Trainings and practice sessions prepare care teams to spot and treat high blood pressure in pregnancy

In hospitals across the country, care teams use a specific set of steps to recognize and treat severe high blood pressure in pregnant women and those who have recently given birth. Although these steps are effective in the hospital, there is no version of the steps for use in clinics and doctors’ offices. That’s why the Maternal Health Community Implementation Program (MH-CIP) research team based at the University of North Carolina used a community-based approach to adapt the hospital-based model to an outpatient setting. Now the team has set out to study promising ways to support outpatient care providers in effectively using the tools. For this, they looked at the connected strategies of training and simulation.

Nineteen teams, made up of a medical assistant, nurse, midwife or physician, and pharmacy staff, took part in the study. In the simulations, one trained participant played the role of a pregnant woman in her third trimester. After assessing the patient’s blood pressure and “treating” her, the care teams received special training on diagnosing and treating severe hypertension in pregnancy, as well as training on how to provide respectful care. After the training, they then repeated the simulation a week or two later.

The researchers’ findings

• The researchers found that after the training sessions, the care teams were much better at sticking to the outlined protocol steps to identify and treat severe hypertension.
• The care provided after the trainings was also found to be more respectful, though additional improvement was needed.
• Most participants felt that the training and simulation process improved their ability to treat patients with severe hypertension in pregnancy and provide them with respectful care.

The evidence-informed opportunities

• This study was done in three Federally Qualified Health Centers. Moving forward, a wider sample of clinical teams can take part. Future studies can also look at how the trainings and simulations worked to improve care. 
• Because these strategies hold promise, the research team is now moving to expand the study to include 20 clinics in North Carolina.