Hypertensive disorders of pregnancy (HDPs) are among the leading causes of severe maternal morbidity and mortality and are preventable when caught and treated appropriately.. In 2021, ALPQC will start the Maternal Hypertension (HTN) Initiative. The resources below have been compiled by an ALPQC subcommittee to help your hospital team establish protocols, processes, and education to ensure pregnant and postpartum patients with hypertension/preeclampsia are identified quickly and managed well to avoid further complications.
ALPQC initially introduced the HTN initiative at the 2020 Annual Summit (see link for Summit agenda and slides at the bottom of this page). The kickoff for the HTN Initiative will take place on January 29th,2021.
Key Documents
Maternal Hypertension Toolkit & Checklist
Maternal Hypertension Driver Diagram
Worksheets
Plan-Do-Study-Act (PDSA) Cycles
Maternal HTN Toolkit
Readiness: Develop & Implement Standard Processes for Optimal Care
- ACOG Committee Opinion 767: Emergent Therapy for Acute-Onset, Severe Hypertension During Pregnancy and the Postpartum Period
- Maternal Early Warning Criteria Protocols and Resources – Council on Patient Safety on Women’s Health Care
- Emergency Department Guidance – FPQC
- Emergency Department Recognition and Treatment – CMQCC
- CMQCC Preeclampsia Toolkit
- Safety Action Series: Blood Pressure Basics
- 7 Simple Tips to Get an Accurate BP Measurement – AHA, AMA
- Accurate BP Measurement – OPQIC
Recognition & Prevention: Educate, Identify, Assess
- Clinical Staff Education
- Severe Hypertension in Pregnancy Bundle & Resources – Alliance for Innovation on Maternal Health (AIM)
- AIM eModules on Severe Hypertension in Pregnancy – Includes 5 modules ranging from 5 to 20 minutes.
- AIM eModule MEWS
- Severe Hypertension in Pregnancy – ACOG District II
- Patient, Family and Staff Support After a Severe Maternal Event AIM Bundle & Resources
- Getting Back Up: Being and Helping the Second Victim – SMFM
- Conduct Regular Drills of Severe Hypertension Protocols
- Safety Action Series: Hypertension Drills
- Obstetric Drill Manual – Council on Patient Safety in Women’s Health Care
- The Role of Medical Simulation – CMQCC
- ACOG District II Simulation and Drill Scenarios & Tools (bottom of page)
- ACOG Simulation Eclampsia Formative Evaluation
- Simulation Scenario – CMQCC
- Drills Change Form – Council on Patient Safety in Women’s Health Care
- Support After a Severe Maternal Event AIM Bundle & Resources
- Getting Back Up: Being and Helping the Second Victim – SMFM
Respond: Timely Treatment of Severe Hypertension
- Timely treatment of severe hypertension
- AIM FAQ Treatment of Severe Hypertension
- First Line Therapies and Seizure Prophylaxis – ACOG District II
- Steps for Preparation, Storage, Ordering and Administration of Magnesium Sulfate – CMQCC
- Post-Discharge Evaluation of Elevated BP – ACOG District II
- Protocols, Draft Order Sets and Checklists:
- ACOG Hypertensive Emergency Checklist
- ACOG Eclampsia Checklist
- ACOG Emergency Department Postpartum Preeclampsia Checklist
- First Line Therapies Algorithms – ACOG District II
- ACOG Sample Order Sets Pocket Guide – ILPQC
- CMQCC Preeclampsia Toolkit
- Sample Preeclampsia/Eclampsia Medication Toolbox – CMQCC
- Provide Patient-Centered Education on Severe Hypertension
- Prenatal and Postpartum Patient Counseling or Education – CMQCC
- FPQC Sample Discharge Instructions
- Urgent Maternal Warning Signs Flyer – ACOG (English and Spanish)
- AWHONN Post Birth Warning Signs Educational Materials (Available in multiple languages)
- Preeclampsia Foundation Signs and Symptoms Materials (English and Spanish)
- Preeclampsia Patient Education Handout – ACOG District II
- Maternal Mental Health: Depression and Anxiety AIM Bundle & Resources
Change Systems: Foster a Culture of Safety and Improvement
- Respectful Patient Partnership
- Safety Action Series – Empowering Patients, Improving Outcomes
- ACOG District II Symposium on Racial Disparities and Implicit Bias in Obstetrical Care
- Reduction of Peripartum Racial/Ethnic Disparities AIM Bundle & Resources
- Harvard Project Implicit
- IHI Achieving Health Equity: A Guide for Health Care Organizations
- March of Dimes – A Health Crisis Impacting Women and Babies of Color
- CDC Hear Her Campaign
- Conduct Debriefs to Evaluate Effectiveness of Care, Treatment, Services
- Huddles, Debriefs, Multi-Disciplinary Reviews Tools
- TeamSTEPPS Team Strategies & Tools to Enhance Performance and Patient Safety: Briefs, Debriefs and Huddles
- Severe Hypertension-Preeclampsia Debrief Form – CMQCC
- FPQC Hypertension in Pregnancy Debriefing Guidance, Forms and Tips
- ILPQC Severe Hypertension Debrief Form
- Severe Maternal Morbidity Review Guidance & Forms – Council on Patient Safety in Women’s Health Care
Additional Resources
- ACOG District II Safe Motherhood Initiative App
- ILPQC Severe Maternal Hypertension Initiative
- FPQC Hypertension in Pregnancy Initiative
- SMFM Course: New Joint Commission Standards for Maternal Safety – Practical Strategies for Implementation
- The Joint Commission R3 Report Issue 24: PC Standards for Maternal Safety
ALPQC 2020 Summit Video and Slides
