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Andrea M Ferrara, DNP, CNM
DNP: Southern California CSU DNP Consortium, Fullerton
Master of Science, Nursing: University of Southern California
Bachelor of Science, Nursing: University of Southern California
 
Enhancing Maternal Outcomes: Evaluation of the OB Hypertension Pilot Program
Project  
Abstract:
Purpose: This program evaluation examines retrospective data from the OB Hypertension Program (OHP) at a large Southern California medical center. The OHP was designed to reduce complications from Hypertensive Disorders in Pregnancy (HDP) by standardizing workflows for patient care and education, ensuring equitable care, and addressing healthcare disparities. Background: HDP is a leading cause of pregnancy-related mortality. At this medical center, chronic hypertension affects 12% of Black patients and 7% of Hispanic patients, compared to 2.6% of White patients. Methods: Using the Logic Model framework, this evaluation analyzed the first 60 OHP participants, focusing on interventions such as low-dose aspirin (LDA) prescribing, standardized counseling and education, enrollment in remote blood pressure monitoring (RBPM), postpartum follow-up within 7–10 days, and assessment of social determinants of health. Results: Patient education by clinicians regarding HDP and associated risks was documented 93.3% (n = 56) of the time, while nursing staff documented HDP education 100% (n = 60) of the time. Among patients with preexisting hypertension (n=14) prescribed LDA, the development of superimposed preeclampsia (n=8) showed minimal reduction (p = .673). Postpartum preeclampsia with readmission occurred in 7% of patients. However, 55 of 60 patients consistently monitored their blood pressure, demonstrating strong adherence. Case manager satisfaction with workflow was also assessed. Implications: OHP improved HDP education, increased LDA prescribing, and enhanced staff knowledge to identify high-risk patients. It successfully increased compliance with RBPM antenatally and postpartum. Though not statistically significant, the high rate of superimposed preeclampsia in LDA patients warrants further investigation.
Team Leader: Laura Sarff, DNP, RN, MBA, CPHQ, NEA-BC
Team Member: Norma Bates, DNP, CNM

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