effects of ACEs may affect neonates before birth. This study aimed to increase the percentage of neonates fully screened for ACEs in a Level III NICU from 2% to 50%.

Design

The project involved developing and implementing a neonatal ACEs screening tool integrated into the electronic medical record. The screening process was refined through a series of Plan-Do-Study-Act (PDSA) cycles to improve the consistency of screening.

Results

Over six months, the proportion of neonates screened for ACEs increased from 2% to 75%. Implementing a separate progress note for ACEs assessments enhanced confidentiality, with 60% of screenings documented privately.

Conclusions

This quality improvement project successfully established a standardized neonatal ACEs screening process, resulting in a higher identification rate of neonates at social risk.

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Data availability

The data for this study is not publicly available to protect the privacy of the patients involved.

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Funding

This study was sponsored by the University of Utah Department of Pediatrics.

Author information

Authors and Affiliations

  1. University of Utah, Department of Pediatrics, Salt Lake City, UT, USA

    Kaitlyn Sacotte & Carrie Torr

  2. University of Utah, Department of Social Work, Salt Lake City, UT, USA

    Jane Nampijja

Authors
  1. Kaitlyn Sacotte
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  2. Jane Nampijja
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  3. Carrie Torr
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Contributions

Kaitlyn Sacotte designed and implemented the study and wrote the manuscript. Carrie Torr helped design the study and edited the manuscript. Jane Nampijja implemented the study and helped edit the manuscript.

Corresponding author

Correspondence to Kaitlyn Sacotte.

Ethics declarations

Competing interests

The authors of this manuscript have no competing financial interests in relation to this work.

Ethics approval and consent to participate

This study was approved by the Institutional Review Board at the University of Utah (Study Number 00158943) and received ethics approval. All methods were performed in accordance with the relevant guidelines and regulations. Informed consent was waived by the Institutional Review Board due to minimal risk of harm.

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Sacotte, K., Nampijja, J. & Torr, C. Improving Neonatal Adverse Childhood Experiences (ACEs) Screening in the NICU: A Quality Improvement Initiative. J Perinatol (2025). https://doi.org/10.1038/s41372-025-02498-5

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