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Presentation Notes

Evidence Based Practice podium presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.

Abstract

Background

Perinatal Mood and Anxiety Disorders (PMADs) are the leading complication related to childbirth – exceeding both pre-eclampsia and gestational diabetes combined. Over 51% of patients who experience a PMAD go undiagnosed. Screening in the immediate postpartum period can predict episodes within 2-8 weeks postpartum.

Purpose

The purpose of this evidence-based project was to implement PMAD screening to all child-bearing patients admitted to the Family Birthing Center (FBC).

Implementation Plan

This project was based on the Iowa model. This project was done at Advocate Sherman Hospital, a level-II hospital, with an average of 1900 births per year. All child-bearing patients admitted to the FBC were screened between 12-24 hours after delivery, using the Edinburgh Postnatal Depression Screening with an algorithm provided for the primary nurse to follow based on patient’s screening score. Every patient was provided with an education packet regarding PMADs.

Outcomes

Through the duration of the data collection period (2-weeks), the rate of screening patients from 0% to 79%. Of those patients screened, 74% screened as mild-risk , 22% screened as moderate-risk, and 4% screened as high-risk.

Implications for Practice

This screening resulted in important risk identification. Results of patients who screened moderate to high risk mirror the newer statistics suggesting up to 1-in-4 mothers who experience a PMAD. This screening has become standard of care, with high risk patients being identified each month. In the last 2-months, one patient screened high. Chart audit confirmed OB provider was made aware and tele-psych was used to initiate psychiatric care for patient, resulting in medication being prescribed as well as follow-up plan in place for patient after discharge. Limitations for this project including patient’s reluctance to answer honestly in fear of retribution and no psychiatry providers currently on staff. Further implementation should include screening of parents who are discharged prior to infants leaving the nursery, prior to infant discharge.

Document Type

Oral/Podium Presentation

Publication Date

11-13-2024


 

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Nov 13th, 12:00 AM

Out of the Darkness: Shining a Light on Maternal Mental Health

Background

Perinatal Mood and Anxiety Disorders (PMADs) are the leading complication related to childbirth – exceeding both pre-eclampsia and gestational diabetes combined. Over 51% of patients who experience a PMAD go undiagnosed. Screening in the immediate postpartum period can predict episodes within 2-8 weeks postpartum.

Purpose

The purpose of this evidence-based project was to implement PMAD screening to all child-bearing patients admitted to the Family Birthing Center (FBC).

Implementation Plan

This project was based on the Iowa model. This project was done at Advocate Sherman Hospital, a level-II hospital, with an average of 1900 births per year. All child-bearing patients admitted to the FBC were screened between 12-24 hours after delivery, using the Edinburgh Postnatal Depression Screening with an algorithm provided for the primary nurse to follow based on patient’s screening score. Every patient was provided with an education packet regarding PMADs.

Outcomes

Through the duration of the data collection period (2-weeks), the rate of screening patients from 0% to 79%. Of those patients screened, 74% screened as mild-risk , 22% screened as moderate-risk, and 4% screened as high-risk.

Implications for Practice

This screening resulted in important risk identification. Results of patients who screened moderate to high risk mirror the newer statistics suggesting up to 1-in-4 mothers who experience a PMAD. This screening has become standard of care, with high risk patients being identified each month. In the last 2-months, one patient screened high. Chart audit confirmed OB provider was made aware and tele-psych was used to initiate psychiatric care for patient, resulting in medication being prescribed as well as follow-up plan in place for patient after discharge. Limitations for this project including patient’s reluctance to answer honestly in fear of retribution and no psychiatry providers currently on staff. Further implementation should include screening of parents who are discharged prior to infants leaving the nursery, prior to infant discharge.

 

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