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Rapid implementation of blood pressure self-monitoring in pregnancy at a UK NHS Trust during the COVID-19 pandemic: a quality improvement evaluation.

التفاصيل البيبلوغرافية
العنوان: Rapid implementation of blood pressure self-monitoring in pregnancy at a UK NHS Trust during the COVID-19 pandemic: a quality improvement evaluation.
المؤلفون: Lavallee L; Nuffield Department of Primary Care Health Sciences, University of Oxford Medical Sciences Division, Oxford, UK layla.lavallee@phc.ox.ac.uk., Roman C; Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford Mathematical, Physical and Life Sciences Division, Oxford, UK., Brace E; Maternity Safety Support Program, NHS England and NHS Improvement London, London, UK., Mackillop L; Nuffield Department of Women's & Reproductive Health, University of Oxford Medical Sciences Division, Oxford, UK., Yang Y; Nuffield Department of Primary Care Health Sciences, University of Oxford Medical Sciences Division, Oxford, UK., Cairns A; Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Dockree S; Oxford University Hospitals NHS Foundation Trust, Oxford, UK., Tarassenko L; Institute of Biomedical Engineering, University of Oxford Mathematical, Physical and Life Sciences Division, Oxford, UK., McManus RJ; Nuffield Department of Primary Care Health Sciences, University of Oxford Medical Sciences Division, Oxford, UK., Wilson H; King's College London Faculty of Life Sciences and Medicine, London, UK., Tucker K; Nuffield Department of Primary Care Health Sciences, University of Oxford Medical Sciences Division, Oxford, UK.
المصدر: BMJ open quality [BMJ Open Qual] 2024 May 30; Vol. 13 (2). Date of Electronic Publication: 2024 May 30.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101710381 Publication Model: Electronic Cited Medium: Internet ISSN: 2399-6641 (Electronic) Linking ISSN: 23996641 NLM ISO Abbreviation: BMJ Open Qual Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BMJ Publishing Group
مواضيع طبية MeSH: COVID-19*/epidemiology , Quality Improvement* , SARS-CoV-2*, Humans ; Female ; Pregnancy ; Adult ; United Kingdom ; State Medicine/organization & administration ; Blood Pressure Monitoring, Ambulatory/methods ; Pandemics ; Self Care/methods ; Telemedicine
مستخلص: Background: This service evaluation describes the rapid implementation of self-monitoring of blood pressure (SMBP) into maternity care at a tertiary referral centre during the COVID-19 pandemic. It summarises findings, identifies knowledge gaps and provides recommendations for further research and practice.
Intervention: Pregnant and postpartum women monitored their blood pressure (BP) at home, with instructions on actions to take if their BP exceeded pre-determined thresholds. Some also conducted proteinuria self-testing.
Data Collection and Analysis: Maternity records, app data and staff feedback were used in interim evaluations to assess process effectiveness and guide adjustments, employing a Plan-Do-Study-Act and root cause analysis approach.
Results: Between March 2020 and August 2021, a total of 605 women agreed to self-monitor their BP, including 10 women with limited English. 491 registered for telemonitoring (81.2%). 21 (3.5%) took part in urine self-testing. Engagement was high and increased over time with no safety issues. Biggest concerns related to monitor supply and postnatal monitoring. In December 2020, SMBP was integrated into the standard maternity care pathway.
Conclusions: This project demonstrated successful integration of SMBP into maternity care. Early stakeholder engagement and clear guidance were crucial and community midwifery support essential. Supplying BP monitors throughout pregnancy and post partum could improve the service and fully digitised maternity records would aid data collection. More research is needed on SMBP in the postnatal period and among non-English speakers. These findings support efforts to implement app-supported self-monitoring and guide future research.
Competing Interests: Competing interests: RJM has received BP monitors for research from Omron and has worked with them to develop a telemonitoring system for which consultancy and licensing payments are received by the University of Oxford. RJM is an NIHR senior investigator. LT is supported by the NIHR Oxford Biomedical Research Centre and is a part-time employee and shareholder in Sensyne Health. LM is supported by the NIHR Oxford Biomedical Research Centre and is a part-time employee of EMIS Group. CR reports consultancy fees from Sensyne Health.
(© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: COVID-19; Health services research; Healthcare quality improvement; Implementation science; Obstetrics and gynecology
تواريخ الأحداث: Date Created: 20240530 Date Completed: 20240530 Latest Revision: 20240603
رمز التحديث: 20240603
مُعرف محوري في PubMed: PMC11141177
DOI: 10.1136/bmjoq-2023-002383
PMID: 38816006
قاعدة البيانات: MEDLINE
الوصف
تدمد:2399-6641
DOI:10.1136/bmjoq-2023-002383