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Nursing's Role in Achieving Excellence in Care Delivery Across the Continuum of Health for New Mothers with Hypertension
Title: Nursing's Role in Achieving Excellence in Care Delivery Across the Continuum of Health for New Mothers with Hypertension
- List three signs and symptoms experienced by new mothers with poorly controlled hypertension.
- Describe two key aspects of the nurse-driven, patient safety initiative led to decreased 30-day hospital readmission rates among new mothers with hypertension.
- Discuss how nurses can advocate for health promotion among new mothers with serious and challenging medical conditions such as hypertension.
The purpose of this innovative program was to prevent readmission of new mothers diagnosed with hypertension.
Proposed change:
In 2010, direct care nurses became disturbed with an increased trend of new mothers readmitted to the hospital within 30 days of discharge with complications associated with hypertension, such as: severe headache, blurry vision, nausea and vomiting. These nurses identified a need to educate patients and improve the gap between hospital and home for women facing the major healthcare challenge of hypertension.
Hypertension is the most common medical problem encountered during pregnancy. It occurs in as many as 10% of first pregnancies and 20-30% of women with a history of chronic hypertension. Hypertensive disorders may cause maternal and fetal morbidity and remains a leading cause of maternal mortality.
Implementation, outcomes and evaluation:
Within an interdisciplinary, Mother/Baby Collaborative Care Council, nurses led the development of an innovative, patient-friendly educational program for new mothers with hypertension. A hallmark of this evidence-based, patient safety initiative is close collaboration and care coordination between inpatient Mother/Baby RNs, Case Management RNs and physicians. In addition, within 24-36 hours of discharge from the hospital, every new mother with hypertension has a home visit by a Community Health RN to assess blood pressure and compliance with prescribed medications, diet, etc. These nurses use patient-centered care to address the diverse needs of new mothers with hypertension.
The setting for this innovative program is a 408-bed, Magnet -designated community hospital on Long Island in New York. In 2010, there were 1, 564 deliveries and 38 new mothers were readmitted for treatment of complications associated with hypertension. In 2011, among 1, 456 deliveries, only 5 new mothers were readmitted with hypertension. This represents a decrease in readmissions of new mothers with hypertension of approximately 85%.
Implications for nursing practice:
As patient care advocates, educators and care coordinators, direct care nurses can improve their own professional practice and achieve excellence in care delivery across the continuum for new mothers with special healthcare needs, such as hypertension.
Keywords:
hypertension, preganancy, new mothers