NOTE: See the detailed Grading Rubric starting on page 6 of the PDF file in Unit 1 under Assignments
for the RUA 2. Please use headers and subheaders, use topic sentences, double check spelling and
APA format, and grade your own paper first according to the rubric before turning it in.
Introduction
See description
Clinical Issue
-NCLEX category – detailed description of relationship between ONE NCLEX category and patient
population.
(reference to NCLEX-RN blueprint on the website will count as one scholarly source)
Importance
- Describe the importance of the clinical issue to the health of the patient population.
- Include the potential negative effect of leaving the clinical issue unresolved for:
-the patient population
-the healthcare system
-other identifiable considerations
Patient Population
-Expand on the description of the human condition found within the patient population.
-Summarize the diversity of the patient population
-ALSO specifically describe/identify the influence that cultural values may have on the plan.
Proposed Solution
-Propose a clear solution to the clinical problem that is supported by a minimum of three scholarly,
peer-reviewed journal articles.
-ALSO expand on the ethical considerations in developing the plan for addressing the issue affecting the
patient population.
Goals
-Discuss the plan that could be implemented by a nurse to address the clinical issue.
-One short term goal and one long term goal of the intervention will be identified – include a description
of how attainment of the goals will be measured.
Short term goal (SMART goal format)
Description of how attainment of the goal will be
measured.
Long term goal (SMART goal format)
Description of how attainment of the goal will be
measured.
Barriers
-Identify 2 potential barriers to the success of the plan as well as a strategy for addressing each one.
Two potential barriers to the success of resolving
or preventing the clinical issue (the plan)
Potential Barrier #1
Potential Barriers #2
A strategy for addressing each barrier
Strategy for barrier #1
Strategy for barrier #2
Benefits
-Describe a minimum of one benefit to the patient population and one benefit to the nursing profession
which will result from carrying out the plan (preventing or resolving the clinical issue).
One benefit to the patient population which will
result from carrying out the plan (preventing or
resolving the clinical issue)
(minimum of 1 scholarly, peer-reviewed journal
article for this)
One benefit to the nursing profession which will
result from carrying out the plan (preventing or
resolving the clinical issue)
Participants and Interdisciplinary Approach
-Identifying all the parties whose participation is important for success of implementing the plan. The
list will include a minimum of two members of disciplines outside of nursing. Include a description of
the benefit of including each member of the team to the success of the plan. A minimum of one
scholarly, peer-reviewed source providing support for the success of the plan by including the
healthcare team member outside of nursing.
Participants in the Plan
(some examples might be…)
Patient
Nursing
Physician/Nurse Practitioner/Physician Assistant
Physical Therapist
Respiratory Therapist
Occupational Therapist
Speech Therapist
Description of the benefit of including each team
member to the success of the plan. (minimum of
one scholarly, peer-reviewed source providing
support for the success of the plan for someone
outside of nursing)
Social Worker
Homecare Nurse
Nursing Assistant/Patient Care Technician
Housekeeping
Case Manager
Others…
Conclusion
-A thorough recap of the purpose of the plan to prevent or help the clinical issue.
-A complete statement describing why addressing this clinical problem matters and to whom.
References
Minimum of 6 SCHOLARLY, PEER-REVIEWED Articles. You can have more than 6 if you have some
which might not be considered peer-reviewed but are quality sources.
Running Head: POSTPARTUM DEPRESSION
Effect of Postpartum Depression in Women
Chamberlain College of Nursing
NR 452: Capstone
March 2019
Introduction
1
POSTPARTUM DEPRESSION
2
Postpartum depression is a condition that occurs after birth. The birth of a newborn can
trigger several emotions such as excitement, joy, fear, and anxiety. These mixed feelings can lead
to depression. It is a serious complication in healthcare that goes under diagnose, and it is relevant
to know that women may have various changes mentally, which affect the overall health and proper
care of the infants and plays a significant risk for new mothers.
Clinical Issue
The purpose of this paper is to identify ways of improving the maternal-infant relationship
for women with postpartum depression. Bringing to knowledge the importance of diagnosing
postpartum early, educating women on how to identify the symptoms of postpartum and different
ways to seek help. One of the four main categories of the NCLEX-RN examination blueprint of
2016 is psychosocial integrity in which the nurse provides nursing care, that helps to promote,
support mental, social and emotional stage of the clients. The clinical issues for postpartum
depression need to be addressed during pregnancy and post pregnancy to assess the mental health
of women.
Importance
The prevalence of postpartum depression is estimated to be between twelve percent and
eighteen percent of new mother ( Lindensmith, 2018). The clinical problem will be underdiagnosed
of postpartum in healthcare, and it is one of the neglected aspects of women's healthcare. It is
important to know that one out of eight women will experience symptoms of postpartum
depression within two weeks after delivery and it can last up to a year. Which means that about
four million birth that occurs yearly in the United State of America and this equals six hundred
thousand postpartum diagnoses ( Madlala and Kassier, 2017).
POSTPARTUM DEPRESSION
3
The potential negative effect of leaving postpartum depression issue unresolved can lead
to a mother and infant relationship to be strained, the woman will be less able to respond to the
baby’s needs. Evidence-based research showed that postpartum depression mothers are inadequate
caregivers due to the lack of mother and infant interaction ( Madlala and Kassier, 2017). The more
advanced the postpartum is left unattended to, can lead to underdevelopment of an infant. It is
important for a new mother to have full attention towards the newborn, especially after birth
because the first year of life is a critical stage, it is where the infant cognitive is developed. If the
mother is not diagnosed in the early stage of postpartum, it can lead to the infant which has limited
social, language and behavioral development in the future. Postpartum depression can lead to poor
hygiene to both the mother and the infant, breastfeeding issues or early cessation which can lead
to poor infant growth.
The fact that postpartum depression as long been known as an illness that affects women
after delivery and confirmed by experts that, it is poorly diagnosed by physicians, unfortunately,
postpartum depression is undertreated every day in our society today. Lack of treatment of
postpartum depression is most likely to cause long-term effects on the infants.
There have been some programs or screening developed for postpartum depression mothers
during pregnancy, post-pregnancy and in a neonatal intensive care unit, which involves
pharmacological interventions, education, coaching, and family involvement (Angarath et al.,
2016).
Patient Population
The difficulties and complications related to underdiagnosed postpartum depression play a
huge problem in healthcare. The patient population that is affected the most with postpartum
POSTPARTUM DEPRESSION
4
depression are women. The main purpose will be to focus specifically more on women that are of
childbearing age.
It is imperative to bring an awareness to the fact that postpartum depression can affect
people from all ethnicity, race, cultures, economic or educational background and that postpartum
depression is a global problem that needs to be addressed aggressively.
Research has shown that cultural factors play a great huge role in triggering postpartum
depression and at the same time can help to alleviate some depression symptoms. The influence
the cultural value has played in postpartum depression, to be specific African women and little
awareness that is brought to the community due to lack of knowledge. The research shows that the
risk for African women in developing postpartum is high, and the surprising aspect of the whole
condition is how a low number of African women seeks for help or her treated for this condition.
Proposed Solution
Solution to the clinical problem of postpartum depression will be recommending a
universal screening tool like Edinburgh postnatal depression screen, which is highly recommended
by the postpartum support international. The postpartum support international team should be, but
not limited to midwifery, primary doctor, obstetrician-gynecologist, the pediatric and social
worker. Edinburg postnatal depression screen is a questionnaire that is developed in helping to
identify some symptoms of postpartum depression as soon as possible, just to be clear (EPDS) is
not a diagnostic tool, but rather a screening tool. The benefit of this screening tool is that there are
self-administered, easy to complete, and there are translated into different languages. The
Edinburgh postnatal depression screen main focused is on the anxiety component, depression
symptoms and suicidal thoughts (Bruno et al., 2016).
POSTPARTUM DEPRESSION
5
The next clinical solution will be the patient health questionnaire, this screening needs to
be used for all patients in the postnatal population. The aim to be able to screen and diagnosed
postpartum depression early and the best part is that there is no fee involved in the screening, it is
also a self-administered tool, with different languages and it is easy to complete. The difference
between Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire is, Patient
Health Questionnaire Survey does not include the anxiety component but includes suicidal
ideation. The implementation of this tool will help to diagnose depression symptoms and the
severity of the condition ( Lindensmith, 2018).
The next clinical solution aim towards telemedicine. The idea behind this proposal was to
see how effective postpartum interventions will be through telemedicine. The process involves
using a different delivery method like the traditional telephone call, smartphone application, secure
video, email. The study showed the effectiveness of using telemedicine because they had a goal
of reaching out to women and delivery care in the comfort of their own home, those that do not
have a way of transportation and daycare can still reach out for help through telemedicine, another
priority will be those that do not want to seen in the physician office for treatment of postpartum
can also access treatment and helps to break down barriers to traditional intervention for
postpartum depression (Nair et al., 2016).
The ethical considerations in developing the plan for addressing the issue affecting patient
population will be developing a plan in which the patient does not feel vulnerable because of the
stigma behind postpartum depression. Making sure that the patient is completely involved in her
care and respecting the privacy of the patients.
Goals
The nurse should formulate the plan in screening for postpartum depression with every
pregnant woman that comes in for a check-up. Start by getting the patient to involve in the
POSTPARTUM DEPRESSION
6
care, proposing a multidisciplinary checklist questionnaire that reminds the healthcare team
members to follow with every patient. The nurse needs to create a short-term goal and a longterm goal.
.
Short term goal (SMART goal format)
The short-term goal will be the reduction of
Description of how attainment of the goal will be
measured.
The nurse will create a mandatory meeting for all
unidentified Postpartum depression by using the
the healthcare team members to attend, by using
checklist for two months on all patients.
the checklist created to train the staff members
the importance of early screening of postpartum
depression with every Patient, ask some
questions to identify the weaknesses in the team
members and those that will need extra one on
one training. The knowledge of each individual
team member will need to be evaluated weekly
and staff meeting will need to be held every
month for the duration of two months to
reassess staff member compliance and
understanding.
Long-term goal (SMART goal format)
The long-term goal involves adopting the
Description of how attainment of the goal will be
measured.
To attain the long-term goal, the nurse will
checklist used the short-term goal for one year by
continue with the implementation that was used
all healthcare team members in the clinic with
in the short-term by continuing with the
every patient.
mandatory monthly meeting, using PowerPoints
for visual effects. Quizzing the team members to
determine their understanding and abiding by
the new protocol. The nurse will determine the
effectiveness of the plan, by gathering all the
data collected from the checklist and presenting
the statistic improvement during the monthly
POSTPARTUM DEPRESSION
7
meeting to determine if the yearly goal has been
met.
Barriers
Two potential barriers to the success of resolving
or preventing the clinical issue (the plan)
Potential Barrier #1: a Potential barrier to the
A strategy for addressing each barrier
new plan, will be no receptiveness of the team
assess the reason why the lack of enthusiasm to
members or unwilling to change
change in the office and present to the staff
Strategy for barrier #1: The nurse will need to
members the good behind implementing the
change with the help of evidence base and visual
aid.
Potential Barriers #2: Lack of parity of insurance
Strategy for barrier #2: Most people know that
coverage for mental health
postpartum depression occurs all the time, but
the coverage of mental health is still a battle with
the insurance company. During this research, I
found out that insurance company is not required
to have coverage for mental health and that is a
huge problem because most people cannot
afford to pay out of pocket for doctor’s visit and
thus making treatment for a mental health
screening to be very expensive.
Benefits
One benefit to the patient population which will
result from carrying out the plan (preventing or
resolving the clinical issue)
One benefit to the patient population from
One benefit to the nursing profession which will
result from carrying out the plan (preventing or
resolving the clinical issue)
One benefit to the nursing profession which
carrying out the plan will be the reduction of
results from carrying the plan, involve noting the
underdiagnose postpartum depression by
effectiveness and improvement of the clients in
implementing telemedicine interventions, which
two to twelve months, span. If the team member
POSTPARTUM DEPRESSION
gives the patient control over the healthcare and
8
follows the plan has created. That will give a
having the convenience by receiving healthcare in boost of confidence within the team members
the comfort of your home. Create privacy, gives
because there are taking good care of the
more time to spend and bond with the family and
patients and noticing a physical and mental
avoiding the headache of transportation or
change.
maybe traffic (Nair et al., 2016).
Participants and Interdisciplinary Approach
To have a successful care for the patient, the multidisciplinary team must communicate
together for the benefit of the patient.
Participants in the Plan
(some examples might be…)
Patient
Description of the benefit of including each team
member to the success of the plan. (minimum of
one scholarly, peer-reviewed source providing
support for the success of the plan for someone
outside of nursing)
The benefit of including the patient in her care
will reduce patient anxiety, create trust between
the patient and the provider, increases patient
satisfaction and helps to improve outcome.
Nursing
The benefit of the nurse being involved in the
patient care will be providing care that is
respectful to the patient and being the voice for
the patient and helping the patient to make the
right decision for her.
Physician/Nurse Practitioner/Physician
The benefit of the provider being involved in
Assistant/psychologist
patient care will improve the patient to client
relationship. The provider has to listen actively to
patient concerns, spend as much time with the
patient during care and explains medical plans in
the patient understanding.
POSTPARTUM DEPRESSION
Social Worker
9
Social worker plays a huge role in the care of the
patient, helps the patient and family member to
understand the condition and how to come to
terms with the diagnosis. They provide decisions
to the patient and counseling for the patient. The
social worker also helps the team member
recognize the emotional stage in which the
patient is in.
Housekeeping
Getting a housekeeper during the postpartum
depression stage will help the mother to focus
more on taking care of herself and the infant,
instead of worrying about cleaning the house.
Other: Family Member
The family member like the spouse, extended
family, and even close friends can be a huge help
to the mother by taking care of the infant when
the mother is going through postpartum
depression. Though this does not directly
improve the mother to infant bonding, it will help
with the development of the infant, when the
father of the infant and grandparents, holds, hugs
and interact with the baby (Lindensmith, 2018).
.
Conclusion
The clinical issues to prevent will be underdiagnosed of postpartum depression in
healthcare in general. The purpose of this plan to bring awareness to postpartum depression among
the multidisciplinary members and the insurance company, that postpartum depression does exist,
and the issue needs to be addressed aggressively because women are afraid of the stigma and in
POSTPARTUM DEPRESSION
10
turns do not seek treatment. It is important to address that postpartum depression can affect one
out of eight women within two weeks of delivery and educate on signs and symptoms.
POSTPARTUM DEPRESSION
11
Reference
Angarath I. Van Der Zee-Van Den Berg, Boere-Boonekamp, M. M., Ijzerman, M. J., HaasnootSmallegange, R. M., & Reijneveld, S. A. (2016). Screening for Postpartum Depression in
Well-Baby Care Settings: A Systematic Review. Maternal and Child Health Journal,
21(1), 9-20. doi:10.1007/s10995-016-2088-8
Bruno, A., Laganà, A. S., Leonardi, V., Greco, D., Merlino, M., Vitale, S. G., . . . Muscatello, M.
R. (2017). Inside–out: The role of anger experience and expression in the development of
postpartum mood disorders. The Journal of Maternal-Fetal & Neonatal Medicine, 31(22),
3033-3038. doi:10.1080/14767058.2017.1362554
Lindensmith, R. (2018). Interventions to Improve Maternal-Infant Relationships in Mothers with
Postpartum Mood Disorders. MCN, The American Journal of Maternal/Child Nursing,
43(6), 334-340. doi:10.1097/nmc.0000000000000471
Madlala, S., & Kassier, S. (2017). Antenatal and postpartum depression: Effects on infant and
young child health and feeding practices. South African Journal of Clinical Nutrition,
31(1), 1-7. doi:10.1080/16070658.2017.1333753
National Council of State Boards of Nursing (2013). NCLEX-RN test plan.
https://www.ncsbn.org/2013_NCLEX_RN_Test_Plan.pdf
Nair, U., Armfield, N. R., Chatfield, M. D., & Edirippulige, S. (2018). The effectiveness of
telemedicine interventions to address maternal depression: A systematic review and metaanaly ...
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