Nursing's Role in Achieving Excellence in Care Delivery Across the Continuum of Health for New Mothers With Hypertension

Abstract

<h2>Paper Presentation</h2><h3>Purpose for the Program</h3> The purpose of this innovative program was to prevent new mothers with hypertension from having to be readmitted to the hospital because of hypertension‐related complications. <h3>Proposed Change</h3> In 2010, direct care nurses became disturbed with an increased trend of new mothers readmitted to the hospital within 30 days of discharge with complications associated with hypertension, such as severe headache, blurry vision, nausea, and vomiting. These nurses identified a need to educate patients facing the major healthcare challenge of hypertension and improve the gap between the care received in the hospital and the home. Hypertension is the most common medical problem encountered during pregnancy. It occurs in as many as 10% of first pregnancies and in 20% to 30% of women with a history of chronic hypertension. Hypertensive disorders may cause maternal and fetal morbidity and remains a leading cause of maternal mortality. <h3>Implementation, Outcomes, and Evaluation</h3> Within an interdisciplinary, Mother/Baby Collaborative Care Council, nurses led the development of an innovative, patient‐friendly educational program for new mothers with hypertension. A hallmark of this evidence‐based, patient safety initiative is close collaboration and care coordination between inpatient mother–baby registered nurses (RNs), case management RNs, and physicians. In addition, within 24 to 36 hours of discharge from the hospital, every new mother with hypertension is visited at home by a community health RN to assess blood pressure and adherence to such things as prescribed medications and diet. These nurses use patient‐centered care to address the diverse needs of new mothers with hypertension. The setting for this innovative program is a 408‐bed, Magnet‐designated community hospital in Long Island, New York. In 2010, there were 1,564 deliveries and 38 new mothers were readmitted for treatment of complications associated with hypertension. In 2011, there were 1,456 deliveries and only five new mothers were readmitted with hypertension. This represents an approximately 85% decrease in readmissions of new mothers with hypertension. <h3>Implications for Nursing Practice</h3> As patient care advocates, educators and care coordinators, direct care nurses can improve their own professional practice and achieve excellence in care delivery across the continuum for new mothers with special healthcare needs, such as hypertension.