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Running head: BLOOD PRESSURE DEVICE IN OBSTETRICS

Blood Pressure Device in Obstectrics


Leslie R. Wiley
The Robert B. Miller College

HADM 300/Medical Informatics


Deb Buck, Adjunct Professor
June 30, 2012

Table of Contents

BLOOD PRESSURE DEVICE IN OBSTETRICS

I.

Abstract

II.

Introduction

III.

Plan

IV.

Finances

V.

Implementation

VI.

Risks and Benefits

VII.

Conclusion

VIII.

References

BLOOD PRESSURE DEVICE IN OBSTETRICS

Abstract
Preeclampsia is a life-threatening blood pressure disorder that
thousands of women are diagnosed with every year. Depending on how far
into the pregnancy the woman is this requires strict bed rest to prevent the
blood pressure from spiking higher and therefore having a premature baby.
In a perfect world, everyone would know how to take an accurate blood
pressure. Since that is not the case, a blood pressure monitoring device is
needed to monitor the womans progress. This information would be stored
and uploaded to the physicians office so that appropriate action could be
taken.

BLOOD PRESSURE DEVICE IN OBSTETRICS

Blood Pressure Device in Obstetrics


Pregnancy can be an exciting time for families. It is also a busy time
getting everything needed to take care of a baby. I remember being
pregnant with my first child. We found out that it was a girl and we had her
room all ready. At thirty weeks into my pregnancy, I came home from work
one night and couldnt put my flip flops on. After a trip to the doctor and a
24 hour urine test, it was confirmed that I had preeclampsia. Strict bed rest
and blood pressure checks every two hours was ordered. I was a nurse at
the time so the physician was comfortable letting me stay home and
checking my own blood pressures. Others are not that fortunate. A blood
pressure monitoring device is needed that will upload the results to the
physician so that when the blood pressure spikes, immediate action can be
taken.
I propose to add five blood pressure monitoring devices to one of our
local obstetricians office. Five is a good number to start with because in a
small practice there usually arent a large number of patients within that
practice who are diagnosed with preeclampsia at the same time.
Hypertension affects approximately 10% of all pregnancies, and is the
second leading cause of maternal death in the USA (Feldman, 2001). It is
imperative to get an accurate blood pressure to ensure the safety of the
mother and the baby. These monitors can be placed on the wrist or the

BLOOD PRESSURE DEVICE IN OBSTETRICS

ankle and worn at all times. Periodically it will take a blood pressure and
heart rate and automatically upload this information to the physicians office.
The information will be logged in that patients chart and if there is a spike in
the blood pressure an alert will be sent the physicians pager. He/She will be
able to contact that patient and instruct them on what to do.
For the physician it will be an upfront cost for the monitors. However,
in the long run it will pay off. Liability insurance is outrageous for an
obstetrician. By using these monitors in the practice for women with
preeclampsia the outcomes could be better thus reducing the number of
suits filed against the obstetrician. Word of mouth is a great source of
business. As a woman that has experienced preeclampsia, I would certainly
choose a physician using this method over a physician that doesnt. This is
financially better for the patient as well. Quicker action taken on this life and
death matter can save the patient money as well as the life of the mother
and baby. If the situation becomes extremely critical expenses start adding
up. These monitors could prevent early hospitalization by allowing women to
stay in the comfort of their own homes.
To implement these monitors they should be tested for accuracy. Once
all of the software is in place it could be trialed on a few of the patients. If
there are any patients with preeclampsia at that time the monitor should be
sent home with them. A comparison should be done by using the monitor
and also the previous method of monitoring. The results will be uploaded

BLOOD PRESSURE DEVICE IN OBSTETRICS

onto the patients chart and should be reviewed daily by the physician and/or
the nurse. The software should be set up at the physicians preference to
send an emergency page to the physician when an increase in blood
pressure occurs. At that time, the physician will call the patient and instruct
them to go to the Labor and Delivery department for further treatment.
With any new technology there are risks involved. One of those is the
accuracy of the readings. The equipment should be tested and calibrated
prior to each use. Patients can also be noncompliant by taking the monitor
off or not following the directions. Home monitors are not always as
accurate as those used in clinics or hospitals. Home readings should
therefore not replace prenatal visits, nor should a "normal" reading mean you
can ignore other symptoms of preeclampsia (Preeclampsia, 2012). Patients
must be educated and understand the signs and symptoms to look for. This
will benefit the patient and could save their life as well as their baby. Being
in the hospital for an extended period is not as comfortable as being at
home. Blood pressure can sometimes go up just from being admitted to the
hospital. The physician and the patient must work together to find the safest
solution for them.
Home blood pressure monitoring is not 100% accurate. Human beings
are not 100% accurate. Every patient is different so a plan of care must be
decided on with the patient to find the best choice. I was able to stay at
home for six weeks on bed rest before I had a critical blood pressure. Some

BLOOD PRESSURE DEVICE IN OBSTETRICS

need to be hospitalized. As long as the mother and baby come out of this
dangerous situation healthy then the right choice was made. Hopefully
someday they will find a cause for preeclampsia and we can better prevent it
from happening. Until then we must carefully monitor.

References
Feldman, D. (2001, Feb.). Blood pressure monitoring during pregnancy.
Retrieved from
http://journals.lww.com/bpmonitoring/Fulltext/2001/02000/Blood_pressure_mo
nitoring_during_pregnancy_.1.aspx?
bot=maior&tam=2&cor=Normal&strSecao=ocorrencia&nrSeq=8678@1&nrs
eqoco=25885

Preeclampsia Foundation. (2012). Preeclampsia foundation signs and


symptoms. Retrieved from http://www.preeclampsia.org/signs-andsymptoms