Degree Name

Nursing Practice, DNP

Publication Date

9-25-2023

Upload Date

2024

First Advisor

Linda Latting

Abstract

Treatment plans are incomplete until providers address a condition’s impact on a potential pregnancy. Primary care providers (PCPs) routinely treat hypertension (HTN), diabetes (DM), chronic kidney disease (CKD), lupus (LP), and antiphospholipid syndrome (APL), which all increase preeclampsia in pregnancy. PCPs may be more prone to overlook pregnancy potential in the context of diseases than those specializing in obstetrics. This quality improvement (QI) project aimed to see if this was true in a small nurse practitioner-owned and run family practice clinic in Oklahoma. A 2022 retrospective chart review for non-pregnant reproductive-age adult females confirmed that no ICD-10 codes for HTN, DM, CKD, LP, or APL co-occurred with a family planning (FP) code. To improve provider recognition of preeclampsia risk and the occurrence of complete treatment plans that included FP for females with HTN, DM, CKD, LP, or APL, non-pregnant adult females received an evidence-based screening for pregnancy potential and disease presence at clinic check-in. Providers received all positive screenings (n = 24) as an alert to the provider for same-visit FP counseling. Results indicate that adopting the screening as a QI measure increased recognition of risk and subsequent same-day FP counseling by 87.5% (z = -12.96, p < .001, 95.00% CI: [-1.01, -.74]). Implications for practice include increasing rates of appropriate, timely, patient-centered FP to those at higher risk of developing preeclampsia should a pregnancy occur, potentially offsetting the extreme patient and healthcare system costs associated with the condition and keeping this patient population safer.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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