Date of Degree

12-2021

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Holly A. DiLeo

Advisor

Nicole Van de Putte

Abstract

Background: Hypertensive disorders during pregnancy have a detrimental effect on maternal and fetal outcomes, causing low birth weights, preterm births, and stillbirths. During pregnancy, hypertensive disorders affect up to 13% of all pregnancies and make up 10% of all maternal mortality in the United States (Centers for Disease Control and Prevention [CDC], 2019). Purpose: The purpose of this DNP project was to implement and standardize a high-risk obstetrical initiative for hypertensive mothers. Summary of Evidence: Data suggest that increased education and increased surveillance for high-risk obstetric patients decreases the need for obstetric services and decreases the evolution of hypertensive disorders during pregnancy. Objectives: This project aimed to decrease mother and infant morbidity and mortality by standardizing an FQHC’s high-risk OB initiative, which attempted to provide face-to-face education with weekly telehealth follow-ups by a Registered Nurse in addition to regular obstetrical appointments. Interventions: Interventions included implementing a standardized enrollment and referral process, creating an electronic dashboard, and providing standardized in-person education and follow-up monitoring by a Registered Nurse. Increasing education and weekly follow-up monitoring will assist in early recognition of hypertensive disease progression and timely patient-specific interventions. Outcomes: The program increased patient program enrollment by 940% and educated fifty-seven pregnant women on the signs and symptoms of preeclampsia and eclampsia. Implications for Practice: This program provides a framework to reduce perinatal and maternal mortality related to hypertensive disorders during pregnancy. This program also strives to empower women during their pregnancy to be active participants in their pre- and post- birth health.

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