Purpose/Objectives:

(1) Determine prevalence of patients with heart disease who screen positive for depression using a 2-item self-report tool (Patient Health Questionnaire-2). (2) Explore feasibility of using screening tool in advance of system-wide deployment to satisfy health insurer's requirement to screen patients with cardiac events for depression.

Significance:

Patients suffering from cardiovascular events have been shown to experience depression/depressive symptoms. A CNS working in the Patient Sphere of Influence can effectively create an evidence-based program that is geared toward a thorough evaluation of depression among these patients.

Design/Background/Rationale:

Numerous well-designed studies support the relationship of depression in cardiovascular patients with poor outcomes. Recently, payers have recommended that healthcare providers screen all patients with a cardiovascular diagnosis using a valid and reliable instrument to identify patients who may need interventions for depression.

Methods/Description:

Using the PARIHS framework, we pilot tested a depression screening instrument and process to estimate the prevalence of patients who scored positive for depression and to identify barriers that arose during the implementation process.

Findings/Outcomes:

Of the 12 patients who were tested, seven patients showed positive scores for depression based on the responses that they provided. The pilot project revealed that a multidisciplinary team with strong leadership and facilitation needed to be in place in order to successfully implement change.

Conclusions:

There is a need for depression screening among patients hospitalized with cardiovascular events. Its implementation can be effectively guided with the use of the PARIHS framework.

Implications for Practice:

The high prevalence of patients who have positive screening for depression indicates the need for effective and accurate diagnosis and treatment of depression among patients suffering from cardiovascular events. The clinical nurse specialist working with a multidisciplinary team can successfully implement this project.

Section Description

The journal is proud to share the student abstracts accepted for poster presentation at the 2009 National Association of Clinical Nurse Specialists Conference. These abstracts are submitted under a separate later deadline and therefore did not appear in the journal with the general abstracts. Congratulations to these CNS students and their faculty mentors.