For a study, researchers wanted to determine if the deployment of a semiautonomous treatment algorithm was linked with increased compliance with the American College of Obstetricians and Gynecologists guidelines for the fast delivery of antihypertensive medicine in the case of chronic severe hypertension. Researchers conducted a single-center retrospective cohort analysis of hospitalized pregnant and postpartum patients treated for severe hypertension between January 2017 and March 2020. Between May 2018 and March 2019, the semiautonomous treatment algorithm was introduced, which comprised vital sign monitoring, blood pressure thresholds for detecting severe hypertension, and automated order sets for recommended first-line antihypertensive medication. The key outcomes were the provision of antihypertensive treatment within 15, 30, and 60 minutes of severe hypertension diagnosis. Using χ2., comparisons were done between the groups before, during, and after implementation. The study only looked at the first incident of severe hypertension that was treated. P<.05. was used to denote statistical significance.
There were 959 obstetric patients treated for severe hypertension in total, with 373 (38.9%) treated prior to implementation, 334 (34.8%) treated during implementation, and 252 (26.2%) treated after implementation. Treatment of severe hypertension within 15 minutes was achieved in 36.5% of cases prior to implementation, 45.8% during implementation, and 55.6% after implementation (P=.001). Treatment within 30 minutes was achieved in 65.9% of the pre-implementation group, 77.8% of the implementation group, and 79.0% of the post-implementation group (P=.004). The percentage of patients treated within 60 minutes did not change (86.3% before, 87.7% during, and 92.9% after implementation, P=.12).
The use of a semiautonomous treatment strategy for severe hypertension was linked to a larger percentage of pregnant and postpartum patients getting their first dose of antihypertensive medicine between 15 and 30 minutes. Implementing comparable algorithms for this and other obstetric indications may shorten the time to appropriate therapy and contribute to improved care equality.
Reference:journals.lww.com/greenjournal/Fulltext/2021/02000/Semiautonomous_Treatment_Algorithm_for_the.2.aspx
