Implementing Postpartum Screening Tools and Resources For ...€¦ · The purpose of the MSN...
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ABSTRACT Postpartum depression (PPD) is a disorder that affects women within the first year after childbirth. There are devastating long-term effects of untreated PPD on a mother and family. The purpose of the MSN Project is to educate mothers (patients) about the signs of PPD via an educational pamphlet. In addition, the aim is to increase awareness and knowledge for providers about the importance of screening for PPD through a screening schedule, a copy of the Edinburgh Postnatal Depression Scale (EPDS) screening tool, and an algorithm using the EPDS. A literature review examined what type of screenings improved outcomes for PPD. The pamphlet summarizes this information for patients and providers. If the materials are utilized, they potentially will help increase the detection and treatment rates of PPD. PICO QUESTION In pregnant and postpartum women, how do postnatal depression screenings compared to prenatal depression screenings predict postpartum depression diagnosis over one year? LITERATURE REVIEW Postpartum depression is widespread. (1) This fact substantiates the need for screening women for postpartum depression. All of the professional organizations suggest screening, but they differ on when and how to screen. Specific guidelines need to be developed and followed to help manage PPD. The majority of women access healthcare services during pregnancy, childbirth, or postpartum. During this period, a depression screening should be implemented. During a thorough literature review, the following themes were discovered: • Importance of screenings • Timing of screenings • Screening tools Controversies were found in the literature review on which screening tool to use. However, the EPDS screening tool had the highest reliability and validity. (2) The end goal is to establish a consistent process to ensure all women who screen positive for depression receive adequate and accessible treatment. Implementing Postpartum Screening Tools and Resources For Mothers at Their Infants’ Well-Child Care Visits Jaclyn Knight, BSN, RN, MSN-FNP Student Implementation • The implementation process will take place in both pediatric and family practice clinics. By having two different clinics, the intended audiences will be reached for optimal implementation. • The screening schedule, algorithm/provider education, and education pamphlet for patients will be given to both clinics. Each clinic will be able to use these resources and implement them when addressing PPD screenings. Evaluation • The evaluation will consist of surveying two groups: the providers and the patients. The questions will be geared toward the deliverables and will includes usability and credibility, as well as any suggestions that may be given. • The valuable feedback and information from the post evaluations will provide information on the effectiveness of the deliverables. THEORETICAL FRAMEWORK Attachment theory by John Bowlby The attachment theory is used to describe how childhood experiences can affect the evolution of caregiving skills. Furthermore, the development of a child can be affected both directly and indirectly by a mother who has depression. (3) A mother with depression may not communicate or interact with her infant the same way as a mother without depression. For example, a mother who is withdrawn is less likely to interact with her infant. Therefore, an infant who suffered from affective deprivation is at risk for an insecure attachment and disorders of depression. (2) The attachment theory shows that the relationship between a mother and infant should be positive. A desired outcome of the attachment theory is an emotional relationship that allows the child to develop beyond surviving by offering opportunities to grow, develop, flourish, and reach the fullest potential possible. (3,4) CONCLUSIONS Untreated PPD has long-term effects on the infant and mother. Early diagnosis and management can reduce the negative impact of PPD by consistently implementing screening for depression. The screening schedule, screening tool, and algorithm can be used by all levels of healthcare providers to detect depression. These tools will allow the providers to feel comfortable and confident in their knowledge about PPD. Healthcare providers can make a difference in depression rates for their patients by consistently screening for PPD and connecting them to appropriate resources. This will significantly improve the lives of mothers and their families. REFERENCES 1. CDC. (2017). Depression among women. Retrieved from https://www.cdc.gov/reproductivehealth/depression/index.htm 2. O’Connor, E., Rossom, R. C., Henninger, M., Groom, H. C., & Burda, B. U. (2016). Primary care screening for and treatment of depression in pregnant and postpartum women: Evidence report and systematic review for the US preventive services task force. The Journal of the American Medical Association, 315(4), 388-406. doi:10.1001/jams.2015.18948 3. Santona, A., Tagini, A., Sarracino, D., De Carli, P., Pace, C. S., Parolin, L., & Terrone, G. (2015). Maternal depression and attachment: The evaluation of mother-child interactions during feeding practice. Frontiers in Psychology,6(1235), 1-11. doi: 10.3389/fpsyg.2015.01235 4. Bornstein, M. H., Suwalsky, J. T., D., & Breakstone, D. A. (2012). Emotional relationships between mothers and infants: Knowns, unknowns, and unknown unknowns. Development and Psychopathology, 24(1), 113-123. doi:10.1017/s0954579411000708 PROJECT METHODOLOGY This project involves access of PPD screening tools for providers and education for patients. The description and development of project deliverables are as follows: Screening schedule for providers • Mothers will be screened at each well-child care visit up to 12 months. Algorithm for providers • The algorithm can be used as a guide for providers concerning interventions for positive PPD screenings. Education for providers • Education for providers consists of using information in the algorithm, such as how to use it, when to use it, and why to use it. Education for patients • An educational pamphlet will be delivered to pediatric and family practice clinics. The education provided will also include signs and symptoms of depression and when to seek help. www.Pexels.com 568027 www.pexels.com 551588 www.pexels.com 1441151 www.pexels.com 1161268 Plan • Implementation of this project will require the healthcare providers to review the provided education and algorithm and use it in patient care. • The tool the providers will be using is the EPDS. The mothers will be screened throughout the postpartum period (2 weeks to 12 months).
Transcript of Implementing Postpartum Screening Tools and Resources For ...€¦ · The purpose of the MSN...
ABSTRACTPostpartum depression (PPD) is a disorder that affects women within the first year after childbirth. There are devastating long-term effects of untreated PPD on a mother and family. The purpose of the MSN Project is to educate mothers (patients) about the signs of PPD via an educational pamphlet.In addition, the aim is to increase awareness and knowledge for providers about the importance of screening for PPD through a screening schedule, a copy of the Edinburgh Postnatal Depression Scale (EPDS) screening tool, and an algorithm using the EPDS. A literature review examined what type of screenings improved outcomes for PPD. The pamphlet summarizes this information for patients and providers. If the materials are utilized, they potentially will help increase the detection and treatment rates of PPD.
PICO QUESTIONIn pregnant and postpartum women, how do postnatal depression screenings compared to prenatal depression screenings predict postpartum depression diagnosis over one year?
LITERATURE REVIEWPostpartum depression is widespread.(1) This fact substantiates the need for screening women for postpartum depression. All of the professional organizations suggest screening, but they differ on when and how to screen. Specific guidelines need to be developed and followed to help manage PPD. The majority of women access healthcare services during pregnancy, childbirth, or postpartum. During this period, a depression screening should be implemented.
During a thorough literature review, the following themes were discovered:• Importance of screenings• Timing of screenings• Screening tools
Controversies were found in the literature review on which screening tool to use. However, the EPDS screening tool had the highest reliability and validity.(2) The end goal is to establish a consistent process to ensure all women who screen positive for depression receive adequate and accessible treatment.
Implementing Postpartum Screening Tools and Resources For Mothers at Their Infants’ Well-Child Care Visits
Jaclyn Knight, BSN, RN, MSN-FNP Student
Implementation• The implementation process
will take place in both pediatric and family practice clinics. By having two different clinics, the intended audiences will be reached for optimal implementation.
• The screening schedule, algorithm/provider education, and education pamphlet for patients will be given to both clinics. Each clinic will be able to use these resources and implement them when addressing PPD screenings.
Evaluation• The evaluation will consist
of surveying two groups: the providers and the patients. The questions will be geared toward the deliverables and will includes usability and credibility, as well as any suggestions that may be given.
• The valuable feedback and information from the post evaluations will provide information on the effectiveness of the deliverables.
THEORETICAL FRAMEWORKAttachment theory by John BowlbyThe attachment theory is used to describe how childhood experiences can affect the evolution of caregiving skills. Furthermore, the development of a child can be affected both directly and indirectly by a mother who has depression.(3)
A mother with depression may not communicate or interact with her infant the same way as a mother without depression. For example, a mother who is withdrawn is less likely to interact with her infant. Therefore, an infant who suffered from affective deprivation is at risk for an insecure attachment and disorders of depression.(2)
The attachment theory shows that the relationship between a mother and infant should be positive. A desired outcome of the attachment theory is an emotional relationship that allows the child to develop beyond surviving by offering opportunities to grow, develop, flourish, and reach the fullest potential possible.(3,4)
CONCLUSIONSUntreated PPD has long-term effects on the infant and mother. Early diagnosis and management can reduce the negative impact of PPD by consistently implementing screening for depression. The screening schedule, screening tool, and algorithm can be used by all levels of healthcare providers to detect depression.These tools will allow the providers to feel comfortable and confident in their knowledge about PPD. Healthcare providers can make a difference in depression rates for their patients by consistently screening for PPD and connecting them to appropriate resources. This will significantly improve the lives of mothers and their families.
REFERENCES1. CDC. (2017). Depression among women. Retrieved from
https://www.cdc.gov/reproductivehealth/depression/index.htm 2. O’Connor, E., Rossom, R. C., Henninger, M., Groom, H. C., & Burda, B. U. (2016). Primary care
screening for and treatment of depression in pregnant and postpartum women: Evidence report and systematic review for the US preventive services task force. The Journal of the American Medical Association, 315(4), 388-406. doi:10.1001/jams.2015.18948
3. Santona, A., Tagini, A., Sarracino, D., De Carli, P., Pace, C. S., Parolin, L., & Terrone, G. (2015). Maternal depression and attachment: The evaluation of mother-child interactions during feeding practice. Frontiers in Psychology,6(1235), 1-11. doi: 10.3389/fpsyg.2015.01235
4. Bornstein, M. H., Suwalsky, J. T., D., & Breakstone, D. A. (2012). Emotional relationships between mothers and infants: Knowns, unknowns, and unknown unknowns. Development and Psychopathology, 24(1), 113-123. doi:10.1017/s0954579411000708
PROJECT METHODOLOGYThis project involves access of PPD screening tools for providers and education for patients. The description and development of project deliverables are as follows:
Screening schedule for providers• Mothers will be screened at each well-child care visit up to 12 months.
Algorithm for providers• The algorithm can be used as a guide for providers concerning interventions for positive PPD
screenings.
Education for providers• Education for providers consists of using information in the algorithm, such as how to use it, when
to use it, and why to use it.
Education for patients• An educational pamphlet will be delivered to pediatric and family practice clinics. The education
provided will also include signs and symptoms of depression and when to seek help.
www.Pexels.com 568027
www.pexels.com 551588
www.pexels.com 1441151
www.pexels.com 1161268
Plan • Implementation of this
project will require the healthcare providers to review the provided education and algorithm and use it in patient care.
• The tool the providers will be using is the EPDS. The mothers will be screened throughout the postpartum period (2 weeks to 12 months).
