Stop the Bleed: A Needs Assessment for the School-aged Population

Background: When penetrating or traumatic injury is involved, uncontrolled hemorrhage is the leading cause of preventable death. Stop the Bleed (STB) is a nationally recognized educational program developed by the National College of Surgeons. It seeks to 1. educate the public on recognizing life-threatening bleeding quickly and 2. what they can do to intervene effectively. The skills taught in this course are proven to reduce morbidity and mortality and address gaps in knowledge, accessibility, and training for the general public. This STB needs assessment seeks to identify how to address these problems and overcome these barriers. Local Problem: Schools in the United States have been severely impacted by the increasing rates of gun violence and are thus susceptible to incidents of life-threatening bleeding. No currently established STB training protocol is standardized or mandated to be implemented in Utah schools. The needs assessment seeks to identify and evaluate Utah schools' current emergency readiness by assessing their emergency preparedness concerning bleeding and penetrating injuries. Methods: A mixed-methods approach was utilized, integrating quantitative surveys, qualitative surveys, and qualitative interviews with a representative sample of school nurses and emergency managers from Utah. Those surveyed included stakeholders from public and private/charter high schools, middle schools, and elementary schools throughout the state's suburban, urban, and rural communities. Interventions: The survey brought attention to school stakeholders' preparedness and attitudes towards the information taught in STB. Subsequent interviews helped to identify the specific preparations, training, skills, and related gaps in these systems. Results: The preliminary needs assessment indicates a lack of continuity across the state regarding STB training in schools. While there is a general agreement on the importance of the material, a district-wide systematic method for teaching, maintaining records of completion, and continued assessment of competency remains to be seen. Stakeholder interviews further confirmed that barriers to implementation include logistics, time, and funding. Conclusion: Utah school district nurses and emergency managers are eager and willing to implement STB training for their staff and may wish to include their students in such training. This can enhance safety not only in the school system but within the local community as well. While the core content should remain the same, the infrastructure to disseminate the training can be flexible from district to district, addressing needs individually. This includes training school nurses as STB instructors, involving local EMS to assist with training events, and involving hospital injury prevention departments for material support.