Using Technology to Facilitate Screening for Postpartum Depression in Pediatric and Family Medicine Settings

Title: Using Technology to Facilitate Screening for Postpartum Depression in Pediatric and Primary Care Settings

Abstract Text Submission for 2008 AWHONN Convention

Liz Powell, MSN, RN

 

Postpartum depression (PPD) is a disabling and potentially devastating condition that affects from five to twenty percent of new mothers.  This serious complication of childbirth often goes undiagnosed and untreated.  According to Chaudron, et al. (2004) most efforts directed at screening and detection occur in the obstetrician’s office at a woman’s postpartum visit, but this has proven to be ineffective in detecting the vast majority of women suffering from PPD.  Many researchers suggest that pediatric well-child visits provide an ideal setting for PPD screening as pediatric providers are likely to have access to the new mother several times during the first postpartum year.  Many barriers including the issue of the mother not being the pediatrician’s patient and the time constraints of a well-baby visit must be addressed in order to make PPD screening in this environment a viable option.

New Jersey has led the way nationally in spotlighting the need for better education, detection and treatment of women with PPD.  In 2006, the New Jersey legislature awarded State grant NJ CD2-070 to Virtua Health for the enhancement of its PPD services. With an existing program in place to screen new mothers for PPD during their postpartum hospital stay, Virtua Health saw screening at well-baby visits in both pediatric and family medicine settings as the next step in best practice care of this population. 

The challenge in developing a pediatric/primary care screening program was to encourage physician participation with a methodology that would minimize the time needed to carry out the screening and any disruption to the office routine.  A collaborative interdisciplinary team designed and implemented a program to provide screening using personal digital assistants (PDAs) that are loaded with the Edinburgh Postnatal Depression Scale (EPDS) a ten-item questionnaire that can be completed by the mother in less than five minutes.  The mother completes the survey on her own, the results are sent to the health system’s perinatal depression team for the appropriate follow-up.  That team also provides physician, staff and equipment support.  This innovative use of technology to reach new mothers has afforded screening opportunities to hundreds of women who might otherwise have suffered in silence.  

This presentation will detail the impetus for this project as well as information related to the development and implementation.    The results of the pilot as well as the implications for the care of new mothers who may be struggling with postpartum adjustment issues will also be included.