Screening for Post-Stroke Depression in an Inpatient Rehabilitation Facility
AuthorAccrombessi, Joy R.
AdvisorVan de Castle, Barbara
MetadataShow full item record
AbstractProblem: The lack of a standardized process for screening and treatment of Post-Stroke Depression (PSD) in a 42-bed Inpatient Rehabilitation Facility (IRF) delayed the diagnosis and treatment of PSD. In fact, interviews carried out in the IRF revealed that 100% of nurses (n=20) did not use a standardized tool to address depressive mood verbalized by patients diagnosed with a stroke. There was a need for a validated PSD screening tool that could promote the early identification and management of the mood disorder. Purpose: The Patient Health Questionnaire-2 to 9 (PHQ-2 to 9) was administered to eligible patients within 24 hours of admission to improve the early identification of PSD over a 15-week period. Also, this project aimed at initiating a follow up step-by-step algorithm of interventions based on the screening scores. Methods: The PHQ-2 to 9 was a two-step validated tool administered and documented into the electronic health record (EHR) by the staff nurse to patients who met eligible criteria. Patients who were identified with PSD received interventions, including PSD education material, antidepressant treatment if clinically appropriate and not contraindicated. Further interventions included consults to recreational therapy, case management, and rehabilitation psychology. Results: Analysis of the project’s outcomes included the implementation of the PHQ-2 to 9 tools in the EHR and the completion of the PSD training by nurses (N=44 total nurses, 100% trained). Moreover, the results suggested 93% of eligible patients (N=68) were screened. Among the patients screened, n=3 (4.5%) had a PHQ-2 to 9 ≥10. Of the patients identified with PSD n=1, (33%) received antidepressant treatment, whereas n=3, (100%) received PSD educational material and outpatient resources to mental health services. Conclusions: The project’s outcomes had the potential to promote the early identification and management of PSD, accelerated the recovery process, the continuation of care to promote quality of life and decrease stroke reoccurrence. The sustainability of the project will require frequent reeducation provided to staff nurses and training of the initiative delivered upon onboarding orientation.
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Identifier to cite or link to this itemhttp://hdl.handle.net/10713/20789
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Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 International