Transcript Pregnancy induced hypertension

Increasing awareness of Pregnancy Induced Hypertension (PIH)
Amanda Parker, SN and Gina Robinson, SN
Purpose
The purpose of this project is to increase the knowledge regarding
pregnancy induced hypertension (PIH) for patients that are
hospitalized during pregnancy.
Aims are to prevent complications related to lack of knowledge,
increase knowledge regarding signs and symptoms along with risk
factors for developing PIH, medications prescribed along with side
effects associated with them, and an overall increase of knowledge
regarding PIH among patients in labor. Less hospitalizations and
adverse events will occur due to this education and elimination of
hospitalizations/admissions to antepartum for factors related to PIH.
Statistics
 1 in 14 pregnancies worldwide (Cleveland Clinic, 2013).
In the U.S., preeclampsia is responsible for approximately
18% of all maternal
deaths (Bureau, 2002).
High blood pressure can harm the mother's kidneys and
other organs, and it can cause low birth weight and early
deliveryn( High Blood Pressure).
 Brochures will be given to women at risk upon
admission that describe common signs and symptoms of
the disease, what puts women at risk, what medications
are prescribed and what their side effects are. It will also
include animations for those that are unable to read the
literature given.
Patient teaching will be done by Labor and Delivery
RN’s and Mother/Baby RN’s, and patients will then
verbalize what they have learned regarding the disease.
PIH is a form of high blood pressure during pregnancy.
Three primary characteristics of the disease are a BP
reading higher than 140/90, protein in the urine, and
edema. It is one of the leading causes of maternal death
and without proper treatment can result in seizures, kidney
and liver damage, and death (Children’s Hospital of
Wisconsin, 2014).
PIH is also more common in pregnant teens and in
women over age 40. it can develop at any time during
pregnancy but is more common after 20 weeks and can
occur after delivery. (Cleveland Clinic, 2013)
Limitations / Lessons Learned
We could run into the issue of women not understanding
the brochure. Since PIH affects pregnant teens they may
be less likely to actually read and follow the information on
the brochure.
Limitations to the project could be women that
come in during labor and have PIH and never mention
the condition to nursing staff until a high blood
pressure
E reading is obtained and this can be fatal as
seizures can occur without proper treatment.
 Early identification of PIH and education about warning
signs and symptoms is critical because early recognition
will allow patients to receive earlier care and prevent
worsening of the disease. If women receive patient
teaching at the time of admission, they will know how to
recognize signs and symptoms that may occur during and
after delivery, and throughout future pregnancies.
References
Improvement Tools/Methods
 Plan-Do-Study-Act improvement method
Brochures will be given to women at risk for PIH at time
of admission which will include both literature and
animations in an easy to read format.
 After patient teaching is completed, patients will be
asked to demonstrate their understanding by stating the
signs/symptoms of PIH along with factors that put
women at risk for the disease, which medications are
prescribed and the common side effects associated with
them. This will allow Bayfront Baby Place to assess how
effective patient teaching on PIH is during hospitalization
along with how competent these women are regarding
the disease.
Process Improvement
Background
Patient teaching will be initiated at the bedside by Triage
RN’s who will implement the treatment needed for PIH
upon arrival to Baby Place. Labor and Delivery RN’s will
then continue the plan of treatment prior to delivery and go
over the risks and benefits of some procedures associated
with PIH and what needs to be done to control the issue
after delivery. Mother/Baby RN’s will continue the teaching
until point of discharge. Patient teaching will be verbalized
by the RN’s to the patients.
Patients will demonstrate an understanding of the topic
by verbalizing what they have learned back to the nurse.
Measures
Team Members
 Triage RN’s
 Labor and Delivery RN’s
 Labor and delivery charge nurse
Mother/Baby Rn’s
Mother/Baby charge nurse
Nurse Manager/ Educator for Baby Place
All patient care technicians
Bayfront Baby Place
 Bureau 2002: www.prb.org/pdf/WorldPopulationDS02_Eng.pdf
 Children’s Hospital of Wisconsin (2014). Pregnancy induced
hypertension. Retrieved from: http://www.chw.org/medical-care/fetalconcerns-center/conditions/pregnancy-complications/pregnancyinduced-hypertension/
 "Diseases & Conditions." Pregnancy Induced Hypertension. N.p., 08
Dec. 2013. Web. 18 June 2014.
<http://my.clevelandclinic.org/healthy_living/pregnancy/hic_pregnan
cy-induced_hypertension.aspx>.
 Nugteren, J., Snijder, C., Hofman, A., Jadone, V., Steegers, E.,
Burdorf, A. (2012). Work-related maternal risk factors and the risk of
pregnancy induced hypertension and preeclampsia during
pregnancy. PLOS one, 10, 1371.
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.p
one.0039263
 Pregnancy Hypertension: An International Journal of Women's
Cardiovascular Health - 12 May 2014
(10.1016/j.preghy.2014.04.003) High Blood Pressure in Pregnancy."
High Blood Pressure in Pregnancy. N.p., n.d. Web. 19 June 2014.
<http://www.nhlbi.nih.gov/health/public/heart/hbp/hbp_preg.htm>.