Date of Award


Document Type

Doctor of Nursing Practice (DNP)

Degree Name

Doctor of Nursing Practice (DNP)



Committee Chair

Kristen Herrin


Postpartum depression--Risk factors--Identification, Postpartum depression--Nursing


Postpartum depression (PPD) is a mental health condition affecting approximately 10-20% of pregnant women in the United States (Wilkinson, Anderson, & Wheeler, 2017). PPD is often underdiagnosed and undertreated, leading to negative neonatal and maternal outcomes. Early detection of PPD in the prenatal setting is crucial for the promotion of maternal and neonatal health. Barriers have been identified with low incidence of prenatal screening, including lack of experience, education, or skill by the health care provider, standard of care policies per facility that do not incorporate routine PPD screening in the prenatal period, and compliance by staff administering screening tools (Legere et al., 2017; Wilkerson et al., 2016). The aim of the practice improvement project is to increase identification of pregnant women at risk for developing PPD early in the prenatal setting. The purpose of this practice improvement project is to implement a PPD screening tool, the Postpartum Depression Predictors Inventory-Revised (PDPI-R), at the second or third trimester prenatal visit to identify pregnant women at risk for developing PPD in an OB/GYN office setting in a Southeastern city. The screening tool consists of 10 prenatal risk factors associated with PPD, including prenatal depression, life stress, social support, prenatal anxiety, marital satisfaction, previous history of depression, self-esteem, socioeconomic status, marital status, and unplanned/unwanted pregnancy (Beck, 2002). Identification of risk factors for PPD indicate only the risk of developing PPD in the postpartum period, allowing for identification of specific interventions to improve the patient outcomes. The practice improvement project was implemented December 2019 and was evaluated after a four-week implementation period. Pre-implementation data collection consisted of chart review for pregnant women, ages 19-45, seen by one OB/GYN physician in the prenatal setting at their second or third trimester visit during the previous four weeks of the start of the implementation phase. Chart audits revealed the number of patients seen by the provider that were eligible for screening, number of patients screened for PPD, number of patients identified as high risk for developing PPD without use of the PDPR-R tool, and number of patients with a history of mental health illness. Prisoners, adolescents, and first trimester visit patients were excluded. Post-implementation data analysis revealed the number of patient eligible to receive the tool, number of patients that were administered the PDPI-R screening tool, number of patients that declined the tool, number of patients identified as high risk for developing PPD, and the highest prevalent risk factors. The results of the study revealed a 15% increase in the number of patients identified as high risk for developing PPD with the use of a screening tool in the prenatal setting. Inconsistencies in administration of the PDPR-R tool were identified and recommendations were made.



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