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Show Postpartum Depression Screening at Well-Child Visits Käty Foutz1, RN, BSN; Ryoko Kausler1,2, PhD, FNP-BC, MN, RN; Mollie R. Cummins1,3, PhD, RN, FAAN, FACMI 1College of Nursing, University of Utah, 2School of Nursing, Boise State University, 3Department of Biomedical Informatics, Spencer Fox Eccles School of Medicine . Screening for postpartum depression at well-child visits increases rates of identification and referral for postpartum depression when compared to no screening. Background • • Results Postpartum depression can occur anytime within the 1st year post-birth, yet most women are only screened at the 6-week postpartum visit.1,2,3 Current evidence shows that screening for postpartum depression at well-child visits can improve identification of postpartum depression and referral for treatment.4.5.6.7.8 Screening Outcomes • Post-implementation rate was 82.6% compared to 0% for pre-implementation (Figure 1). • 26% (5/19) of those screened had positive results. • Of those identified, 40% (2/5) were referred for treatment. Provider Perspectives Purpose • To increase screening and referral for postpartum depression in women by implementing a screening and referral process at well-child visits in the first year after giving birth. Methods • • • • • • A quality improvement project implemented in a rural family medicine clinic in Idaho September 2024-December 2024 Determined best practices through a review of the literature Developed a practice-specific guideline using the Plan-Do-Study-Act (PDSA) cycle Utilized Edinburgh Postnatal Depression Scale (EPDS) Plus for screening Conducted pre- and post-interviews to assess providers’ perspectives on processes, barriers, benefits, usability, feasibility, and satisfaction with postpartum depression screening at well-child visits and conducted chart audits to monitor improvement. • • Figure 2 Provider Perspectives: Before and After Implementation • • Before implementation, most providers used the PHQ9 (75%, 3/4) to screen for depression. One (25%, 1/4) used the EPDS. All providers were open to using a new tool (100%, 4/4). Before implementation, half of providers (50%, 2/4) felt time was a barrier. After implementation, most felt time was a challenge (75%, 3/4). Providers found the practice-specific guideline usable (M=8.75, SD=1.09), feasible (M=9, SD=1.22), and satisfactory (M=9.5, SD=0.5). The ease of using the protocol had a mean of 8.75 (SD=0.43). Key themes presented in Figure 2. Conclusions • • • References Screening for postpartum depression at well-child visits can increase rates of identification and referral for postpartum depression. Tailoring a practice-specific guideline unique to each practice may ensure greater sustainability. Future quality improvement projects may include when to refer for treatment and how to make the protocol more time efficient. @uofunursing @utnurseresearch |
