Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Lynne Jensen

Clinical Mentor

Dr. Peggy El-Mallakh

Committee Member

Dr. Karen Stefaniak

Abstract

Purpose: The purpose of this practice inquiry project was to evaluate provider adherence to depression screening documentation in the ambulatory electronic health record (AEHR) before and after changing locations of the depression screening questions within the AEHR. Provider knowledge about depression screening and barriers related to depression screening were also examined.

Methods: A retrospective chart review was completed for patients seen for an annual exam by a physician provider in a women’s primary care clinic. Data collected included demographic data, co-morbid conditions, depression screen documentation (PHQ-2 & PHQ-9), and interventions documented. A questionnaire was sent to providers in the primary care clinic to assess knowledge about depression and identification of barriers related to depressions screening.

Results: The retrospective chart review indicated that 2% of the patients were screened for depression before the screening tool was moved in the AEHR, and 78% were screened after the screening tool was moved. There were no significant differences in the two population samples. Only one patient out of 50 was screened before the screening tool was moved, but 13 patients were given prescriptions for medications for the treatment of depression. Provider knowledge of the location of the screening tool has increased. Furthermore, time was identified as the greatest barrier to screening for depression.

Conclusion: Depression screening improved after changing the AEHR placement of the depression screening questions in the areas in which providers document prevention. “Yes” responses from the patient on the PHQ-2 indicated a positive screen for depression, and these positive responses on the PHQ-2 automatically directed the provider to the PHQ-9, a more extensive instrument for depression that measures symptom severity. Time was the most significant barrier to screening for depression. Primary care providers may be the only healthcare professional that are able to screen for depression since these providers are most easily accessible to patients. Treating depression helps improve overall health, but can also impact the management of other chronic diseases as well.

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