Interventions for Postpartum Depression - RNAO

1 Nursing Best Practice GuidelineShaping the future of NursingInterventions for Postpartum DepressionApril 2005 Greetings fromDoris Grinspun Executive DirectorRegistered Nurses Association of Ontario It is with great excitement that the Registered Nurses Association of Ontario (RNAO)disseminates this nursing best practice guideline to you. Evidence-based practice supportsthe excellence in service that nurses are committed to deliver in our day-to-day offer our endless thanks to the many institutions and individuals that are makingRNAO s vision for Nursing Best Practice Guidelines (NBPGs) a reality. The Governmentof Ontario recognized RNAO s ability to lead this program and is providing multi-year funding. TazimVirani NBPG program director with her fearless determination and skills, is moving the program forwardfaster and stronger than ever imagined. The nursing community, with its commitment and passion forexcellence in nursing care, is providing the knowledge and countless hours essential to the creation andevaluation of each guideline.

2 Employers have responded enthusiastically to the request for proposals (RFP),and are opening their organizations to pilot test the NBPGs. Now comes the true test in this phenomenal journey: Will nurses utilize the guidelines in their day-to-day practice? Successful uptake of these NBPGs requires a concerted effort of four groups: nurses themselves, otherhealthcare colleagues, nurse educators in academic and practice settings, and employers. After lodgingthese guidelines into their minds and hearts, knowledgeable and skillful nurses and nursing students needhealthy and supportive work environments to help bring these guidelines to life. We ask that you share this NBPG, and others, with members of the interdisciplinary team. There is much tolearn from one another. Together, we can ensure that Ontarians receive the best possible care every timethey come in contact with us. Let s make them the real winners of this important effort!

3 RNAO will continue to work hard at developing and evaluating future guidelines. We wish you the best fora successful implementation!Doris Grinspun, RN, MSN, PhD(cand), OOntExecutive DirectorRegistered Nurses Association of Ontario1 Interventions forPostpartum DepressionDisclaimerThese best practice guidelines are related only to nursing practice and not intended to take into accountfiscal efficiencies. These guidelines are not binding for nurses and their use should be flexible toaccommodate client/family wishes and local circumstances. They neither constitute a liability ordischarge from liability. While every effort has been made to ensure the accuracy of the contents at thetime of publication, neither the authors nor the Registered Nurses Association of Ontario (RNAO) giveany guarantee as to the accuracy of the information contained in them, nor accept any liability, withrespect to loss, damage, injury or expense arising from any such errors or omission in the contents ofthis work.

4 Any reference throughout the document to specific pharmaceutical products as examplesdoes not imply endorsement of any of these the exception of those portions of this document for which a specific prohibition or limitationagainst copying appears, the balance of this document may be produced, reproduced and published, inany form, including in electronic form, for educational or non-commercial purposes, without requiringthe consent or permission of the Registered Nurses Association of Ontario, provided that an appropriatecredit or citation appears in the copied work as follows:Registered Nurses Association of Ontario (2005). Interventions for Postpartum ,Canada: Registered Nurses Association of Best Practice GuidelineHow to Use this DocumentThis nursing best practice guidelineis a comprehensive document providing resourcesnecessary for the support of evidence-based nursing practice. The document needs to be reviewed andapplied, based on the specific needs of the organization or practice setting/environment, as well as theneeds and wishes of the client.

5 Guidelines should not be applied in a cookbook fashion but used as a toolto assist in decision making for individualized client care, as well as ensuring that appropriate structuresand supports are in place to provide the best possible , educators, administrators, and other health care professionals who are leading and facilitatingpractice change will find this document valuable for the development of policies, procedures, protocols,educational programs, assessment and documentation tools. It is recommended that the nursing bestpractice guidelines be used as a resource tool. Nurses providing direct client care will benefit from reviewingthe recommendations , the evidence in support of the recommendations and the process that was used todevelop the guidelines. However, it is highly recommended that practice settings/environments adaptthese guidelines in formats that would be user-friendly for daily use. This guideline has some suggestedformats for such local adaptation and wishing to use the guideline may decide to do so in a number of ways: Assess current nursing and health care practices using the recommendations in the guideline.

6 Identify recommendations that will address identified needs or gaps in services. Systematically develop a plan to implement the recommendations using associated tools and is interested in hearing how you have implemented this guideline. Please contact us to share your resources will be made available through the RNAO website assist individuals and organizations to implement best practice for Postpartum Depression23 Nursing Best Practice GuidelineProgram Team:Tazim Virani,RN, MScN, PhD(candidate)Program DirectorStephanie Lappan-Gracon,RN, MNProgram Coordinator Champions NetworkHeather McConnell,RN, BScN, MA(Ed)Program ManagerJosephine Santos,RN, MNProgram CoordinatorJane M. Schouten,RN, MBAP rogram CoordinatorBonnie Russell,BJProgram AssistantCarrie ScottAdministrative AssistantJulie BurrisAdministrative AssistantKeith Powell,BA, AITWeb EditorInterventions forPostpartum DepressionRegistered Nurses Association of OntarioNursing Best Practice Guidelines Program111 Richmond Street West, Suite 1100 Toronto, Ontario M5H 2G4 Website: Dennis, RN, MScN, PhDTeam LeaderAssistant ProfessorFaculty of Nursing University of TorontoToronto, OntarioSue Bookey-Bassett, RN, BScN, MEdProject ManagerNear Miss Study, University of Toronto and Independent ConsultantOakville, OntarioDonna Bottomley, BA, MSW, RSWP erinatal, Obstetrical & NICU Social WorkerOttawa HospitalGeneral CampusOttawa, OntarioBarbara Aileen Bowles, RN, BSN, PNC(C)Staff NurseMaternal Child Family CentreSt.

7 Catharines General SiteNiagara Health SystemSt. Catharines, OntarioJudi DeBoeck, RN, BA CHPEP ublic Health NurseMother Reach ProgramCounty of OxfordPublic Health & Emergency ServicesWoodstock, OntarioMarilyn Evans, RN, PhDAssistant ProfessorSchool of NursingUniversity of Western OntarioLondon, OntarioDenise H bert, RN, BScN, MScFamily Health SpecialistHealthy Babies, Healthy Children ProgramOttawa Public HealthOttawa, OntarioJoAnne Hunter, BScN, MHSc, RN(EC)Primary Care Nurse PractitionerFamily Health CentreUniversity Health NetworkToronto, Ontario Stephanie Lappan-Gracon, RN, MNRNAO Program Staff Facilitator, Program CoordinatorNursing Best Practice Guidelines ProgramRegistered Nurses Association of OntarioToronto, OntarioElizabeth McGroarty, RN, COHN(C) COHN-S,CRSP, Cert HRMO ccupational Health ConsultantMyriad ServicesToronto, OntarioKaren McQueen, RN, BScN, MA(N)Assistant ProfessorFaculty of NursingLakehead UniversityThunder Bay, OntarioPhyllis Montgomery, RN, MScN, PhDAssociate ProfessorSchool of Nursing Laurentian UniversitySudbury, OntarioInterventions for Postpartum Depression4 Development Panel MembersDeclarations of interest and confidentiality were made by all members of the guideline development panel.

8 Further details are available from the Registered Nurses Association of Best Practice GuidelineLori Ross, PhDResearch ScientistWomen s Mental Health &Addiction Research SectionCentre for Addiction & Mental HealthToronto, OntarioMarcia Starkman, MSN, RN, CS Nurse PsychotherapistPostpartum PartnershipRichmond Hill, OntarioSharon Thompson, RN, BScN Nurse CounsellorWomen s Health CentreSt. Joseph s Health CentreToronto, OntarioUlla Wise, RN, MNPublic Health Nurse Mental Health SpecialistToronto Public HealthToronto, OntarioBonnie Wooten, RN, MPAP rogram ManagerFamily Health ServicesMiddlesex-London Health UnitLondon, OntarioThe RNAO and the development panel would liketo acknowledgeDawn Kingston, RN, BSc, MSc,Research Assistant, for her work in conducting thequality appraisal of the literature and preparationof evidence RNAO development panel would like toacknowledge the following individuals forproviding valuable feedback in criticallyappraising this guideline in relation to theAGREE Collaboration Ciliska, RN, PhD Professor, School of NursingMcMaster University & ConsultantCity of Hamilton, Public Health ResearchEducation & Development ProgramHamilton, OntarioWendy Sword, RN, PhDAssociate Professor, School of NursingMcMaster University & ConsultantCity of Hamilton.

9 Public Health ResearchEducation and Development ProgramHamilton, OntarioInterventions for Postpartum Depression6 AcknowledgementStakeholders representing diverse perspectives were solicited for their feedback and the Registered Nurses Association ofOntario wishes to acknowledge the following for their contribution in reviewing this Nursing Best Practice Guideline:Diane Alain, Professeure, La Cit coll giale, University of Ottawa, Ottawa, OntarioBeth Baxter, RN, BScNPublic Health Nurse, Child and Reproductive Health, Hastings & Prince Edward Counties Health Unit, Trenton, OntarioMargaret Belliveau, RN, BSN, PNC(C)Perinatal Nurse Educator, St. Joseph s Health Care, London, OntarioDebra Bick, RM, BA (Hons), MMedSc, PhDProfessor of Midwifery and Women s Health Centre for Research in Midwifery and Childbirth, Faculty of Research in Midwifery and Childbirth, Faculty ofHealth and Human Sciences, London, United KingdomDiane Clements, RN, MN Director, Nursing Directorate, Ministry of Health Services, Victoria, British ColumbiaLaura Cook, RN, BScNPublic Health Nurse, Perth District Health Unit, Stratford, OntarioDiane de Camps Meschino, Psychiatrist, MD,Leader, Reproductive Life Stages ProgramFRCPC BSc(Hons)

10 Sunnybrook & Women s Health Sciences Centre, Women s College Site, Toronto, OntarioSharon Dore, RN, PhDAdvanced Practice Nurse, Clinical Nurse Specialist, Women s HealthHamilton Health Sciences, Hamilton, OntarioRebecca Dupuis, RN, BAANP ublic Health Nurse, Simcoe County District Health Unit, Midland, OntarioSheryl Farrar, BSc, MHScPublic Health Promotion, Hastings & Prince Edward Counties Health Unit, Belleville, OntarioLisebeth Gatkowski, RN, MHNC ommunity Nurse, Community Liaison Program, St. Joseph s Healthcare: Centre for Mountain Health Services, Hamilton, OntarioPat Hanly, RN, BScN,Public Health Manager, Perth District Health Unit, Stratford, OntarioKathryn Hayward-Murray, RN, BA(N), Nursing Director, Maternal Child, Credit Valley Hospital, Mississauga, OntarioMSc(T), ICCEG abriella Herr, RN(EC), BScN, PHCNP Primary Health Nurse Practitioner, Family Practice, University Health Network,Toronto, OntarioSusan James, BScN, MN, PhDDirector, Midwifery Education Program, Laurentian University, Sudbury, OntarioCatharine Kennedy, RN, BScNPublic Health Nurse, Regional Niagara Public Health Department, St.