210 Postpartum educational initiative to improve knowledge of warning signs of severe maternal morbidity

Abstract

To evaluate whether the implementation of a postpartum educational initiative is associated with improved knowledge of warning signs of severe maternal morbidity. The Association of Patients' Health, Obstetric, and Neonatal Nurses aimed to improve postpartum discharge instruction with an educational flyer, "POST-BIRTH," that described 9 warning signs of severe maternal morbidity (SMM). The first 4 signs (Pain in chest, Obstructed breathing, Seizures, Thoughts of harm) require a call to emergency services (EMS) and the next 5 require contacting a provider immediately (Bleeding, Incision complications, Red or swollen leg, Temperature elevation, persistent Headache). We utilized the flyer in a pre and post-implementation study of English-speaking postpartum patients discharged with a live neonate who could be contacted within 2 weeks by phone to assess their knowledge of the warning signs. Our primary outcome was the percentage of correct answers, defined as contacting EMS for questions related to "POST" or a provider immediately for those related to "BIRTH." Our secondary outcomes were the percentage of nearly correct answers, defined as contacting either EMS or a provider immediately for any of the scenarios, and correct and nearly correct responses for each. Pre-implementation, 347 patients were discharged, 164 (44.7%) were eligible, and 151 (90.4%) completed the survey. Post-implementation, 268 patients were discharged, 199 (74.3%) were eligible, and 183 (92.0%) completed the survey. The post-implementation group was younger and more likely to be publicly insured (Table 1). Compared to the pre-implementation group, the post group had significantly more correct responses (30% v. 60%, P<0.001) and nearly correct responses (80% v. 90%, P<0.001). Those in the post group were more likely to answer correctly for all scenarios, with the exception of seizures (Table 2). The implementation of an educational initiative for postpartum patients is associated with improved knowledge of warning signs of severe maternal morbidity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)