Describe the process you would follow to assess the organization where you plan to conduct our project for opportunities for improvement including the identification of stakeholders.
My project has had a few setbacks since I enrolled in this program. I was initially going to work with an obstetrician/gynecologist, a midwife, and a women’s health nurse practitioner who ran a women’s health practice. We were narrowing down project possibilities when they were involved in a motor vehicle accident. Two of them died and the survivor sustained injuries that made practicing difficult, so they sold the practice. Under the new ownership, there were no advanced practice nurses which eliminated it as a possible project site. As a result, I have elected to proceed with the case study option for my practicum project. I will be looking at using the Edinburgh Postnatal Depression Scale (EPDS) to screen postpartum women when they bring their infant into the pediatrician’s office for routine well-child visits. Postpartum depression is a common complication of pregnancy that affects roughly 20% of women during the pregnancy, after delivery, and up to a year later (Underwood et al., 2016).
If I were going to implement this project, I would approach the pediatric practice located in a shopping center near my house. The practice has three locations across St. Johns and Duvall counties. They have pediatricians who went to medical schools or osteopathic medical schools along with pediatric nurse practitioners. My daughter has been taking her two boys there since moving to Florida in early 2020. During the routine well-child visits for her 11-month-old, there have been the occasional questions asking how she was doing but no formal screening for postpartum depression. The American College of Obstetricians and Gynecologists recommends that a woman should have some type of contact with a maternal care provider within three of giving birth, ongoing care as indicated, and then a full evaluation prior to twelve weeks after birth (American College of Obstetricians and Gynecologists, 2018). The Bright Futures/American Academy of Pediatrics (AAP) has established a schedule of well-child visits which includes being evaluated within 3-5 days of birth and then at 1, 2, 4, 6, 9, and 12 months of age (American Academy of Pediatrics, 2021). With more frequent visits to them in the months following the birth of a child, the pediatrician’s office is a great place to screen for postpartum depression and make referrals as indicated (Olin et al., 2017).
Determine the ultimate goals for your DNP project and how they relate to the organization’s mission and vision.
The goal for my practicum project is to determine the effect that implementing the EPDS to screen for postpartum depression in a pediatric setting will have on the identification and referrals for mental health support in 8-10 weeks. Rainbow Pediatric Center (2021) has a mission “to partner with parents, caregivers, and educators to raise kids into healthy, self-reliant, emotionally stable, and empathetic young adults” (para 2). Evidence-based, prevention-focused, and holistic are among the core values for the practice (Rainbow Pediatric Center, 2021, para 3). I believe that the proposed practicum project aligns quite well with their mission and vision.
American Academy of Pediatrics. (2021). AAP schedule of well-child care visits. Retrieved from https://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx
American College of Obstetricians and Gynecologists. (20218). Optimizing postpartum care: ACOG Committee Opinion No. 736. Obstetrics and Gynecology 131: e140-150.
Olin, S. S., McCord, M., Stein, R. E. K., Kerker, B. D., Weiss, D., Hoagwood, K. E., & Horwitz, S. M. (2017). Beyond screening: A stepped care pathway for managing postpartum depression in pediatric settings. Journal of Women’s Health 26(9), 966-975. https://doi.org/10.1089/jwh.2016.6089
Rainbow Pediatric Center. (2021). About us. Retrieved from https://www.rainbowpediatriccenter.com/about-us/#core-value
Underwood, L., Waldie, K., D’Souza, S., Peterson, E. R., & Morton, S. (2016). A review of longitudinal studies on antenatal and postnatal depression. Archives of Women’s Mental Health 19, 711-720. https://doi.org/10.1007/s00737-016-0629-1