Antenatal mental health screening in the southern United States: a best practice implementation project

INTRODUCTION: Antenatal depression, also known as prenatal or perinatal depression, is a type of clinical depression that can affect women during pregnancy. Evidence-based practices indicate that mental health screenings conducted during pregnancy reduce the risk of pregnancy complications and postpartum depression. OBJECTIVES: This evidence implementation project was conducted at a women's services clinic at an academic medical center in the southern United States. The project aimed to improve antenatal mental health screening through the implementation of best practices. METHODS: This project followed the JBI Evidence Implementation audit and feedback framework to identify best practices, barriers to adherence, and implementation strategies. Eight best practices were used as audit criteria, based on a JBI Best Practice Evidence Summary. After a baseline audit, interventions included educating staff on the appropriate use of screening scales, having patients complete the screening tool as part of the intake documentation, and ensuring accurate documentation of scores in the electronic health record. A follow-up audit using the same criteria was performed, and the pre- and post-audit results were compared. RESULTS: Post-audit data showed increased adherence to best practices for four of the eight audit criteria. None of the patients met the intervention parameters for three of the eight audit criteria. Therefore, the data for those criteria was 0% both pre- and post-implementation. CONCLUSIONS: Staff training, streamlined documentation practices, and encouraging patients to complete screening tools before the intake visit can improve adherence to best practices for antenatal mental health screening. Recommendations for sustainability include recorded training videos and resource sheets for continuing education and the orientation of new staff. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A568.