Depression Screening in Hospice and Palliative Care

Abstract

Purpose: The purpose of this DNP quality improvement project was to expand hospice/palliative care nursing knowledge and screening for depression in patients with a life-limiting illness. Background: Data shows that untreated depressive disorders are as high as 25% in patients receiving hospice and palliative care services. Methods: The subjects were registered nurses (RN) providing care to hospice/palliative care patients with a life-limiting illness at a local hospice care center. The Adult Learning Theory (ALT) Andragogy informed the methods and development of this project. The project utilized a one group pre-test/post-test design with an evidence based educational intervention on the topic of depression screening followed by a recommendation to utilize the PHQ-9 in the clinical care setting. The design is descriptive and utilizes a pre and post assessment process offered before and after a targeted education session for RNs on depression and depression screening. Results and recommendations were presented to both the administrators at Casa de la Luz as well as the participant RNs and any interested CDLL team members. Results: The pre and post survey evaluated differences in RN’s knowledge about depression, familiarity with screening tools, and their inclination to implement depression screenings or use depression screening tools in their future practice at CDLL. The findings from the pre and post surveys indicate the CDLL RNs: appreciated the knowledge gained on depression and depression screening specific to the hospice/palliative care setting, were open to the use of the PHQ-9 as a screening tool for depression at CDLL and the majority were agreeable to implementing a screening tool used for depression at CDLL. Conclusions: With the prevalence of underdiagnosed and undertreated depression in patients receiving hospice/palliative care services, the education of RNs is imperative to providing patients with highest quality health care and optimal quality of life. Increasing knowledge and awareness among RNs about depression and depression screening processes can serve as the motivation for implementing change and promotes opportunities to enhance the comprehensive (physical and psychological) care of patients.