Background: Despite postpartum depression (PPD) being the most common medical complication surrounding childbirth affecting 10-20% of new mothers, it is often underdiagnosed and undertreated, especially in primary care. Universal screening with a validated tool is recommended for all postpartum women as evidence shows that formal screening is superior to non-formal screening in detecting women with PPD. Unfortunately, most primary care providers do not formally screen. In southern Maricopa, low income minority women were found to have a higher than average prevalence of PPD. Thus, it is important for providers in this area to screen. Purpose: The purpose of this quality improvement project was to determine provider knowledge, practice behaviors, and perceived facilitators and barriers to PPD screening at an urban Federally Qualified Health Center in the Southwestern United States. This needs assessment was then used to make site-specific recommendations for PPD screening to enhance early identification of women with PPD. Design: A quality improvement project using a quantitative descriptive design. A quantitative survey assessed provider knowledge, practice behaviors, perceived barriers, and perceived facilitators regarding PPD screening. Setting: Wesley Health Center, a primary care clinic in Phoenix, Arizona. Participants: Five primary care providers in family practice. Results: Universal screening with validated screening tools was common. More than half of providers (60%) universally screen all postpartum women for depression with a formal screening tool up to one year postpartum. Providers were correctly using validated screening tools for PPD such as the Patient Health Questionnaire-2 (PHQ-2), PHQ-9 and Edinburgh Postnatal Depression Scale (EPDS), but only one provider (20%) was aware that the PHQ-2 and PHQ-9 are validated for that specific purpose. Wesley is already attempting to universally screen for depression with a two-step process using the PHQ-2 and PHQ-9 for all patients, but participants report that support staff sometimes forget to provide patients with the screening tool before the provider visit, patients sometimes decline to be screened, and providers either forget to catch the opportunity or do not have time. Identified facilitators to screening are support staff (80%) and the electronic health record (20%). Conclusion: One major strength of the clinic is that it already has a policy of universally screening for depression that is validated for use for PPD. The findings from the study indicate that this policy is not always followed due to barriers such as lack of time, support staff not providing screening tools before the provider encounter with the patient, and providers forgetting to screen. The screening process could be enhanced by taking the time to ensure that tools are readily accessible, gathering the input from support staff on the barriers they face to screening patients, and utilizing the electronic health record to make the process more automated. Enhancing the policy already in place would be enhancing screening practices for PPD and improve early detection of this condition. Findings will be disseminated via an executive summary and PowerPoint presentation to the staff.

Abstract Title Reducing Adverse Events: Medication Reconciliation in Primary Care Purpose Primary care patients experience high levels of adverse drug reactions due to inaccurate medication reconciliation practices. Project Aims The project aims to improve medication reconciliation in a primary care setting. Outcome Measures Outcomes measures include identified medication discrepancies, staff satisfaction related to the use of the MATCH tool, and patient age ranges and gender. Methods Over a 4 week period, the clinic staff integrated the evidenced based instrument, Medication at Transitions and Clinical Handoff (MATCH) tool. Initially, the office manager provided a MATCH tool and a copy of the patients current medication list. The patient entered new and discontinued medications on the tool. The medical assistant reconciled the medication list in the electronic medical record. The nurse practitioner then reviewed the medications and compared the data to the MATCH tool. Lastly, the office manager scheduled the next patient appointment and attached a reminder to bring current medications. The completed MATCH tools (n=88) were collected for analysis. Findings Eighty-eight (n=88) MATCH tools with patient medication discrepancies, age ranges, genders, and staff responses were completed. Limitations included a 4-week time frame to use the tool, medical assistant buy-in related to the MATCH tool use, patient compliance to bring in medications to their next appointment, and patients ability to recall home medications. Implications Medication reconciliation is essential to patient care and safety in primary care settings. The MATCH tool is evidenced based and can improve medication reconciliation and reduce adverse drug reactions.

Ensuring the safety and welfare of children has a lasting effect on society. As we progress to a more inclusive concept of what constitutes a family, the effect of same sex parenting (SSP) must be considered. Health related outcomes describing the advantages, disadvantages and unique challenges experienced by this population is surprisingly robust.

No description available.

No description available.

Purpose: Quality improvement project to improve diabetic retinopathy education and screening in a rural primary care clinic to meet the standard of care. Aims: To improve the delinquency rate of diabetic retinopathy screening. Processes: Participants included those with type 1 and type 2 diabetes ages 18 and up in the rural health clinic. Diabetic retinopathy screening importance education was displayed in the clinic and provided to each applicable patient in the form of a handout. A diabetic eye camera was brought to the rural health primary care clinic to offer more convenient access and free eye exams to clinic patients with diabetes. The project was deemed quality improvement by the IRB. Results: (To be determined after project implementation – results anticipated to be excellent based on the number of patients who are signed up to participate in this day.) There are 486 patients with a diagnosis of diabetes in the clinic. ___ were delinquent in eye exam prior to implementation and ___ were delinquent after. Limitations: Project performed in only one clinic; project leader is employed at the clinic in this study. Conclusions: Implementation of the eye exam day improved the delinquency rate of diabetic retinopathy screening in the clinic and proved to be a valuable means of enhancing patient compliance and satisfaction of routine eye health monitoring in patients with diabetes.

Abstract Purpose: Mental illness in the United States is a well-documented prevalent health concern. Mental health conditions are extensive and subject to mental illness stigma that negatively impacts client care. Aims: This quality improvement project aims to implement the NAMI In Our Own Voices presentation in conjunction with a ninety-minute anti-stigma educational session to reduce mental illness stigma among nursing students. Methods: This quality improvement project utilizes a pretest-posttest study design to evaluate the implementation of the National Alliance on Mental Illness In Our Own Voices presentation in conjunction with a ninety-minute anti-stigma educational session’s impact on mental illness stigma reduction. The Open Minds Stigma Scale for Health Care providers will be used to determine the level of stigma reduction in undergraduate baccalaureate nursing students. Results: Results are pending project implementation approval from the National Alliance on Mental Illness. Conclusion: No conclusion can be determined at this time as study results are pending.

No / Background. The placement of welfare advice services in family practice to assist patients with health-related social and economic issues (e.g. disability benefits) has gathered momentum over the last decade in the UK. This expansion of primary care raises a number of issues for practices hosting these services. Objectives. To gain the views of advice workers and primary care staff about the issues raised in hosting a welfare advice service across 30 practices in inner city Bradford. Methods. Views were obtained through focus groups with six advice workers, and primary care staff in 14 practices. A questionnaire was also posted to all practice managers asking their opinions about the service. Results. The focus groups highlighted a number of advantages for patients, including improvements in health and quality of life through increased income and reduced stress from social and economic issues. For practice staff, the service provided a resource to refer patients for welfare advice, reducing the time spent dealing with welfare issues, thereby reducing workload. This was confirmed in the questionnaire to practice managers where 72% said the service had saved time for GPs and reception/office staff. The advice workers raised concerns about the perceived level of commitment to the service from some staff at some practices. Practice staff were particularly concerned about the need for feedback about referrals. Conclusion. Providing welfare advice in family practice can act as a valuable resource for primary care staff helping to address their patients health-related social and economic needs.

No description available.

Implementation of provider-made follow-up appointments for depression in primary care Rebecca Vaughn College of Nursing, East Tennessee State University; Whitson Hester School of Nursing, Tennessee Technological University Author Note Rebecca Vaughn https://orcid.org/0009-0007-0731-3316 College of Nursing, East Tennessee State University There are no conflicts of interest to disclose. Corresponding concerning this manuscript should be addressed to Rebecca Vaughn 108 Reed Mill Lane Monroe TN 38573 Zrev2@etsu.edu Abstract Depression is a common condition diagnosed and managed in primary care. Follow-up is inconsistent and low in these settings, creating a gap in care that impacts management, adherence to treatment, and patient outcomes. The purpose of this quality improvement project was to implement in-room scheduling of follow-- up appointments by providers of newly diagnosed depression patients. The project aimed to improve follow-up of newly diagnosed depression patients and adherence to treatment in primary care. The setting of the project was a primary care clinic care located in North-East Tennessee. The IRB determined that no approval was needed. A 12-week retrospective chart review was conducted to determine baseline rates and demographics for the project. During the six-week project , providers scheduled follow-up appointments and documented them on the data collection form. Providers were given a pre/post-test before and after implementation to measure providers confidence levels. While the study is ongoing , and results are pending, the expected outcomes include improved follow-up rates and improved adherence to treatment which will lead to improved outcomes in depression. Keywords: depression, primary care, follow-up, adherence