实施由护士发起的方案，改善围产期严重高血压的应对措施。

IF 3.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

American Journal of Obstetrics & Gynecology Mfm Pub Date : 2024-07-09 DOI:10.1016/j.ajogmf.2024.101424

引用次数: 0

摘要

背景：为提高对围产期高血压急症的识别和应对能力，医院实施了由护士发起的标准化方案：为提高对围产期高血压急症的识别和应对能力，医院实施了一项由护士发起的标准化方案：研究设计：这项质量改进措施由一个多学科团队制定，包括临床医生和护理人员教育，以及实施由护士发起的标准化重度高血压治疗方案。该项目分为三个阶段：实施前（2020 年 7 月至 2020 年 10 月）、实施（2020 年 11 月至 2021 年 6 月）和维持（2021 年 7 月至 2022 年 5 月）。主要目的是在孕妇和产后人群中增加以指南为基础的高血压急诊治疗。以指南为基础的治疗是指在严重高血压发生后 30 分钟内复查血压以确诊高血压急症，在确诊后 30 分钟内服用降压药，并在治疗后适时复查血压。过程测量包括确诊时间、启动方案时间、降压药物用药时间、降压药物用药后复查血压时间，以及适当的二次用药时间。平衡指标包括产妇入住重症监护室、临床上明显的产妇低血压、胎儿死亡、新生儿出生体重和 Apgar 结果：在项目实施期间，共发现 503 例高血压急诊（实施前 98 例[20%]，实施时 172 例[34%]，持续时 233 例[46%]）。与其他阶段相比，持续阶段的慢性高血压患者和自我认同为非西班牙裔黑人的比例较高。基于指南的治疗从实施前的 18.4% 增加到持续阶段的 75.1%（结论）：护士发起的高血压急症治疗方案大大提高了围产期高血压急症的指导性治疗，缩短了诊断和治疗高血压急症的时间，并增加了在有指征时接受治疗的患者人数。该方案非常实用，利用了产科现有的资源。提供产科护理的机构可考虑使用类似方案，以提高对高血压急症的识别和应对能力，从而降低与高血压急症相关的孕产妇和新生儿发病率和死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Implementing a nurse-initiated protocol to improve response to perinatal severe hypertension

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来源期刊

American Journal of Obstetrics & Gynecology Mfm Medicine-Medicine (all)

CiteScore

7.40

自引率

3.20%

发文量

254

审稿时长

40 days

期刊介绍： The American Journal of Obstetrics and Gynecology (AJOG) is a highly esteemed publication with two companion titles. One of these is the American Journal of Obstetrics and Gynecology Maternal-Fetal Medicine (AJOG MFM), which is dedicated to the latest research in the field of maternal-fetal medicine, specifically concerning high-risk pregnancies. The journal encompasses a wide range of topics, including: Maternal Complications: It addresses significant studies that have the potential to change clinical practice regarding complications faced by pregnant women. Fetal Complications: The journal covers prenatal diagnosis, ultrasound, and genetic issues related to the fetus, providing insights into the management and care of fetal health. Prenatal Care: It discusses the best practices in prenatal care to ensure the health and well-being of both the mother and the unborn child. Intrapartum Care: It provides guidance on the care provided during the childbirth process, which is critical for the safety of both mother and baby. Postpartum Issues: The journal also tackles issues that arise after childbirth, focusing on the postpartum period and its implications for maternal health. AJOG MFM serves as a reliable forum for peer-reviewed research, with a preference for randomized trials and meta-analyses. The goal is to equip researchers and clinicians with the most current information and evidence-based strategies to effectively manage high-risk pregnancies and to provide the best possible care for mothers and their unborn children.