OBJECTIVES: The current best practice implementation project aimed to improve the quality of continuity of care and emotional well-being in women with high-risk pregnancies. INTRODUCTION: Perinatal mental health disorders, such as perinatal depression and anxiety, are considered major health issues and are associated with poor maternal and neonatal outcomes. Women with high-risk pregnancies are considered a group of women with a substantial vulnerability and the value of continuity of care is vital in this group. METHODS: The current project used the pre-post implementation clinical audit following the JBI Evidence Implementation framework. A baseline audit and a follow-up audit were conducted involving 120 high-risk pregnant women in a hospital's obstetric unit. An intervention was performed establishing a midwife consultation and a referral circuit for the different healthcare professionals. A screening was performed through several validated questionnaires. RESULTS: To reflect the continuum of care, three topics were selected, including antenatal psychosocial assessment, intrapartum care and postpartum depression assessment, with a total of 10 criteria. The baseline audit results showed 0% compliance in all the criteria since the proposed standards of care did not exist before the audit. After the implementation of the strategies, the compliance achieved 100% in all audit criteria. A multidisciplinary hospital guideline was established for standardized care and mental well-being care for high-risk pregnant women. CONCLUSION: Follow-up in the mental health of pregnant women is insufficient. Improving emotional well-being in pregnancy should be a target of clinical practice. More national and international guidelines to assess mental well-being during pregnancy and the postpartum period should be developed.

Hospital Universitario Infanta Leonor

Spanish Centre for Evidence Based Health Care A Joanna Briggs Institute Centre of Excellence JBI Clinical Fellowship Madrid Spain

The Czech Republic Centre for Evidence Based Healthcare The Joanna Briggs Institute Centre of Excellence Czech National Centre for Evidence Based Healthcare and Knowledge Translation Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

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