Document Type
DNP Project
Department
School of Nursing
Date of Degree
Spring 2026
Degree
Doctor of Nursing Practice (DNP)
Primary Advisor
Joyce Knestrick, PhD, FNP-BC, FAANP, FAAN
Keywords
Perinatal Depression; Postpartum Depression; Substance Use Disorder; Screening Protocols; Obstetrics; Gynecology
Abstract
Background/Significance: Perinatal mood, anxiety, and substance-use disorders remain leading contributors to maternal morbidity, impaired maternal–infant bonding, and preventable adverse outcomes. Although national organizations recommend universal screening during pregnancy and postpartum, implementation gaps persist due to inconsistent provider practices, workflow variability, and unclear referral pathways. Strengthening both provider competency and system- level processes is essential to improving identification and follow-through in obstetric settings.
Purpose: The purpose of this quality improvement project was to evaluate and strengthen the consistency, quality, and reliability of perinatal depression and substance-use screening practices at an OB/GYN Clinic by implementing standardized screening protocols using the Edinburgh Postnatal Depression Scale (EPDS) and the Screening, Brief Intervention, and Referral to Treatment (SBIRT) framework.
Methods: A pre–post intervention design was used. Eight obstetric providers completed an educational intervention and standardized workflow integration. Provider confidence and referral-pathway knowledge were measured using Likert-scale surveys and analyzed with paired- samples t-tests. Aggregate electronic health record (EHR) data were analyzed to assess screening completion and referral follow-through. Descriptive statistics and run chart analysis were performed using Microsoft Excel and SPSS.
Results: Provider confidence significantly increased from pre- to post-intervention (M = 2.25 to 3.50), t(7) = 7.64, p < .001. Referral knowledge also significantly improved (M = 1.88 to 3.38), t(7) = 7.94, p < .001. Post-implementation, 766 screenings were completed, demonstrating sustained workflow integration. Of the 71 positive screens, 61 resulted in documented referrals, yielding an 85.9% referral follow-through rate; however, this reflects referrals placed in the medical record and does not indicate whether patients ultimately completed or attended the referred consultation.
Conclusions: Standardized screening protocols combined with provider education and workflow redesign significantly improved provider competence, screening consistency, and referral adherence. Embedding evidence-based tools within structured clinical systems promotes sustainable improvements in perinatal mental health care delivery.
Copyright Notice
©2026 Ava Smith. All rights reserved.
Recommended Citation
Smith, A. (2026). Implementing Standardized Screening Protocols for Perinatal and Postpartum Depression and Substance Use: A Quality Improvement Project. , (). Retrieved from https://hsrc.himmelfarb.gwu.edu/son_dnp/198
Open Access
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