Standardized Postpartum Depression Screening of NICU Mothers

Abstract

The purpose of this QI project was to determine the feasibility of instituting a standardized postpartum depression screening guideline in the NICU. A draft guideline was developed that instructed medical providers to screen all NICU mothers who read English or Spanish. Screenings were to be performed at two weeks, one month, four months, six months postpartum and at discharge. The Edinburgh Postnatal Depression Scale (EPDS) was used for screening. Documentation in the neonate’s progress notes included negative (score less than 12) or positive (>/= 12) screening results and whether referral for services was rendered. Demographic information and compliance rates were gathered from chart audits. During implementation, 178 neonates were present, and the average weekly census was 61.8 neonates. There were 168 appropriate screenings, and 43 screenings were completed for a compliance rate of 25.6%. Of the completed screenings, eight required referrals and eight referrals were documented (100%). Identified barriers included difficulties with providers being able to connect with mothers at the bedside, discomfort with ability to manage care for a mother who screened positive, and ease of tracking. This QI project demonstrated successfully the feasibility of implementing a guideline to standardize PPD screening in the NICU. However, to address implementation barriers, it is recommended that the guideline specify who is responsible for oversight and administering screenings, increase provider education about community resources for mothers, and modify electronic health records to improve documentation.