Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

4-13-2022

Graduate Advisor

Dr. Alicia Hutchings, PhD, RN, CNE

Committee

Dr. Alicia Hutchings, PhD, RN, CNE

Dr. Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C

Dr. Becky Boedeker, DNP, RNC-MNN, IBCLC, C-ONQS

Abstract

Problem: Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal morbidity, mortality, and postpartum readmission. Several evidence-based algorithms and protocols have been implemented in the inpatient setting to treat severe blood pressure and prevent complications. However, there remains an opportunity to improve the postpartum care transition and discharge education for patients with these conditions in an attempt to decrease 30-day postpartum hypertension readmissions.

Methods: This pilot project utilized a descriptive design and took place on a postpartum unit at a Midwest metropolitan high-risk obstetrical teaching hospital. Interventions included patient-specific discharge education, distribution of a home blood pressure cuff, scheduling a blood pressure follow-up appointment prior to discharge, and a follow-up telephone call two days after discharge. Data was collected via retrospective and prospective electronic medical record review.

Results: The total sample size was 50 (25 retrospective and 25 prospective) participants. Although the 30-day postpartum hypertension readmission rate did not decrease, patient follow-up and home blood pressure monitoring increased. The follow-up telephone calls proved to be an opportunity to address patient concerns and questions that may not have been addressed otherwise.

Implications for Practice: Although they did not decrease the readmission rate in this sample, improvements in discharge education, home blood pressure monitoring and the follow-up phone calls were found to be beneficial as they led to improved patient outcomes, readmission when indicated, and increased patient follow-up and contact with a healthcare provider.

Share

COinS