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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