Postpartum depression screening effective in the pediatric setting
Before the project’s implementation, baseline data demonstrated a 33% PPD screening rate using the EPDS; after implementation, the project increased screening rates to 80%.
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CHICAGO—Standardized postpartum depression (PPD) screening and use of a referral algorithm can be effective in the ambulatory pediatric setting, according to research presented at the National Association of Pediatric Nurse Practitioners' 39th National Conference on Pediatric Health Care.
Samantha Russomagno, BSN, RN, CPN, and Julee Waldrop, DNP, PNP, FAANP, FAAN, conducted a quality improvement project aimed at improving PPD screening rates and appropriate referrals at a rural pediatric primary care clinic. The Edinburgh Postnatal Depression Scale (EPDS) was administered at the clinic's newborn, 2-week, 1-month, 2-month, 4-month, and 6-month well-child checks (WCCs). Depending on the EPDS score, mothers were referred to their obstetrician/gynecologist, primary care provider, and/or a local mental health counselor using a resource and referral guide developed for this project.
A total of 414 mothers were included; 8 refused screening. Before the project's implementation, baseline data demonstrated a 33% PPD screening rate using the EPDS. After implementation, the project increased screening rates to 80%. Although not statistically significant, the project improved referral rates from 66% to 79%. The referral algorithm was functional for providers and can be replicated by other pediatric practices. Mothers' refusal to be screened accounted for 13% of instances when screening was not performed appropriately.
“By standardizing PPD screening, developing a referral/resource guide, and implementing a referral algorithm in the pediatric setting, more PPD cases can be identified, further evaluated, and treated, which directly improve maternal and infant health outcomes,” the authors concluded.
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Russomagno S, Waldrop J. Improving postpartum depression screening and referral in the pediatric setting. Presented at the National Association of Pediatric Nurse Practitioners 2018 National Conference; March 19-22, 2018; Chicago.