1. Purpose Improvement Tools/Methods Limitations / Lessons Learned Statistics Process Improvement Increasing awareness of Pregnancy Induced Hypertension (PIH) Amanda Parker, SN and Gina Robinson, SN  The purpose of this project is to increase the knowledge regarding pregnancy induced hypertension (PIH) for patients that are hospitalized during pregnancy.  Aims are to prevent complications related to lack of knowledge, increase knowledge regarding signs and symptoms along with risk factors for developing PIH, medications prescribed along with side effects associated with them, and an overall increase of knowledge regarding PIH among patients in labor. Less hospitalizations and adverse events will occur due to this education and elimination of hospitalizations/admissions to antepartum for factors related to PIH.  PIH is a form of high blood pressure during pregnancy. Three primary characteristics of the disease are a BP reading higher than 140/90, protein in the urine, and edema. It is one of the leading causes of maternal death and without proper treatment can result in seizures, kidney and liver damage, and death (Children’s Hospital of Wisconsin, 2014).  PIH is also more common in pregnant teens and in women over age 40. it can develop at any time during pregnancy but is more common after 20 weeks and can occur after delivery. (Cleveland Clinic, 2013)  Early identification of PIH and education about warning signs and symptoms is critical because early recognition will allow patients to receive earlier care and prevent worsening of the disease. If women receive patient teaching at the time of admission, they will know how to recognize signs and symptoms that may occur during and after delivery, and throughout future pregnancies.  Brochures will be given to women at risk upon admission that describe common signs and symptoms of the disease, what puts women at risk, what medications are prescribed and what their side effects are. It will also include animations for those that are unable to read the literature given.  Patient teaching will be done by Labor and Delivery RN’s and Mother/Baby RN’s, and patients will then verbalize what they have learned regarding the disease.  We could run into the issue of women not understanding the brochure. Since PIH affects pregnant teens they may be less likely to actually read and follow the information on the brochure.  Limitations to the project could be women that come in during labor and have PIH and never mention the condition to nursing staff until a high blood pressure reading is obtained and this can be fatal as seizures can occur without proper treatment. Bayfront Baby Place  Plan-Do-Study-Act improvement method  Patient teaching will be initiated at the bedside by Triage RN’s who will implement the treatment needed for PIH upon arrival to Baby Place. Labor and Delivery RN’s will then continue the plan of treatment prior to delivery and go over the risks and benefits of some procedures associated with PIH and what needs to be done to control the issue after delivery. Mother/Baby RN’s will continue the teaching until point of discharge. Patient teaching will be verbalized by the RN’s to the patients.  Patients will demonstrate an understanding of the topic by verbalizing what they have learned back to the nurse.  Brochures will be given to women at risk for PIH at time of admission which will include both literature and animations in an easy to read format. References  Bureau 2002: www.prb.org/pdf/WorldPopulationDS02_Eng.pdfwww.prb.org/pdf/WorldPopulationDS02_Eng.pdf  Children’s Hospital of Wisconsin (2014). Pregnancy induced hypertension. Retrieved from: http://www.chw.org/medical-care/fetal- concerns-center/conditions/pregnancy-complications/pregnancy- induced-hypertension/http://www.chw.org/medical-care/fetal- concerns-center/conditions/pregnancy-complications/pregnancy- induced-hypertension/  "Diseases & Conditions." Pregnancy Induced Hypertension. N.p., 08 Dec. 2013. Web. 18 June 2014.. "Diseases & Conditions." Pregnancy Induced Hypertension. N.p., 08 Dec. 2013. Web. 18 June 2014. <http://my.clevelandclinic.org/healthy_living/pregnancy/hic_pregnan cy-induced_hypertension.aspx>.  Nugteren, J., Snijder, C., Hofman, A., Jadone, V., Steegers, E., Burdorf, A. (2012). Work-related maternal risk factors and the risk of pregnancy induced hypertension and preeclampsia during pregnancy. PLOS one, 10, 1371. http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.p one.0039263 http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.p one.0039263  Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health - 12 May 2014 (10.1016/j.preghy.2014.04.003) High Blood Pressure in Pregnancy." High Blood Pressure in Pregnancy. N.p., n.d. Web. 19 June 2014.. High Blood Pressure in Pregnancy." High Blood Pressure in Pregnancy. N.p., n.d. Web. 19 June 2014.. Background  1 in 14 pregnancies worldwide (Cleveland Clinic, 2013).  In the U.S., preeclampsia is responsible for approximately 18% of all maternal deaths (Bureau, 2002). High blood pressure can harm the mother's kidneys and other organs, and it can cause low birth weight and early deliveryn( High Blood Pressure). Team Members  Triage RN’s  Labor and Delivery RN’s  Labor and delivery charge nurse  Mother/Baby Rn’s  Mother/Baby charge nurse  Nurse Manager/ Educator for Baby Place  All patient care technicians Measures  After patient teaching is completed, patients will be asked to demonstrate their understanding by stating the signs/symptoms of PIH along with factors that put women at risk for the disease, which medications are prescribed and the common side effects associated with them. This will allow Bayfront Baby Place to assess how effective patient teaching on PIH is during hospitalization along with how competent these women are regarding the disease. E