Date of Conferral

2022

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Bridgette Malchow

Abstract

AbstractThe United States has the highest maternal mortality rate among industrialized nations, and hypertension is one of the leading causes of maternal morbidity and mortality. Given that pregnancy-related hypertension can develop anytime during the perinatal period, and complications arising from this condition can cause harm, early detection is associated with better outcomes. Best practice alerts in the electronic health record and Blue-tooth-enabled medical devices linked to health information systems can provide real-time notification of critical values to health care professionals. This project evaluated the clinical usefulness of two health care technologies—preeclampsia e-alerts and remote blood pressure monitoring—in facilitating early detection of maternal hypertension. The project was supported by the Wagner Chronic Care Model. Sources of evidence included an internal database, peer-reviewed articles, de-identified quality improvement data, and semi-structured interviews with two program coordinators. QI Macros control chart was used to analyze the preeclampsia e-alert data. Remote patient monitoring data, including acceptance rate, transmission rate, and acute hypertension protocol adherence, were reviewed to evaluate timely and evidence-based hypertension management. The analysis showed that simultaneous use of preeclampsia e-alerts and telemonitoring enables earlier detection and improved surveillance of maternal hypertension. This project substantiates that the adoption of innovative, technology-based approaches for monitoring and managing maternal hypertension has high potential to decrease hypertension-related morbidity and mortality, which can contribute to positive social change across multiple communities.

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