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2021 prov rn ca; 2021 prov rn poster; alaska; anchorage; pamc
Nursing | Obstetrics and Gynecology
Background: In 2019, a large hospital in Alaska joined the Alaska Perinatal Quality Collaborative (PQC). The first project was the AIM Hypertension Project. The goals of the project were to reduce severe maternal morbidity among preeclampsia cases by 20% and Increase the timely treatment of hypertension to 80%. Other process and structure measures included education, simulation, clinical debriefs, and follow-up visits.
Methods/Approach: The PQC used monthly educational sessions, data collection and review of every case with severe hypertension, and Plan-Do-Study-Act cycles. Data collection occurred over an 18-month period. Cases were identified by the Washington State Hospital Association database and reviewed for timely treatment of severe hypertension. Timely treatment is defined as either a systolic BP of equal to or greater than 160mmHg or diastolic equal or greater than 120mmHg that persists for greater than 15 minutes. The patient must be treated with an anti-hypertensive within 60 minutes of the first blood pressure.
Results: Data collection occurred from July 2019-December 2020. A total of 225 cases were reviewed. The 2020 rate of timely treatment of severe hypertension increased to 81.3% (Goal of 80%). The project was able to reduce the variation in practice. There were three months with 100% timely treatment. In measuring the Severe Maternal Morbidity from Pre-eclampsia cases, the 2019 rate was 8.4%. The2020 rate was 6.9% (Goal 6.72%). The PSJH overall rate was 8.7%.
Conclusions: This project was able to standardize the processes around the management of severe hypertension through order sets, standards of work, education, simulation, and EPIC alerts. This large hospital implemented bedside debriefs and quarterly case reviews of cases that resulted in severe maternal morbidity.
Implications for Practice: This project demonstrated the power of working collaboratively with the statewide PQC to improve patient outcomes. There were significant challenges with COVID-19 priorities and distractions. Overall, both nurses and physicians are committed to timely treatment and the reduction of severe maternal morbidity.
Women & Children
Obstetrics & Gynecology
Conference / Event Name
2021 Providence RN Conference
Schloeder, Danette, "Improving Outcomes for Pregnant Women with Severe Hypertension" (2021). View all. 30.