Date of Award
Doctor of Nursing (ND)
Roberta Durk, DNP, APRN, CPNP-PC
Background: The most common complication of pregnancy is depression. 1 in 7 pregnant women experience perinatal depression. It affects maternal and infant morbidity and mortality. It occurs more often than gestational diabetes, pre-eclampsia, or preterm birth. Untreated depression during pregnancy has profound negative effects, including increased risk of poor compliance with care, smoking, substance use, worsening existing medical conditions, loss of both personal and financial support, suicide, and infanticide.
Purpose: The purpose of this quality improvement project was to implement a standardized process to universally screen pregnant women for depression during antenatal, intrapartum, and postpartum periods. The ultimate goal was to improve safety for mothers and babies.
Methods: This quality improvement project was conducted in a small obstetrics and gynecology practice in Las Cruces, New Mexico. The four-week study utilized the Plan, Do, Act, Study (PDAS) quality improvement method. The study included pregnant patients aged 18-39 years seen by a certified nurse midwife. The Edinburg Perinatal/Depression Scale was administered to the patients before their viability visit, during the 2nd and the 3rd trimester, prior to discharge after birth, and postpartum. Screening, Brief Intervention, and Referral to Treatment (SBIRT), an evidence-based approach, was applied to all patients.
Results: Twenty-eight pregnant patients were evaluated over 4 weeks. Four patients were diagnosed with probable depression, six patients with fairly high possibility of depression, and four with possible depression; 18 were unlikely to have depression. No patients had suicidal tendencies. Conclusions: It is important for all pregnant patients to be screened for depression throughout their pregnancies. Screening proved cost effective without becoming time consuming. Reevaluation allows for increased safety during pregnancy. This quality improvement project could be adapted to other providers in the practice and to other practices with minimal cost, staff training or increased visit time. The practice improved services by using depression screening. It improved the care and safety of mothers and babies by providing more effective and equitable care.
Petersen Whittington, Sarah, "The Sixth Vital Sign: Implementing a Depression and Anxiety Screening Quality Improvement Project for Pregnant Patients" (2023). Cohort XI. 10.