New hospital guidelines to help mothers at risk of postpartum depression

Although 13 percent of new mothers experience postpartum depression (PPD) in the first year after childbirth, few women recognize the symptoms and seldom discuss their feelings with a health care provider. University of Louisville Hospital (ULH) hopes to change this statistic through a new policy to guide hospital-based perinatal nurses in caring for women with risk of PPD.

M. Cynthia Logsdon, PhD, APRN, FAAN, professor, University of Louisville School of Nursing, and associate chief of nursing research, University of Louisville Hospital and the James Graham Brown Cancer Center, and her team created evidence-based practice guidelines using research recently published on-line in The American Journal of Maternal Child Nursing.

"The hospital policies and procedures are designed to provide perinatal nurses the tools they need to prepare new mothers so they are able to self-monitor for and know what steps to take if they experience symptoms," Logsdon said.

According to Logsdon, most hospitals lack comprehensive perinatal patient PPD assessment, education and referral policies. Although professional organizations such as the Registered Nurses' Association of Ontario previously published a best practices guideline, the recommendations did not focus on the first few days following childbirth or nursing care while the new mother was hospitalized.

"Our recommendations for nursing practice of hospital-based perinatal nurses go beyond previous published guidelines," Logsdon said.

Logsdon and her team, Diane Eckert, BSN, RN, clinical manager, mother-baby unit, ULH, and Roselyn Tomasulo, RN, MSN, perinatal educator, collaborated with internationally-known researchers in the field to draft the article, Identification of Mothers at Risk for by Hospital Based Perinatal Nurses. A task force of clinical nurses was consulted to determine how to improve nursing practice at ULH. Implementation included identifying at-risk patients and referral sources; physician and staff education was another component.

"When many nurses enter the profession, they don't fully understand their critical role as patient educators," Tomasulo said. "We are helping our perinatal nurses feel more competent in their roles by offering inter-hospital on-line education and staff training."

During the obstetric patient admission process, ULH perinatal nurses now assess new mothers for PPD and suicide risk factors: low-income status, lack of social support and previous history of depression. If a patient is at risk, it is reported to the obstetrical physician. The evening before hospital discharge, all new mothers fill out a questionnaire that utilizes the Edinburgh Postnatal Depression Scale (EPDS). Mothers are asked questions such as whether they feel anxious or worried for no particular reason and whether they feel sad or miserable. The higher the score, the greater the risk for PPD.

The physician, social services worker and oncoming shift nurse are then informed. The nurse who administered the EPDS reviews the results of the depression screening with the patient and her support person. Patients also are informed about depression symptoms and what to do if they begin to feel hopeless.

New go home with a list of community resources and physician referrals, so names and numbers are at their finger-tips in case they need to seek help. They're asked to retake the EPDS questionnaire about a week later after leaving the hospital to see if they're experiencing PPD symptoms.

"We hope our work will be seen as a model of good policy and can be considered by other hospitals and professional organizations," Logsdon said.

More information: The article can be found on-line, journals.lww.com/mcnjournal/toc/publishahead

add to favorites email to friend print save as pdf

Related Stories

Poor sleep quality linked to postpartum depression

Dec 10, 2008

Postpartum depression (PPD) can lead to poor sleep quality, recent research shows. A study published in the current issue of the Journal of Obstetric, Gynecologic, & Neonatal Nursing shows that depression symptoms worsen ...

Postnatal depression can possibly be prevented drug-free

Jan 16, 2009

A heart-to-heart chat with a peer has proven an effective way to prevent postnatal depression in high risk women, cutting the risk of depression by 50%, according to a University of Toronto nursing study published in BMJ ...

To keep nurses, improve their work environments

Dec 08, 2011

Nurses working in hospitals around the world are reporting they are burned out and dissatisfied with their jobs, reported researchers at the University of Pennsylvania School of Nursing's Center for Health Outcomes and Policy ...

Urinary incontinence doubles risk of postpartum depression

Jun 20, 2011

Women with urinary incontinence after giving birth are almost twice as likely to develop postpartum depression as those without incontinence, according to a new study led by Wendy Sword, a professor in McMaster University's ...

Hospital nurses dissatisfied with health benefits

Feb 14, 2011

Researchers at the University of Pennsylvania have found that nearly 41 per cent of nurses working in American hospitals and health-care settings were dissatisfied with their health-care benefits. The figure is more than ...

Recommended for you

Sexual fantasies: Are you normal?

2 hours ago

Hoping for sex with two women is common but fantasizing about golden showers is not. That's just one of the findings from a research project that scientifically defines sexual deviation for the first time ever. It was undertaken ...

AMA 'Code of Ethics' offers guidance for physicians

8 hours ago

(HealthDay)—The American Medical Association (AMA) Code of Ethics and other articles provide guidance for physicians in relation to public health emergencies, according to a report from the AMA.

Pot-infused edibles: One toke over the line in Colorado?

12 hours ago

Marijuana shops have sprouted across Denver ever since Colorado legalized the drug for adults in January, but the popularity of pot-infused edibles has surprised authorities, and parents are seeking a ban ahead of Halloween.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.