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Mothers with postpartum depression can be benefited by improved screening

by Pragati Singh

According to recent Cedars-Sinai quality improvement (QI) research, nurse education is the key to properly screening women for postpartum depression, which affects 15% of moms.

The findings were reported in the American Journal of Obstetrics and Gynecology. Training that helped nurses become comfortable with the topic of depression, as well as develop a nonjudgmental attitude and openness to a patient’s questions and concerns, is critical, said Eynav Accortt, PhD, principal investigator of the QI review and director of Cedars-Reproductive Sinai’s Psychology Program.

One of the most prevalent perinatal medical issues is depression and anxiety during pregnancy or the first 12 months following birth. Postpartum depression is generally marked by chronic sorrow, exhaustion, feelings of hopelessness and worthlessness, and difficulty sleeping or eating. Some mothers find it difficult to care for their newborns.

Hospitals have been asked to implement postpartum depression screening and referral programmes in order to detect and assist women who are experiencing mental health issues. It might be difficult to create effective screening systems and procedures. A new quality improvement (QI) project led by Cedars-Sinai researchers in the Department of Obstetrics and Gynecology acknowledges nurse education and training as critical to properly screening women in their care.

In addition, our research found that framing the screening as part of the medical center’s commitment to family wellbeing, rather than just using the term “depression,” was beneficial. It helped us to normalise the difficult adjustment to parenting that many of these patients go through, “Accortt, a clinical psychologist and assistant professor in the Department of Obstetrics and Gynecology, made the statement.

The article, Implementing an Inpatient Postpartum Depression Screening, Education, and Referral Program: A Quality Improvement Initiative, was published in the American Journal of Obstetrics and Gynecology—Maternal-Fetal Medicine.

Nurses are frequently on the front lines of postpartum depression screening programmes, yet nursing schools seldom offer training in mental health screening or teaching.

Using data from over 19,500 women who gave birth at Cedars-Sinai, researchers were able to assess the advantages of increased training for nurses who are in charge of screening new moms for depression.

“We realised we needed to do a better job of identifying patients at risk before they left the hospital,” said Sarah Kilpatrick, MD, PhD, senior author of the QI research and the Helping Hand of Los Angeles Chair in Obstetrics and Gynecology at Cedars-Sinai.

To make the system function, we discovered that it is a difficult process that requires focused teamwork among nurses, physicians, and information technology experts. Kilpatrick explained. “Our methodology should be replicable at other institutions, allowing even more families to diagnose and treat postpartum depression.”

A particular questionnaire intended to assess the existence and severity of a mood illness is a crucial tool for examining a patient for postpartum depression. Because many nurses who were called upon to administer the questionnaire within two days of a patient giving birth were concerned about doing it correctly, in-service training was an important quality improvement measure; nurses watched a clinical psychologist demonstrate the process with a staff member playing the role of the patient.

If the findings of a new mother’s questionnaire indicate that she requires assistance before leaving the hospital, a consultation with a social worker might be planned.

The social worker begins by providing a compassionate, nonjudgmental ear and then provides help and resources based on the patient’s requirements.If the lady appears unstable and in need of a comprehensive mental examination, she may seek psychiatry. Otherwise, she might send her to our Reproductive Psychology Program or our patient navigator, who can assist in connecting her to community care, “Accort stated.

Cedars-postpartum Sinai’s depression screening programme has expanded to include outpatient follow-up. A screening programme for women who have had a stillbirth or are in the obstetrics critical care unit has also been launched.

If we care about our patients’ mental health, screening must be made routine, just like we screen pregnant patients for diabetes. It must be done in such a way that patients feel comfortable answering the questions truthfully, and there must be consistent follow-up of patients at risk for postpartum depression once they leave us, “said Kilpatrick.

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