Publication Date


Document Type

Scholarly Project


Psychiatric and Mental Health Nursing


Depression is common amongst patients with cardiovascular disease. This evidence-based project was designed to evaluate the impact of a practice improvement intervention for screening and referrals in cardiac patients with depression. The American Heart Association Advisory Council recommends depression screening, treatment, and support to provide adequate diagnosis, treatment, and follow-up to patients. Cardiacrehabilitation (CR) is a coordinated effort of structured treatments with physical, mental, and social components, to favorably influence cardiac healing and resume optimal functioning. The problem is current depression screening and referrals are not being documented electronically in the cardiac rehabilitation (CR) setting limiting real-time communication amongst the healthcare team. Descriptive data (number of patients screened, positive screens documented, and number of appropriate referrals completed electronically) will be collected and evaluated. This project successfully implemented a new electronic Patient Health Questionnaire 2-9 (PHQ2-9) depression and referral screening document flowsheet. A 30-day post intervention chart audit revealed a 97% documentation improvement rate for PHQ2-9 surveys. 11% of the patients screened positive for moderate depression. 27% of those patients received a documented referral. Improving the current charting system to an electronic charting system should enhance communication between members of cardiac multidisciplinary team to improve patient care. Further research and staff education need to occur to align patients with moderate to severe depression with a referral. The overall goal of this project was to provide the best evidence for practice improvement in depression care for patients with cardiac disease.