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A Depression Screening Protocol for Patients With Acute Stroke: A Quality Improvement Project
1Questions or comments about this article may be directed to Celia McIntosh, DNP RN FNP-C CCRN CEN SCRN CNRN, at celia.mcintosh@rochesterregional.org. She is a Nurse Practitioner, Department of Neurology, Rochester Regional Health, Rochester, NY.
Summary
Implementing an evidence-based depression screening protocol improved early detection and treatment of poststroke depression (PSD) in hospitalized patients. This systematic approach enhances care for stroke survivors, potentially improving long-term outcomes.
Area of Science:
- Neurology
- Psychiatry
- Clinical Medicine
Background:
- Poststroke depression (PSD) is a common complication affecting stroke survivors' recovery and quality of life.
- Despite its prevalence, PSD is frequently underdiagnosed and undertreated, leading to adverse outcomes.
- Inconsistent screening and treatment practices exacerbate the problem for patients and caregivers.
Purpose of the Study:
- To evaluate the effectiveness of an evidence-based depression screening protocol in enhancing early PSD detection and treatment.
- To explore relationships between protocol interventions, depression scores, and diagnostic outcomes.
Main Methods:
- Retrospective chart review of 79 hospitalized acute stroke patients.
- Depression assessment using the Patient Health Questionnaire-9 (PHQ-9).
- Analysis of demographic, medical, and protocol variables using descriptive statistics, chi-square, and Pearson correlation tests.
Main Results:
- 48% of patients were identified as depressed (PHQ-9 score > 4); a history of depression correlated with higher severity.
- Patients screening positive were more likely to receive educational materials and medical treatment for PSD before discharge.
- Nurses' documentation of screening results significantly improved post-protocol implementation.
Conclusions:
- The Evidence Based Depression Screening and Treatment (EBDST) protocol effectively improved early PSD detection and treatment in hospitalized stroke patients.
- The EBDST protocol facilitated systematic, evidence-based depression screening for acute stroke patients.
- Adoption of the EBDST protocol may lead to better long-term health, reduced mortality, and improved functional recovery.
