DNP Projects

Date of Award

7-31-2024

Document Type

Graduate Paper

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Carie Braun

Second Advisor

Danielle Protivinsky

Third Advisor

Jennifer Peterson

Subject Categories

Maternal and Child Health | Maternal, Child Health and Neonatal Nursing | Nursing | Public Health and Community Nursing

Abstract

This quality improvement project sought to increase screening rates and referrals for pregnant and postpartum depression/ anxiety using the Edinburgh Postnatal Depression Scale (EPDS) and increase the rate of mental health referrals as a result of that screening in an underserved population /community health mobile clinic. Maternal mental health is a key public health concern. In the most recent community health needs assessment (2022-2025) in one Midwestern rural community, priority needs were identified with the top priority of building families with access to culturally competent healthcare, including access to mental health services (Central MN Alliance, 2022). Under-reporting anxiety and depression Is extended by low levels of screening In this population due to lack of access to healthcare.1 In 7 women will develop postpartum depression (PPD) and as many as half of these women will go undiagnosed (Mughal, Azhar, & Siddiqui, 2024). The setting for this project is a free nurse-led mobile clinic that travels throughout Central Minnesota, focused on areas of the community that are underinsured or uninsured. The population of focus for this project is Hispanic women who are pregnant/postpartum or within 1 year postpartum. Interventions for this project were 1) the integration of the EPDS to screen all pregnant/postpartum patients at a nurse-led mobile clinic in Central, Minnesota to address prenatal and postnatal care for pregnant women; ) resulting referrals to the local family health center or applicable resources for mental health support. Throughout the implementation period 25 eligible (pregnant/postpartum) patients attended the clinic all were postpartum patients ranging from 2 weeks to 32 weeks after birth 19 were screened using the Edinburgh Postnatal Depression Scale (76%) and 6 refused screening (24%) Scores on the EPND ranged from 1 (indicating a very low number of screening indicators) to 12. 8 of the 19 screened patients (42%) were referred to the Family Health Center for potential postpartum depression and anxiety. Follow-up on those patients referred revealed nearly 90% of referred patients actually attending mental health appointments. 14 staff members provided feedback on the utility and sustainability of the screening and referral process. All 14 staff members felt the project was culturally sensitive and met the community’s needs. The mobile clinics goal Is to continue this screening service. The number of patients screened and referred as well as nurse satisfaction with the process and outcomes supports the benefits of screening for postpartum depression in the mobile health clinic. The process increased care equity and resulted in a positive response to attending mental health appointments. Overall, the project benefited the mobile health patients in this community and helped to close a gap in awareness and recognition of depression and anxiety in this vulnerable population.

Additional Files
Hamm Samantha Poster Presentation.pdf (194 kB)
Project Poster
Download

Share

COinS