Assessing the Problem: Quality, Safety, and Cost Considerations Essay

Assessing the Problem: Quality, Safety, and Cost Considerations Essay

Assessing the Problem: Quality, Safety, and Cost Considerations Essay

Postpartum depression (PPD) is one of the commonest mental health illnesses among females in the reproductive age. If unmanaged, PPD can have far-reaching adverse implications on mothers and their infants, including a high risk of incompliance to treatment, worsening of existing health conditions, financial losses, substance abuse, suicide, and infanticide (Moore Simas et al., 2019). Therefore, this paper seeks to discuss the impact of PPD on quality, safety, and cost on the health system and individual and propose strategies to address it.

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How PPD Impacts the Quality of Care, Patient Safety, and Costs to the System and Individual

Patient Safety

PPD adversely affects the quality of care not only to the mother but also to her infant. Untreated PPD presents maternal health risks such as excessive alcohol consumption, use of illicit drugs, weight problems, breastfeeding problems, challenges in social relationships, and persistent depression (Slomian et al., 2019).  Furthermore, PPD has negative consequences for the infant since it increases the risks for impaired cognitive functioning, emotional maladjustment, behavioral inhibition, externalizing disorders, and medical and psychiatric in adolescence (Slomian et al., 2019). A mother who results to excessive alcohol or illicit drug use from PPD may be reluctant to receive the recommended postnatal care, thus affecting the quality of care provided. Besides, PPD affects the healthcare system since it limits health providers from providing the ideal postpartum care since PPD affects mothers’ health-seeking behaviors. For instance, a mother with PPD may fail to understand and adhere to the health education provided in the postpartum period, which can affect the quality of self-care resulting in postpartum complications.

Patient Safety

PPD significantly affects the safety of the mother, the child, and other patients in the hospital.  PPD increases a woman’s odds of having suicidal thoughts, ideations, and suicidality, which puts the mother’s safety at risk. Women with PPD often have thoughts of self-harm and causing harm to the baby (Moore Simas et al., 2019). Besides, since breastfeeding is often impaired in mothers with PPD, the infant may be inadequately fed, increasing the risk of malnutrition and other systemic disorders. Excessive alcohol consumption and illicit drug use attributed to PPD further increase the mother’s risk of harming herself and the baby.

Costs

PPD increases costs to the affected patients and the healthcare system due to treatment and psychotherapy costs. According to a study by Epperson et al. (2020), families with a member with PPD had a higher mean of total expenses on medical and pharmaceutical services and products during the first year after childbirth than families without PPD. The high healthcare costs that mounted up after diagnosis of PPD are due to the increased utilization of healthcare resources directly related to the treatment of PPD. The findings provide greater insight into the potential economic burden attributed to PPD. It reveals that healthcare costs can go past the woman to affect the entire household. Furthermore, Epperson et al. (2020) highlight a research that established that a high financial burden of PPD in the United States, with the costs of unmanaged mood disorders in the 2017 birth cohort being approximately $14 billion.

How Organizational/Governmental Policies Can Affect PPD’s Impact on the Quality of Care, Patient Safety, And Costs

Various states have enacted policies addressing postpartum mental health to improve the quality of maternal care, safety, and reduce costs.  Governmental policies are grouped in several categories, including Education mandates, by which a mother or their family member must be provided education concerning peripartum depression (Rowan et al., 2017). Screening mandates require health providers to screen for depression in the postpartum period, and policies on PPD awareness mandate campaigns to be provided to the general population. In addition, task force mandates oblige a study group or state-level task force to investigate and give postpartum mental health reports.

States with policies on PPD screening include West Virginia, New Jersey, Illinois, and Massachusetts. New Jersey’s education and screening mandate increased the number of women with PPD initiated on early treatment with antidepressants and counseling (Rowan et al., 2017).  Generally, the policies have increased the number of women with positive PPD screens referred for mental health care. In addition, they have increased access to mental healthcare for low-income women, thus improving the quality of care to women from disadvantaged communities (Rowan et al., 2017). Education mandates have increased the percentage of women who accept a mental health referral and make a mental health visit, thus increasing patient safety.         

How the Policies Will Guide Actions in Addressing Care Quality, Patient Safety, and Costs

The education mandates will guide my practice by developing individualized patient education plans for postpartum mothers and their family members on PPD. The education plans will address risk factors, signs and symptoms, preventive measures, and treatment options for PPD. In addition, screening mandates will guide my practice by integrating depression screening in the care plan for postpartum mothers (Rowan et al., 2017). Before discharging a mother after childbirth, I will screen her for PPD to determine if they are at risk and the severity of PPD symptoms. Furthermore, mandates on PPD awareness campaigns will guide my practice on organizing education campaigns to educate the general public on PPD, including clinical features, prevention interventions, available treatment options, and care for a woman with PPD.

Effects of the Policies or Legislation on the Nursing Scope of Practice

            The policy on patient education affects the scope of practice since nurses are required to provide health education to postpartum mothers and their families (Rowan et al., 2017). Besides, policies on screening affect nurses’ scope as they are required to implement screening interventions to identify patients with or at risk of PPD. The nurses’ scope further entails conducting public education campaigns and participating in task forces to investigate postpartum mental health in their respective states.

Strategies to Improve the Quality of Care, Enhance Patient Safety, and Reduce Costs to the System and Individual

The proposed strategy to enhance the quality of care, patient safety, and minimize costs to patients and the health system about PPD is educating new mothers on the signs and symptoms of postpartum depression. Health education is a goal and a fundamental value of nursing care in the postpartum period. However, education to increase PPD literacy may require patient education to be provided in the antenatal period and reinforced in the postpartum admission and after discharge.

The Council on Patient Safety in Women’s Health Care advocates that each mother in each health care setting receives suitably scheduled postpartum education on depression and anxiety and to include the family members. Kendig et al. (2017) assert that offering suitable and prompt resources materials on PPD can help women and family members recognize its signs and symptoms, especially given that it often goes undiagnosed and undertreated. Prompt patient education on the signs and prevalence of PPD helps alleviate the stigma, empowers mothers and their families to seek mental care, and offers knowledge guides advocacy for the woman and other women (Kendig et al., 2017). Furthermore, helping women and their families differentiate between the usual anxiety, postpartum blues, and PPD increases their knowledge of these conditions.

Available resources of benchmark data on education to new mothers on the signs and symptoms of PPD include: “Depression During and After Pregnancy: A Resource for Women, Their Families, and Friends,” it answers common inquiries and provides links to extra informational resources (Kendig et al., 2017). Another source is the “Moms’ Mental Health Matter,” which provides education to health providers and consumers on persons at risk for PPD, signs of PPD, and how to seek help.

Conclusion

PPD is attributed to a high risk of maternal and infant morbidity and mortality and is a major patient safety issue. PPD health risks impact the quality of care and health outcomes of postpartum mothers.  Policies on PPD will guide my action in providing care to women with PPD and promoting high-quality and safe PPD care interventions. The state policies impact the scope of nursing practice since nurses must provide specific care interventions to improve the quality and safety of patient care and lower healthcare costs. My proposed strategy is to educate new mothers on the signs and symptoms of postpartum depression to increase their awareness of the condition and increase health-seeking behaviors.

References

Epperson, C. N., Huang, M. Y., Cook, K., Gupta, D., Chawla, A., Greenberg, P. E., & Eldar-Lissai, A. (2020). Healthcare resource utilization and costs associated with postpartum depression among commercially insured households. Current Medical Research and Opinion, 36(10), 1707-1716.

Kendig, S., Keats, J. P., Hoffman, M. C., Kay, L. B., Miller, E. S., Moore Simas, T. A., Frieder, A., Hackley, B., Indman, P., Raines, C., Semenuk, K., Wisner, K. L., & Lemieux, L. A. (2017). Consensus Bundle on Maternal Mental Health: Perinatal Depression and Anxiety. Obstetrics and gynecology, 129(3), 422–430. https://doi.org/10.1097/AOG.0000000000001902

Moore Simas, T. A., Huang, M. Y., Patton, C., Reinhart, M., Chawla, A. J., Clemson, C., & Eldar-Lissai, A. (2019). The humanistic burden of postpartum depression: a systematic literature review. Current medical research and opinion, 35(3), 383-393.

Rowan, P. J., Duckett, S. A., & Wang, J. E. (2017). State mandates regarding postpartum depression. Psychiatric Services, 66(3), 324-328.

Slomian, J., Honvo, G., Emonts, P., Reginster, J. Y., & Bruyère, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s Health, 15, 1745506519844044. https://doi.org/10.1177/1745506519844044

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I need help with the second part of my capstone project for nursing. I will be adding some personal content when you’re done. My capstone project intervention is on educating new moms on the signs and symptoms on postpartum depression. My instructor checks the resources to make sure they make sense. For this topic she has suggested articles from ACOG, NAMI or APA these are just suggestions. I will be uploading all grading requirements.
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