Postpartum Depression: A Multi-Disciplinary Initiative for Staff Education and Patient Management

Gualtieri, Anneliese W.

Tuesday, June 26, 2012 : 3:45 PM

Title: Postpartum Depression: A Multi-Disciplinary Initiative for Staff Education and Patient Management

Baltimore 3-5 (Gaylord National Harbor)

Vicki A. Lucas, RNC, BSN, MNEd, WHNP, PhD , PeriGen, Inc. and Vicki Lucas, LLC, Phoenix, MD

Jane Lodise, BS, RNC , Nursing Education and Professional Development Department, Albert Einstein Medical Center, Philadelphia, PA

Anneliese W. Gualtieri, BSN, RN , Patient Safety & Performance Improvement Department, Albert Einstein Medical Center, Philadelphia, PA

Agnes B. Fuentes, MA, BSN, RNC , Nursing Education and Professional Development Department, Albert Einstein Medical Center, Philadelphia, PA

Discipline: Professional Issues (PI), Childbearing (CB)

Learning Objectives:

Describe the multidisciplinary education implemented in the nurse-driven postpartum depression (PPD) program.
Describe algorithms developed for patient screening, patient management, and patient and family education pertaining to PPD.
Analyze the educational, clinical, and quality outcomes associated with the multidisciplinary PPD program.

Submission Description:

Purpose for the program: Program goal was to identify patients at risk for postpartum depression and bridge the gap between in-patient and outpatient care at Albert Eisten Medical Center.

Proposed change:

Three objectives were established to meet this goal:

Educate multidisciplinary care providers about postpartum depression and identification of patients at risk.
Develop a management plan to link in-patient and outpatient care.
Use advanced technology to screen and identify patients who are at risk of developing PPD and provide education and appropriate follow-up care after discharge.

Implementation, outcomes and evaluation: This nurse-driven program, grounded in Watson’s Theory of Human Caring, involved other disciplines throughout the process: obstetric, psychiatric, and pediatric/neonatal physicians, social services, outpatient office staff and community referral services. The AWHONN recommended screening tool Edinburgh Postnatal Depression Scale (EPDS), patient management algorithms, and staff scripts for patient screening were used to facilitate implementation that was initiated simultaneously with a new electronic medical record system (EMR). The intelligent EMR was used to alert the nurses to screen all patients for PPD and to track the outcomes of the program and to audit all charts. The clinical outcomes revealed staff compliance with screening all women for PPD. The education outcomes demonstated significant participation from the multidisciplinary and multispecialty providers in the nurse driven education program which led to significant improvements in the identification and management of PPD. The program resulted in clinical practice changes across disciplines.

Implications for nursing practice: Screeening for PPD is predominantly a nursing function. Nurses need to take the lead in screening all women for PPD and to work with multidisciplinary and multispecialty providers to standardize and integrate the inpatient and outpatient management for PPD. Keywords: Multidisciplinary program for post partum depression