Journal of obstetric, gynecologic, and neonatal nursing : JOGNN · 2025
Decreasing Time to Treatment in Women With Hypertensive Disorders of Pregnancy in a High-Volume Hospital Obstetric Triage Setting.
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Elischer Meredith Hunter, Schaeffer Ann
Аннотация
OBJECTIVE: To increase the percentage of women with severe-range blood pressure during the perinatal period who are treated within 30 min from 25% to at least 50% within 8 weeks.
DESIGN: Plan-Do-Study-Act model comprising four 2-week cycles with data-driven tests of change every cycle.
SETTING: A high-volume, community, academic obstetric triage.
PATIENTS: We conducted interventions with women identified at risk for or diagnosed with hypertensive disorder of pregnancy (N = 182). In addition, we surveyed a convenience sample of women (n = 30) about their understanding of hypertension care and maternity care staff (n = 39) about their knowledge of treatment for hypertensive disorders of pregnancy.
INTERVENTION/MEASUREMENTS: We implemented two interventions: standardized screening for hypertensive disorders of pregnancy using a modified preeclampsia early recognition tool and an algorithm-based checklist for effective treatment for hypertensive disorders of pregnancy. We measured use and outcomes through chart review and analyzed data with descriptive statistics.
RESULTS: After the intervention, the percentage of women treated within 30 min increased to 97%. Mean medication administration times decreased from 41.4 to 11.2 min (p < .001), which demonstrated a significant improvement in care.
CONCLUSION: Standardized screening and care improved time to treatment among women with hypertensive disorders of pregnancy. This advanced practice nurse-led initiative is adaptable for widespread implementation.
DESIGN: Plan-Do-Study-Act model comprising four 2-week cycles with data-driven tests of change every cycle.
SETTING: A high-volume, community, academic obstetric triage.
PATIENTS: We conducted interventions with women identified at risk for or diagnosed with hypertensive disorder of pregnancy (N = 182). In addition, we surveyed a convenience sample of women (n = 30) about their understanding of hypertension care and maternity care staff (n = 39) about their knowledge of treatment for hypertensive disorders of pregnancy.
INTERVENTION/MEASUREMENTS: We implemented two interventions: standardized screening for hypertensive disorders of pregnancy using a modified preeclampsia early recognition tool and an algorithm-based checklist for effective treatment for hypertensive disorders of pregnancy. We measured use and outcomes through chart review and analyzed data with descriptive statistics.
RESULTS: After the intervention, the percentage of women treated within 30 min increased to 97%. Mean medication administration times decreased from 41.4 to 11.2 min (p < .001), which demonstrated a significant improvement in care.
CONCLUSION: Standardized screening and care improved time to treatment among women with hypertensive disorders of pregnancy. This advanced practice nurse-led initiative is adaptable for widespread implementation.