Core Concepts for Trauma-Informed Substance Use Education in Graduate Nursing: A Delphi Study

BACKGROUND: Trauma exposure and substance use frequently co-occur, yet guidance for integrating trauma-informed substance use education in graduate nursing is limited. PURPOSE: This study aimed to establish consensus on core concepts for trauma-informed substance use education in graduate nursing. METHODS: A 3-round Delphi study was conducted with nursing educators, trauma-informed and substance use experts, and individuals with lived experience. Round 1 elicited concepts, round 2 involved importance ratings, and round 3 focused on prioritization. RESULTS: Nine core concepts were identified, all achieving consensus in round 2 (80%-95% rated ≥4). Round 3 showed differences in prioritization (χ2 (8) =49.84, P < .001; Kendall's W = 0.27). Highest ranked concepts included trauma as a root cause, safe and empowering environments, and empathic care. CONCLUSIONS: These findings provide a consensus-based framework to guide curriculum development and prepare advanced practice nurses to deliver trauma-informed, stigma-reducing care.