Implementation of Depression Screening in the Postpartum Population in the Primary Care Setting: A Quality Improvement Project

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Haman, Stacy
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Abstract Purpose: The purpose of this Quality Improvement Project was to implement and evaluate a postpartum depression screening protocol in a primary care setting using a validated postpartum screening tool. Background: Postpartum depression (PPD) was identified as a clinical problem as it is observed in 10-20% of new mothers globally (World Health Organization [WHO], 2019). The need for universal screening and appropriate treatment plan for postpartum women is recommended by the American College of Obstetricians and Gynecologists, American Academy of Pediatrics, and United States Preventive Services Task Force. Sample/Setting: The sample was women ages 19 and older in the postpartum period from initial childbirth to one year postpartum. The setting was a Midwest suburban primary care clinic. Methods: The methods included the implementation and evaluation of a validated postpartum depression screening tool in a primary care clinic setting. This tool was the Edinburgh Postnatal Depression (EPDS). Results: Retrospective data analysis identified that routine postpartum depression screening in this clinical setting did not occur in 2019. There was a total of 16 women seen for their six-week postpartum visit during the months of August-December 2019 and none (0%) had a validated PPD screening performed. During the months of August through December 2020, 13 women were seen for their six-week postpartum visit and all of them (100%) were screened using the validated PPD screening tool. Conclusion: Every woman who came in for her six-week postpartum visit was screened. Although none of the 13 women received a score on their EPDS of 10 or greater (which would more than likely indicate PPD), they were all screened, and depression or lack thereof was addressed and discussed. Using the validated screening tool to assess for PPD allows for standardized assessment of all postpartum women, therefore allowing no woman to fall through gaps of care.
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