Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-12-2018

Graduate Advisor

Laura Kuensting

Committee

Louise Miller

Chris Elliott

Abstract

Problem: The Patient Centered Medical Home (PCMH) model of care improves health care quality and patient experience of care, and decreases costs. Depression screening is a requirement for becoming a PCMH. The purpose of this quality initiative was to obtain baseline data to describe depression screening rates among female adult patients receiving women’s health care within a Midwestern public health department seeking PCMH recognition.

Methods: The study utilized a descriptive, observational design and was guided by the Plan-Do-Study-Act framework. A retrospective medical record review was used to assess the rate of depression screening utilizing the PHQ-2 and PHQ-9 tools, and the rate of treatment.

Results: In the pilot study period there were 417 documented visits, and the PHQ-2 depression screening rate was 32.61% (n = 136). The rate for a PHQ-9 was 5.92% (n = 8), and the treatment rate was 2.95% (n = 4). Linear regression analyses found that positive PHQ-2 screenings significantly predicted the occurrence of PHQ-9 screenings (p < .001). Furthermore, positive PHQ-2 and PHQ-9 screenings significantly predicted the rate of treatment (p < .001).

Implications for Practice: Findings support the continued use of a validated depression screening tool to identify depression risk or other related mental health risks. Prior to this project, there was no formal depression screening. Women’s health patients were identified for depression risk through screening who may not have otherwise been identified. Through successful implementation of the PHQ-2 and PHQ-9 tools, the public health department is better prepared to achieve PCMH recognition.

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