Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-11-2018

Graduate Advisor

Nancy Magnuson

Committee

Roberta Lavin

Roxanne Vandermause

Heidi Tymlew

Abstract

Problem: The gold standard for managing preeclampsia in the postpartum patient is 24- hours of magnesium sulfate as this is the time the patient is most susceptible to experiencing a seizure (American College of Obstetricians & Gynecologists, 2013). However, these patients are at an increased risk for experiencing adverse health outcomes, as well as interruptions in maternal-infant bonding due to the mother requiring a higher level of care. Methods: A one group pretest-posttest design was conducted to gain a better understanding of the current practice while also assessing the willingness of physicians to change prescribing behavior after receiving the research-based education. Results: During the study period, 49 obstetric providers agreed to participate in the study. There was no statistically significant difference between survey results regarding likelihood to prescribe a reduced course of magnesium sulfate (p=.821). However, there was a statistically significant difference seen between the perception that 24-hours of magnesium sulfate is necessary to manage preeclampsia (p=.020) and the theory that patients with preeclampsia without severe features could benefit from an abbreviated treatment course (p=.012). Implications for Practice: While data results do not indicate an immediate change in the prescribing of magnesium sulfate, physicians expressed interest in continued efforts to study this topic. There is an opportunity to improve patient safety by standardizing patient education. Additionally, a discrepancy was noted between the physicians’ perceptions of the postpartum acuity of the preeclamptic patient. Bridging the gap between nursing and providers ensures that providers have a reasonable expectation of the postpartum experience.

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