Quality improvement project: implementing a standardized postpartum depression screening protocol in an outpatient pediatric setting

Abstract

Background: Postpartum depression (PPD) continues to be a common condition following childbirth affecting 1 in 5 birthing parents during the postpartum period. The American Academy of Pediatrics (AAP) recommends screening birthing parents for PPD at well-child visits within the first 6 months of the infant's life. The Edinburgh Postpartum Depression scale is a well validated tool used to identify postpartum depression in the birthing parent. Local Problem: A site assessment at an outpatient pediatric clinic identified practice differences among the pediatric providers once a EPDS screen was completed. The provider group expressed interest in standardizing their approach with results of EPDS screens. Methods: To increase screening and referral rates by standardizing care when screening birthing parents for PPD with the utilization of a screening protocol tool. Interventions: A screening protocol was adapted and created with targeted interventions depending on the EPDS score and symptoms expressed by the birthing parent. The protocol utilized for this project was adapted by a stepwise approach protocol created by Olin et al., (2017) called "PPD Stepped Care". Additionally, an educational pamphlet with associated resources was created to aid the providers in creating dialogue about PPD during well-child visits. Results: Surveys revealed most staff and providers within the clinic found screening for PPD to be important for pediatric health and well-being. Screening rates and referral practices improved from baseline data after the implementation of the standardized screening tool. The provider group determined continued use of the standardized screening protocol tool in practice beyond the implementation period for this DNP project. Conclusion: This project provided an outpatient pediatric clinic an improved screening process for PPD and standardized a referral process for birthing parents who have been determined positive using the EPDS tool.