Document Type

Doctoral Project

Publication Date

11-6-2017

Abstract

Postpartum depression (PPD) affects approximately 10-15% of women and can have serious negative effects on mothers, infants, and families. PPD can persist throughout the first year after delivery when mothers no longer have consistent contact with their primary health care provider. The U.S. Preventive Services Task Force, the American Congress of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the American Academy of Pediatrics recommend screening for depression when support systems are in place to ensure referral for further evaluation, diagnosis, and treatment. Pediatric providers have consistent interactions with mothers and infants during well-child visits. During this evidence based practice improvement project, a screening program for depression was implemented using the Edinburgh Postnatal Depression Scale (EPDS) at the 2 week, 2 month, 4 month, 6 month, well-child visits. Mothers who screened positive were provided community resources and referred to their primary care provider. The Evidence-Based Practice Improvement Model (EBPI) guided this project. Eight pediatric providers, seven licensed practical nurses (LPN), two receptionists, and the office manager were educated on the significance and risks of PPD, the effectiveness of PPD screening, the use of the EPDS, and steps to take when the screening indicated a risk for PPD was present. A total of 255 mothers were eligible for screening and 160 mothers (67%) completed the EPDS during the three month implementation period. Documentation iv of the screening and distribution of resource packets and referrals given to mothers occurred at a nearly 100% rate. In addition, demographic information including mother’s age, mother’s race, marital status, age of infant, gestational age of infant, method of feeding, and type of insurance was also collected. Providers, staff, and patients in this clinic benefited from education on PPD and screening continues to be included in the selected well-child visits. Implementation of PPD screening in other settings is indicated to demonstrate the effectiveness of identifying mothers with PPD.


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