Follow‐up Text Messages for Patients at High Risk of Postpartum Hypertension

Abstract

Poster Presentation Purpose for the Program A subset of postpartum patients in whom hypertension was diagnosed was readmitted within 7 days of giving birth at the hospital because of advancing disease. Our current practice for providing care to these women was to have them return for reevaluation at a 1‐week follow‐up appointment at our hypertensive clinic. As a result of our readmission data, we determined that increased outreach was needed between discharge time and follow‐up time when subtle signs of advancing disease may occur. Proposed Change To improve patient outcomes and decrease our 7‐day readmission rate for this population, we piloted a nurse outreach program using text messages (TM) as a tool to bridge this time gap. We hypothesized that TM would provide the woman flexibility in response time that would better meet her and her infant's needs during this early recovery period. The implementation of TM is not time dependent, and the script can be cut and pasted from patient to patient. Implementation, Outcomes, and Evaluation The purpose of this TM was to provide reassurance, answers to questions and problem‐solving solutions, and to identify women who needed escalated care. We developed a standardized TM that was sent to women 3 to 4 days after discharge. During our 3‐month pilot ( N = 123 patients), we observed a 34% ( n = 41) response rate; 27% ( n = 11) required a follow‐up phone contact to attain additional information to determine if escalation was needed. In nine instances, phone triage was adequate in addressing concerns. Two of the 11 phone contacts indicated a need for escalation in care and referral to an acute care center. In one TM the woman stated, I'm at the baby's appointment and they checked my blood pressure and I think I need to go to the hospital but I have no way to get there. In response to this woman's needs, the nurse called the woman to obtain further assessment, determined that additional care was required, and facilitated the woman's transport to care. Implications for Nursing Practice Nurses and participants expressed satisfaction with TM. Because of the success of this pilot program, we plan to offer it to all postpartum women in whom hypertension is diagnosed to determine whether our 7‐day readmission rate for this issue decreases.