Introduction:
According to the Stroke Foundation, 1 in 2 stroke survivors will develop depression and 1 in 4 stroke survivors will develop anxiety. Current systems and processes in the QEII Hospital Acute Stroke Unit (ASU) do not reflect the Stroke Foundation guidelines, and are not supporting the screening of patients for potential mood changes following a stroke.
Methods:
Participants included multidisciplinary staff (n= 53) on the ward 4B ASU and stroke survivors (n = 6). A lean six sigma approach was used to guide this quality improvement project. Inductive content analysis was used to analyse the qualitative data, and descriptive statistics was used to summarise quantitative data.
Results:
Project diagnostics revealed possible barriers to routine mood screening including lack of staff confidence, poorly define roles and responsibilities, limited time and a knowledge gap around what standardised tools are available. Results from the staff survey and patient stories indicated patients do value being asked questions around mood changes. Solution principles and tools informed the development of three prioritised solutions. These solutions included the utilisation of the available Patient Health Questionnaire-2 (PHQ-2) screening tool, staff education and modification of case conference and discharge summary auto-text templates.
Relevance to clinical practice:
Results and themes identified through the diagnostic phase have clearly indicated the need to standardise mood screening processes on the ASU to support both patients and staff.