Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.


Date of Graduation


Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing


Linda J. Hulton

Karen Spencer


Background: Postpartum depression (PPD) affects approximately 10%-20% of women after childbirth. PPD is a disabling condition that can have serious health implications on mothers and their infants. Experts estimated that only 50% of women with PPD are diagnosed. Lack of education about screening practices can cause the disorder to go undiagnosed and untreated.

Purpose: The purposes of this quality improvement (QI) project were 1). To increase the provider and staff knowledge about the importance of screening with the implementation of a standardized screening tool 2). To increase PPD screening rates to 100% 3). To increase appropriate referrals to mental health services by 15%. 4). To increase adherence to the Maternal Mental Health Safety Bundle toolkit to 80%.

Methods: Using the Rapid Cycle Quality Improvement (RCQI) from the Institute for Healthcare Improvement (IHI) framework, three cycles of the Plan-Do-Study-Act (PDSA) were used to measure and implement an educational intervention. A gap analysis identified a need for change in PPD screening through an examination of retrospective data collection of the Edinburgh Postnatal Depression Scale (EPDS) screening tool. The first cycle initiated the change in clinical practice with the project preparation. The second cycle implemented an educational intervention by surveying the provider and staff on their pre-and post-knowledge about PPD, screening and referral practices, and adherence to the Maternal Mental Health Safety Bundle toolkit. The third cycle analyzed data of PPD screening and follow-up and referral rates, pre-and post-surveys from the provider and staff reported knowledge and adherence to the Maternal Mental Health Safety Bundle toolkit.

Results: The post-education self-reported knowledge survey indicated improved mean scores for four out of the six survey questions, PPD screening rates increased to 100%, adherence to the safety bundle increased to 100%. There were no referrals and follow-up to be made based on the 100% negative screening rates.

Conclusion: Provider and staff education on PPD screening and adherence to the safety bundle was associated with increased knowledge about the condition, PPD screening rates and adherence to the safety bundle at a private women’s health care practice.

Keywords: postpartum depression, education, screening, maternal safety bundle toolkit



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