Implementation of a Universal Screening Program for Postpartum Depression in the Primary Care Setting: A Doctor of Nursing Practice Project

Postpartum depression is a depressive disorder that occurs in the period after childbirth and can have significant and long-lasting negative impacts on mothers, infants, and families if not appropriately addressed. Screening is the first step in identifying women at risk for postpartum depression. Implementation of a postpartum depression screening program has significant impacts for the healthcare team, as well as patients and families. In addition to improving quality of life and outcomes for patients and families, the program increases awareness of postpartum depression, creates a standardized screening process for the clinic to follow, and facilitates compliance with current recommendations. Guided by the Iowa Model, the purpose of this project was to review the relevant literature regarding screening for postpartum depression and to implement an evidence-based postpartum depression screening program using a validated screening tool to increase identification of women at risk for postpartum depression. A review of the literature revealed consistently higher rates of screening and detection of postpartum depression using a validated screening tool; however, screening practices vary greatly in regards to timing, frequency, setting, and tools utilized, and existing recommendations from professional organizations offer inconsistent guidelines on screening programs. This project utilized the Edinburgh Postnatal Depression Scale for mothers who presented to well child checks in the family practice setting. Surveys were scored, and a clinical algorithm based on score was followed in order to determine next steps for diagnosis and management. Process and outcome variables were continuously analyzed in order to create a feasible, consistent, and sustainable screening program to identify women at risk for postpartum depression.