Allen Birthing Center, Allen, Texas.
J Perinat Neonatal Nurs. 2020 Oct/Dec;34(4):324-329. doi: 10.1097/JPN.0000000000000489.
The aim of the project was to identify women at risk for developing preeclampsia who present for birth center care in order to initiate preventative treatment and retain them within the birth center practice. Birth center patients with preeclampsia disqualify for birth center care requiring hospital transfer. The target population consisted of pregnant women choosing birth center care with certified nurse midwives. Quality improvement method was utilized. Over 5-weeks, patients with 12 to 28 weeks' gestation were screened for preeclampsia risk factors; patients with high risk for preeclampsia initiated low-dose aspirin (LDA). All patients were evaluated for preeclampsia diagnosis up to 2 weeks postpartum. Outcomes were evaluated through chart audits. Screening for preeclampsia risk significantly increased LDA use. Preeclampsia screening did not statistically reduce incidences of preeclampsia but did show a moderate reduction. Use of LDA did not statistically reduce preeclampsia diagnoses but had a large reduction effect. Screening for preeclampsia in birth center patients results in increased use of LDA and potentially decreased rates of hospital transfer. Implementing preeclampsia screening is cost-effective and allows for increased patient retention.
该项目的目的是识别有先兆子痫风险的在分娩中心就诊的妇女，以便开始预防性治疗并将其留在分娩中心进行护理。患有先兆子痫的分娩中心患者不符合分娩中心护理标准，需要转院治疗。目标人群是选择由注册护士助产士提供分娩中心护理的孕妇。采用了质量改进方法。在 5 周多的时间里，对 12 至 28 周妊娠的患者进行了先兆子痫风险因素筛查；对有先兆子痫高风险的患者开始使用小剂量阿司匹林（LDA）。所有患者在产后 2 周内都进行了先兆子痫的诊断评估。通过病历审核评估结果。对先兆子痫的筛查显著增加了 LDA 的使用。先兆子痫筛查并没有在统计学上降低先兆子痫的发生率，但确实显示出中等程度的降低。LDA 的使用并未在统计学上降低先兆子痫的诊断率，但具有较大的降低效果。对分娩中心患者进行先兆子痫筛查可增加 LDA 的使用，并可能降低转院率。实施先兆子痫筛查具有成本效益，并可提高患者保留率。
