Decreasing Time to Treatment in Women With Hypertensive Disorders of Pregnancy in a High-Volume Hospital Obstetric Triage Setting.

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.