Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

9-18-2024

Graduate Advisor

Vanessa Loyd, Ph.D., DNP, RN

Committee

Vanessa Loyd, Ph.D., DNP, RN

Lisa Sitler, Ph.D., RN, MSN-Ed, APHN-BC, SANE

Allison Rajaratnam, MPH, CPH

Abstract

Background: Acute coronary syndrome (ACS) and depression have profound impacts on patient outcomes. Patients who experience ACS are at increased risk of developing depression, which is associated with an increased risk of death and recurrent cardiac events. The evidence following ACS events promotes routine depression screening. The purpose of this project was to identify early depression in patients 65-99 years of age who had a recent diagnosis of ACS during their hospitalization.

Methods: This quality improvement (QI) project was a prospective descriptive observational design implementing a depression screening protocol to evaluate post-ACS referrals within 7-14 days of screening from February 2024 to May 2024. A convenience sample was utilized. Participants were 65-99 years of age who had a diagnosis of ACS during their hospitalization, met the criteria for a specific department hospital readmission reduction program (HRRP), and were discharged home. Exclusion criteria were not having an ACS diagnosis during hospitalization, did not meet the criteria for the HRRP, and were not discharged home. Data collected included age, history of depression, gender, ACS diagnoses, PHQ-2 and PHQ-8 scores.

Results: There were (N=18) patients who met criteria for this project. There were (N=19) screening opportunities for depression due to one patient having two hospitalizations. Of these, (n=13; 68.4%) screening opportunities were completed, and of those, (n=1; 7.7%) screened positive, which made data analysis for intervention follow-up not possible. There was no significant relationship between gender and PHQ-2 scores (r (11) =.453, p=.120).

Implications for Practice: Implementing a depression screening protocol to potentially improve health outcomes following ACS and collaborating with the PCP could contribute to early identification and treatment for depression.

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