Sue & Bill Gross School of Nursing

Introduction

Hypertensive disorders of pregnancy (HDP) are associated with increased maternal morbidity and long-term cardiovascular disease (CVD) risk. Despite recommendations for early postpartum blood pressure (BP) monitoring and cardiovascular risk counseling, postpartum education regarding HDP and future CVD risk remains inconsistent. This quality improvement (QI) project aimed to implement and evaluate feasibility of a standardized multicomponent educational bundle designed to improve patient knowledge of long-term CVD risk and accurate BP measurement techniques and to ensure patient access to a BP cuff at home.

Methods           

This QI project was implemented on postpartum inpatient units at an academic medical center. The intervention included a brief educational video, printed educational handouts, interactive counseling, and a BP measurement return demonstration checklist. Educational content focused on HDP-associated cardiovascular risk, follow-up recommendations, concerning signs requiring medical evaluation, and home BP measurement technique. Participants completed pre- and post-intervention surveys assessing knowledge related to CVD risk and BP monitoring technique. Other measures included patient satisfaction, completion of BP return demonstrations, and confirmation of patient access to BP cuffs.

Results

Postpartum patients diagnosed with HDP participated in the project (n=7). Most patients demonstrated increased awareness and knowledge following implementation of the educational bundle. 86% of patients reported improved awareness regarding the relationship between HDP and future CVD risk. Knowledge scores related to CVD risk improved in 71% of patients, with mean scores increasing from 31 to 45 out of 100 post-intervention. Knowledge regarding accurate BP measurement technique improved in 57% of patients, with mean scores increasing from 66 to 83 out of 100 post-intervention. 58% of patients reported they were likely or very likely to recommend the educational bundle to others, and all patients confirmed access to a BP cuff at home. Implementation findings highlighted the importance of workflow integration, stakeholder engagement, and timing of education delivery.

Implications and Conclusion

This QI project demonstrated that a standardized multicomponent educational bundle is a feasible approach to improving inpatient postpartum HDP education. The intervention supported patient understanding of long-term CVD risk and BP measurement technique. This project may help inform future refinement and sustainability of standardized postpartum HDP education processes.