Date of Degree

12-2020

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Christopher P. Weidlich

Abstract

The National Institute of Mental Health (2017) estimates that 9.2 million people age 18 years and older are diagnosed with bipolar disorder in the United States. Research has shown pregnancies in women with mental health problems have higher rates of poor outcomes and complications (Epstein et al., 2014; Freeman, 2007; Rusner et al., 2016; Scrandis, 2017). Aim. The purpose of this scholarly project is to provide standardized patient education, increase urine human chorionic gonadotropin screening rates, and to set up a gynecologic care bridge for patients considering pregnancy and are diagnosed with bipolar disorder. Evidence. The Centers for Disease Control and Prevention (2019b) estimates 51% of pregnancies are unplanned and recommends planning for pregnancy ahead of time. The American College of Obstetricians and Gynecologists (2019) recommends a multidisciplinary care team for patients that plan on pregnancy. Mood-stabilizing and anti-psychotic medications are known human teratogens (Bodén et al., 2012; Mittal et al., 2015; Stahl, 2017). Method. Female patients with bipolar disorder, ages 18-65 years, received standardized medication and contraception education. These patients were screened for pregnancy intentions or human chorionic gonadotropin. Patients that met criteria were connected with a gynecologic provider. Results. 158 patients were screened for pregnancy and offered education over ten weeks. 37 patients had recent pregnancy tests. 50 patients were indicated for follow up. Implications. Medication safety is of paramount importance for this high-risk population. Data captured during this project provides a snapshot. This process should be continuous and championed by health care organizations.

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