Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Margaret Dexheimer Pharris


Doctor of Nursing Practice


Problem Statement: Depression post-myocardial infarction (MI) is a risk factor for worse cardiac outcomes and all-cause mortality (Gan et al., 2014; Lane et al., 2002; Lichtman et al., 2008; Lichtman et al., 2014; May et al., 2017; Wu & Kling, 2016).

Purpose: The purpose of the quality improvement (QI) project was to determine if implementing a depression screening protocol in cardiology clinics would increase depression screening in patients who have had an MI in the last year.

Methods: A QI project utilizing a quasi-experimental, two-group design was used to compare rates of depression screening in post-MI patients before and after implementing a depression screening protocol. A convenience sample was selected from two cardiology clinics – one metropolitan hospital- affiliated and the other suburban. The pre-screening group included 116 post-MI patients, 75 of whom met inclusion criteria for screening, seen in February and March 2017. The post-screening group included 85 post-MI patients, 65 of whom met inclusion criteria for screening, seen in October and November 2017. Depression screening was done using the patient health questionnaire two-item (PHQ-2) screening tool, and if either question was answered positively, then the nine-item (PHQ-9) questionnaire was used.

Results: With the implementation of the depression screening protocol there was an increase in depression screening for those who met criteria for screening from 0 (0%) out of the 75 candidates in the pre-implementation group to 23 (35%) out of the 65 candidates in the post-implementation group. Of the 23 who were screened in the cardiology clinic, 11 (48%) went on to complete the PHQ-9 with eight of them having scores that indicated moderate to major symptoms of depression.

Conclusion: Implementing a depression screening protocol in the cardiology clinic did increase depression screening in post-MI patients.