ABSTRACT:
Background and significance: Hypertensive disorders of pregnancy complicate about 10% pregnancies and are a leading cause of maternal morbidity and mortality
Purpose : The purpose of this quality improvement project was to evaluate a program a home blood pressure monitor to all postpartum patients who had a hypertensive diagnosis and elevated blood pressure.
Methods: The program includes a blood pressure monitor, instructions for its use, education about hypertension, and a guidance grid with standardized blood pressure parameters reviewed prior to discharge from the hospital. Patients are taught about potential adverse outcomes during postpartum. Patients are instructed to follow-up with their care provider based on the parameters. A retrospective medical record review was used to evaluate clinical outcomes.
Results : Medical records of 185 patients indicated that 20% (n=36) who received the home BP monitor reported one or more mild-o-severe range blood pressure(s) during postpartum. Twenty-eight percent (n=52) had outpatient medication adjustments, including decreasing, increasing, starting, and discontinuing medications. Nice percent (n=17) of patients returned to the obstetric triage for evaluation. There was patient overlap between those those experiencing elevated blood pressures, medication adjustment, and those who returned to hospital to evaluation,
Clinical Implications : Ongoing monitoring may improve identification and management of postpartum hypertension and potentially prevent progression to progression to hypertensive -related adverse events.