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A Standard Practice Protocol for Addressing Depression in a Hospice Setting.

Beth A Williams, Carrie L Cormack

    Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association
    |September 4, 2023
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    Summary

    Implementing a standardized protocol for depression screening in hospice care improved patient identification and treatment. This approach ensures consistent evaluation and increased recognition of depression symptoms in terminally ill patients.

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    Area of Science:

    • Palliative Care
    • Psychiatry
    • Gerontology

    Background:

    • Depression exacerbates physical and psychiatric distress in life-limiting illnesses.
    • It is linked to increased pain, fatigue, dyspnea, and reduced survival.
    • Addressing depression in hospice settings requires structured protocols and validated tools.

    Purpose of the Study:

    • To develop and implement a standardized protocol for depression screening and treatment in a hospice setting.
    • To evaluate the effectiveness of the protocol in identifying and managing depression among newly admitted patients.

    Main Methods:

    • A protocol was developed and integrated with electronic medical records.
    • Validated screening tools, including the Patient Health Questionnaire-2, were used during psychosocial assessments.
    • Patients were referred for pharmacological and nonpharmacological treatments based on depression severity.

    Main Results:

    • 100% of eligible patients were screened for depression.
    • 52% of patients were identified with some severity of depression.
    • 26% were referred for treatment, with 50% receiving pharmacological and 26% nonpharmacological strategies.
    • A statistically significant difference in depression severity was observed post-intervention.

    Conclusions:

    • Standardized protocols enhance consistent evaluation of depression in hospice care.
    • The implemented protocol increased the recognition of depression symptoms.
    • This systematic approach facilitates appropriate referral and treatment for depressed hospice patients.