What are the screening tools in identifying patients with depression in primary care?



In one paragraph provide a rationale for why this is a compelling and significant PICOT for your area of nursing practice. Discuss the “so what?” in terms of prevalence of the issue, impact on quality, and impact on cost / impact on patient outcomes. [Module 2 Objective 1] Cite appropriately and provide references in APA style.

Clinical question: What are the screening tools in identifying patients with depression in primary care?

Why the PICOT is compelling and significant for my area of care: It is significant for my area of practice because depression is undertreated in primary care. I want to make sure patients that are receiving care in the primary care settings are assessed appropriately. PICOT: For adults in primary care settings (P), what is the effect of two-step depression screening (I), compared with one-step depression screening (C) on diagnosis and timely treatment of depression, (O)? The reason for selecting this topic is to enhance the management of depression in the primary care setting and provide the patients with the best method of managing the disease (Glasziou, Del Mar, & Salisbury, 2007). This PICOT question is an intervention question, because it is exploring the best way to integrate mental health services in primary care. Rationale: Depression is anticipated to be the leading causal for the disability, and the second contributor to global disease burden by 2020 (Glasziou, 2007). The devastation resulting from depression is based on the number of years lost to death as well as disability, which will be exceeded only by heart disease. Therefore, screening or managing depression is significant to reduce the occurrence of the associated risks and mortality. Depression has been found to be common in primary care setting (Ng, How & Ng, 2017). In most cases, depression is a recurring or chronic disease, and should be treated as a chronic illness. According to research, millions of patients in primary care do not receive effective treatment when it comes to depression management. This is because depression in primary care is usually under-diagnosed, under-treated and under-detected due to inadequate training and barriers to screening tools. The use of validated scales in patient screening, diagnosis and measuring the therapy response is integral in providing appropriate care for patients suffering from depression (deGruy, 2015). Concerning the proposed disease cost and depression prevalence, depression in primary care remained underdiagnosed and undertreated partially because of low confidence in the identification and treatment of mental health diseases. Much research proposes re-engineering of primary health care to monitor adherence to treatment and symptoms over time besides screening patients for depression (Dreskin, 2018). Diagnosis and treatment for mental health illnesses require a clinical awareness of the significance of the problem, understanding of the available tools for screening, and a systematic approach for the application of patient-centered evidence-based treatment (Melnyk & Fineout-Overholt, 2018). References Dreskin, M. (2018). Depression Care Management—an Evidence-Based, Collaborative Care Approach to Treating Depression in a Primary Care Setting. The Permanente Journal, 89(5), 78-92. Glasziou, P., Del Mar, C. & Salisbury, J. (2007). Evidence-based practice workbook (2nd ed.). Malden, MA; Blackwell. ISBN: 9781405167284 Melnyk, B., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. ISBN: 978-1496384539 New Edition deGruy, F. V. (2015). Treatment of depression in primary care. Annals of family medicine, 13(1), 3. Ng, C. W. M., How, C. H., & Ng, Y. P. (2017). Managing depression in primary care. Singapore medical journal, 58(8), 459.

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