In response to the rising rates of hypertensive emergencies in pregnant patients, Froedtert Hospital’s Birth Center implemented the Alliance for Innovation on Maternal Health (AIM) Severe Hypertension in Pregnancy Patient Safety Bundle. Nurses collaborated with other health care professionals to develop protocols, algorithms, staff education, simulations and patient education. Algorithms were created to identify severe hypertension and notification parameters, with the ultimate goal of administering the appropriate anti-hypertensive medication within 60 minutes of the initial blood pressure result.
Simulations and education modules were provided initially and continued annually. In 2021, the Birth Center joined the Wisconsin Perinatal Quality Collaborative (WisPQC) Maternal Hypertension Initiative. WisPQC assisted with data collection and use of Plan-Do-Study-Act cycles to improve Froedtert Hospital patient outcomes. Initial baseline data showed Froedtert Hospital patients receiving treatment within the first 60 minutes had fluctuated between 63%-96% from month to month. Over time, significant progress has been achieved, delivering anti-hypertensive treatment within 60 minutes at a rate of 90% or above.
Standardized treatment reduces complications for both the birthing parent and the baby, and it identifies patients needing postpartum hypertension follow-up care. To ensure ongoing monitoring, the Birth Center implemented the Babyscripts Postpartum Hypertension Program. Under this program, individuals with hypertensive disorders receive a blood pressure cuff upon discharge and are instructed to regularly monitor their blood pressure at home. Through a dedicated application on their smart devices, patients can conveniently upload their readings, which are monitored 24/7. In the event of elevated or severe results, patients are promptly contacted and guided through the necessary next steps. The Birth Center and nursing team remain committed to prioritizing hypertension, thereby aiding in the reduction of hypertensive morbidity and mortality.