Improving Patient Safety by Increasing Patient Access to Blood Pressure Monitoring Kits and a Follow-Up Guide for Postpartum Patients

Abstract

During a review of data regarding obstetric readmissions, it was noted that approximately half of the postpartum readmissions were because of elevations in blood pressures. Postpartum hypertension is observed in as many as 20% of women within 6 weeks of birth. For many patients who are discharged, the next blood pressure check would be at their 6-week postpartum check-up, unless noted with symptoms of high blood pressure, such as severe headache, visual changes, and/or epigastric pain. To provide blood pressure kits and a standardized blood pressure monitoring guidance grid for all patients who were noted with some type of hypertensive issue, on discharge from the hospital (chronic hypertension, gestational hypertension, or preeclampsia). A blood pressure monitoring kit was selected. A standardized home guidance grid was created for postpartum patients, with input from obstetric physicians regarding parameters for follow up. E-mails were sent to all obstetric physicians to alert them of the purpose of and availability of the program. Training was provided for all the obstetric and postpartum nurses on how to educate the patient in regard to use of the blood pressure kit and the guidance grid. Some patients were readmitted earlier. Several patients were able to start on blood pressure medication or have medication adjustments made in the outpatient setting. Verbal feedback from the patients who received the blood pressure kit has been positive. Some patients have stated that it would have been difficult to go and purchase a new blood pressure cuff for monitoring with a newborn. Programs such as this for home blood pressure monitoring and increases in patient education regarding postbirth warning signs will lead to an increased awareness about issues that can occur in the postpartum period. These programs and the actions to remove barriers for patients will likely lead to an increase in patient safety.