Peripartum Cardiomyopathy

Abstract

The care of women with peripartum cardiomyopathy (PPCM) presents unique nursing challenges. It is imperative that the health care team has a solid understanding of cardiac disease and pregnancy. All nurses know that cardiac disease impacts the maternal–fetal dyad, but few nurses possess the degree of knowledge required to provide optimal care to women with PPCM throughout the perinatal continuum of care. A formal needs assessment was conducted with the nursing staff of the heart failure center and obstetric units. Results indicated a perceived increase in the incidence of the diagnosis, an overwhelming need for education regarding the care of a woman with PPCM, and a desire to form an alliance between cardiac and perinatal advanced-practice nurses to provide seamless care for patients with PPCM. Education was provided to cardiac and obstetric nurses. The following resources were created: inpatient care guidelines; a heart failure stoplight specific for use during pregnancy; a list of safe medications in pregnancy–breastfeeding; contraception options, and patient education. Education was provided to nurses in both units. Pretest score mean was 50.7%. All nurses demonstrated improvement in posttest scores after education (posttest score M = 95.3%; 100% nurses scored more than 85% on posttest). Since inception of this program, we have provided care for 10 patients with PPCM. Equally as important as increased knowledge is the now-present open line of consultation and collaboration among the heart failure nurses, obstetric nurses, and perinatal clinical nurse specialist. A diagnosis of PPCM is frightening, unexpected, and overwhelming. As the shock of the diagnosis subsides and the reality of the disease’s impact on daily living sets in, it becomes clear that added levels of support are necessary. That, in part, is why this initiative was developed. Knowledge empowers nurses and patients. Knowledge enables nurses to provide the requisite intricate care for this high-risk population. Knowledge assists the patients in decreasing stress and anxiety, thereby allowing them to concentrate on caring for themselves and their newborns. This type of holistic care can only be provided through multidisciplinary collaboration.