Digital Repository Masters Theses Spring 2026 Implementation of an Evidence-Based Nurse Education Training on Postpartum Hypertension Discharge Teaching Abigail Roberts Weber State University Follow this and additional works at: https://dc.weber.edu/collection/wsudoctoral Roberts, A. 2026. Implementation of an Evidence-Based Nurse Education Training on Postpartum Hypertension Discharge Teaching. Weber State University Doctoral Projects. https://cdm.weber.edu/digital/collection/WSUDoctoral This Project is brought to you for free and open access by the Weber State University Archives Digital Repository. For more information, please contact archives@weber.edu. WSU REPOSITORY MSN/DNP Implementation of an Evidence-Based Nurse Education Training on Postpartum Hypertension Discharge Teaching Project Title by Abigail Roberts Student’s Name A project submitted in partial fulfillment of the requirements for the degree of MASTERS OF NURSING Annie Taylor Dee School of Nursing Dumke College of Health Professions WEBER STATE UNIVERSITY April 19, 2026 Ogden, UT Date Abigail Roberts, RN April 19, 2026 Student Name, Credentials (electronic signature) Date April 19, 2026 MSN Project Faculty (electronic signature) Anne Kendrick, DNP, RN, CNE (electronic signature) DNP, N, CNE MSN Program Director Note: The program director must submit this form and paper. Date April 25, 2026 Date 1 Implementation of an Evidence-Based Nurse Education Training on Postpartum Hypertension Discharge Teaching Abigail Roberts Annie Taylor Dee School of Nursing Weber State University Trish Gibbs MSN Project April 19, 2026 2 Abstract Purposes/Aims: This project aims to increase nurses’ confidence in providing discharge teaching and improve recognition of postpartum hypertension after discharge by implementing standardized education for the postpartum population. Rationale/Background: Postpartum hypertension is a leading cause of hospital readmission and maternal morbidity. Many patients lack adequate education regarding postpartum hypertension and the signs and symptoms to watch for. Delayed recognition leads to severe blood pressure that can cause serious, life-threatening, and long-term health complications. Methods: An evidence-based postpartum hypertension education program was developed for nurses and implemented on a postpartum unit. This included standardized discharge teaching, written educational materials, instructions on how to monitor blood pressure at home, and how and when to contact healthcare providers. Pre- and post-intervention data are collected to evaluate patients’ and nurses’ knowledge of postpartum hypertension. Results: Implementation of the education program may increase nursing staff confidence in delivering standardized, evidence-based postpartum hypertension education. Based on the research, it is anticipated that nurses will report that patients demonstrate understanding of postpartum hypertension symptoms through successful teach-back as part of established discharge criteria, which may lead to improved patient outcomes. Conclusions: Standardized postpartum hypertension teaching enhances patient knowledge and improves the quality of postpartum care. Structured discharge education increases confidence in care delivery and self-management at discharge. Keywords: Postpartum hypertension, patient education, blood pressure monitoring, readmission prevention 3 Implementation of an Evidence-Based Nurse Education Training on Postpartum Hypertension Discharge Teaching Postpartum hypertension is a common issue that is often overlooked and can lead to readmission after delivery (Mei, 2023). This can be attributed to insufficient education, doctors' failure to address the problem, and patients’ lack of understanding regarding their role in monitoring their blood pressure (Clapp, 2024). This project aims to provide postpartum nurses with targeted training on discharge teaching for patients. Postpartum nurses play a pivotal role in providing patients with the education necessary to manage care after discharge. When patients are well educated and understand the signs and symptoms, how to monitor their blood pressure remotely, and which critical values to monitor, they are less likely to be readmitted to the hospital (Clapp, 2024). Statement of Problem Hypertension is the most common health concern leading to postpartum readmission in the United States, accounting for 9.3% of postpartum readmissions (Chang, 2023). Being readmitted to the hospital can have negative consequences for patients, including frustration with their doctors and a belief that early education intervention before discharge could have prevented readmission (Viswanathan, 2024). Empowering postpartum women with education about potential complications helps them prepare for what could happen. It increases the likelihood of early intervention and decreases readmission related to postpartum hypertension (Chang, 2023). Nurses require proper education to feel confident teaching patients the importance of hypertension. If nurses feel confident and possess the tools to properly educate their patients, readmission rates related to postpartum hypertension are likely to decline. Further, postpartum nurses must educate their patients on a broad range of educational topics, which can strain 4 nurses. This project aims to standardize hypertension education, thereby increasing nurses’ confidence and facilitate effective teaching. This education will include providing patients with hypertension or at risk for hypertension with a handout highlighting the importance of remotely monitoring their blood pressure, instructions on when and how to contact their doctor, and the symptoms of high blood pressure. Significance of the Project This project seeks to address the gap between inpatient discharge teaching and effective post-discharge recognition and management of postpartum hypertension, driven by nurses' limited confidence in educating patients on this topic. Evidence suggests that many patients remain underinformed about their current diagnoses and the conditions for which they are at risk (Lovgren, 2023). Nurses are uniquely positioned to bridge this gap by providing clear, consistent, and evidence-based education that responds directly to patients’ questions and concerns. Patient education is an integral component of nursing practice; the use of standardized educational protocols provides an effective means to ensure consistency and comprehensiveness. Standardizing discharge education for high-risk patients not only equips patients with essential knowledge but also supports interdisciplinary collaboration by reducing preventable hospital readmissions (Lovgren, 2023). This is particularly significant in the postpartum population, where readmissions are a growing concern that can be reduced through targeted interventions and improved education (Niu, 2021). In conclusion, comprehensive hypertension education provided by postpartum nurses can empower patients to engage in effective selfmanagement, provide nurses with a structured framework, and ultimately reduce the incidence of readmissions. 5 Review of the Literature This literature review examines the importance of nurses educating patients regarding postpartum hypertension, the evidence-based guidelines nurses can reinforce, and the significance of training nurses in postpartum hypertension education at discharge (Zhu, 2023). These challenges underscore the need to evaluate strategies that enhance nurses’ confidence and effectiveness in educating postpartum mothers. The literature review will address the following PICOT question: In postpartum nurses (P), how does the implementation of a standardized, evidence-based training on discharge education (I), compared to current practice (C), affect nurses’ confidence in implementing postpartum discharge education (O) two weeks after implementation? (T) Framework The model selected for this project is Lewin’s Change Model, which emphasizes the concepts of unfreezing, changing, and refreezing. This framework supports viewing change as an ongoing process, rather than a one-time event, which is essential for this project. The approach also allows continuous adaptation to meet each patient's individual needs (Stanz, 2021). The first stage in the model is to Unfreeze: This is the stage where we prepare for change. A PowerPoint presentation will aim to help nurses understand the issue and recognize why this is a problem clinicians can collectively address. This presentation will emphasize how education helps build urgency by sharing statistics (Hussain, 2022). The unit manager will approve this change and help motivate by sharing facts and statistics regarding the issue. The PowerPoint is central to this phase because it raises awareness of the problem (Hussain, 2022). The second stage is the Change phase: the implementation part of the process. Resources will be provided to these nurses, including PowerPoint presentations and handouts, and the 6 training will help facilitate this change. The pre-implementation survey will also capture nurses’ initial reactions and identify any barriers to this project (Stanz, 2021). Refreeze is the final phase of the process, which involves evaluating the change's effectiveness through a post-survey to assess nurses’ feelings (Hussain, 2022). If survey results reflect a positive change, focus will shift to sustaining the change long-term. Strengths and Limitations Lewin’s Change Model is the most used change framework in healthcare because it is simple and clear, with straightforward steps to follow (Stanz, 2021). Furthermore, this model considers the human emotions behind change. It helps nurses understand why changes are needed and provides an excellent framework for sustainability (Hussain, 2022). Despite its many advantages, this model has been suggested to be too linear for the healthcare setting (Stanz, 2021). Research indicates that healthcare is inherently complex, and the simple three-step processes often fail to capture the full scope required for effective change. However, Lewin’s model is particularly well-suited for this project because it offers a structured framework that emphasizes clear communication and the use of motivation strategies to support successful implementation (Hussain, 2022). Search Strategies A literature search was conducted to identify current evidence using Google Scholar and Weber State University’s Stewart Library’s One Search. Only articles from 2020 through 2025 were included in this literature review, so the information is current. The search included keywords of “hypertension” AND “postpartum women”, “readmission” AND “postpartum women”, “decreasing readmission after delivering a baby”, “hypertension” AND “readmission 7 rates”, “importance of discharge education” AND “nurses.” Various Boolean combinations were created using the phrases above to broaden the search. Synthesis of the Literature The literature highlighted three major themes regarding the importance of postpartum hypertension education led by nurses: 1) the importance of nurse education in postpartum hypertension care, 2) evidence-based strategies nurses can teach and reinforce, and 3) implementing nurse training for postpartum hypertension education. The Importance of Nurse Education in Postpartum Hypertension Care Postpartum hypertension is a common issue that is often overlooked and can lead to readmission after delivery (Mei et al., 2023). A woman being readmitted to the hospital while caring for a newborn can be highly distressing (Viswanathan, 2024). Research suggests that structured discharge education significantly improves maternal health outcomes and helps close gaps in patient understanding (De los Reyes et al., 2022). Comprehensive nurse-led education focused on recognizing hypertension symptoms, remote blood pressure monitoring, and knowledge of how and when to contact the provider has demonstrated efficacy in decreasing readmission rates, increasing appointment attendance, and improving patient outcomes after discharge (Clapp, 2024; Mei, 2023; Niu, 2021). Effective discharge education is especially critical for managing postpartum hypertension. Nurses play a vital role in this process, particularly in teaching early symptom recognition (McCarter et al., 2022). However, many women are discharged without a clear understanding of warning signs, highlighting the need for more thorough education (McCarter, 2022). Compounding the issue, some patients are sent home with elevated-although not yet severe- blood pressure levels, and are later readmitted to the hospital (Viswanathan, 2024). This 8 cycle can lead to frustration for both providers and patients and represents a preventable gap in care. Evidence-Based Strategies Nurses Can Teach and Reinforce: A clear plan for managing hypertension after being discharged is key to supporting new mothers’ long-term health (Mei, 2023). A program tailored specifically to the patient’s needs can improve care and potentially reduce the likelihood of postpartum hospitalization (Lemon, 2024). Nurses play a critical role by providing education on self-monitoring and promoting effective self-care at home (Zhu, 2023). Evidence-based discharge teaching should include guidance on home blood pressure monitoring, tracking symptoms, and how to obtain clinical support if necessary. Research supports the effectiveness of these strategies. Niu (2021) found, through a nonrandomized controlled trial involving 214 postpartum women, that using a telehealth intervention after hospital discharge and before their standard 6-week follow-up appointment resulted in a 3.2% decrease in hospital readmissions for hypertension (Niu, 2021). This study demonstrates that telehealth monitoring decreases readmissions in this population (Niu, 2021). Additionally, Kitt (2024) found that telehealth monitoring postpartum can decrease critical blood pressures, thereby decreasing women’s risk of postpartum cardiovascular disease. Additional evidence highlights the benefits of home monitoring. According to Mei et al. (2023), women who took their blood pressure at home after giving birth and being discharged from the hospital were 11% less likely to be readmitted. These results were obtained from a study involving 390 patients who monitored their blood pressure at home, along with a control group of 390 women. Results showed a statistically significant correlation (p<0.01), indicating a strong association between home monitoring and decreased readmissions. Additionally, they 9 found that doctors who closely followed up with their patients had fewer readmissions. A limitation of this study is that it collected data for only 6 months (Mei, 2023). Home blood pressure monitoring is a cost-effective and easy way to reduce postpartum readmissions (Corlin, 2023; Lemon, 2024). Patients’ statements about their care provide a unique perspective on the healthcare system. Viswanthan et al. completed a qualitative study that explored the experiences of nine women who were readmitted to the hospital due to hypertension (2024). Through short interviews, researchers gathered the women’s perspectives on follow-up care, interactions with the providers, preferences regarding care management, and their emotional responses to being hospitalized again postpartum. Patients had an overall feeling of frustration with their doctors, a lack of education related to hypertension, and a belief that early education intervention before discharge could have prevented readmission. Overall, this study highlighted the importance of education before patients are sent home and early follow-up care with their provider (Viswanathan, 2024). Implementing Nurse Training for Postpartum Hypertension Education Improving postpartum outcomes begins with ensuring that nurses receive formal training to ensure they are confident in delivering effective discharge education (McCarter, 2022). An essential part of that training is to emphasize the importance of follow-up care and telehealth monitoring with their provider. Clapp et al. (2024) conducted a quantitative study involving 360 patients to determine whether automated scheduling and reminders increased appointment attendance. This study was conducted across one hospital and five outpatient clinics. There were a control group and an intervention group, with personalized messages and reminders sent to people’s phones to remind them of their appointments. The p-value was p < 0.05, indicating a 10 strong correlation between attendance with and without reminders. Attendance increased by 18.7% among patients who received these reminders and personalized messages, and there were 5.8% fewer hospital readmissions in this population (Clapp, 2024). Postpartum women also benefit from comprehensive education about potential complications and how to respond if they occur (Chang, 2023). Similarly, Lovgren (2023) found that postpartum women discharged with antihypertensive medications are significantly less likely to be readmitted to the hospital. Patients who have clinicians who closely follow up and provide early intervention are more likely to attend their appointments and less likely to be readmitted to the hospital (Niu, 2021). The quality of postpartum education is associated with postpartum readmissions and complications (de los Reyes, 2022). De los Reyes et al. (2022) found that when nurses receive continuous education based on AWHONN’s standardized modules, long-term patient outcomes improve. Patient safety and readmission rates dropped dramatically when nurses received standardized teaching to educate their patients on (de los Reyes, 2022). Patients need to obtain thorough postpartum education, especially on hypertension, and if this is done, it can decrease readmission rates after delivery. Summary of Literature Review Findings and Application to the Project In conclusion, comprehensive, nurse-led education has been identified as an effective intervention that can be implemented to help decrease readmission in postpartum women with hypertension (Lemon, 2024). This includes educating patients on regulations that help them monitor their blood pressure, such as scheduling follow-up appointments with their doctor, using telehealth services, and using remote blood pressure monitoring devices. Nurses should also 11 ensure that patients understand the signs and symptoms of hypertension and emphasize the importance of seeking prompt medical attention if these occur. Project Plan and Implementation This section outlines the plan to implement evidence-based nurse education to enhance discharge teaching on postpartum hypertension. This plan is based on the findings from the literature review and Lewin's Change Model. The project will include a structured educational component that may increase postpartum nurses’ knowledge and confidence in teaching patients at discharge about the importance of recognizing the signs and symptoms of hypertension and when to seek medical help. This project will include an educational PowerPoint presentation sent to nurses, a standardized patient handout to supplement discharge teaching, and pre- and postimplementation surveys to evaluate nurses' confidence in this subject and their ability to teach it. This section will also outline the project's implementation process and provide details on the intended recipients and the interdisciplinary team members who will participate in project implementation. Plan and Implementation Process This plan will be implemented in the Women and Newborn unit at a local hospital. This unit is a postpartum care setting where nurses are responsible for teaching patients about how to care for themselves and their newborns after giving birth. The intended recipients of this project are the postpartum nurses who work on this unit; these nurses are directly responsible for providing patient education and play a crucial role in preventing postpartum complications, particularly those related to hypertension. This project began by identifying a care gap and completing a literature review. The implementation process will begin by gaining support and approval from stakeholders. Once this 12 project is approved, a PowerPoint presentation will be created that highlights key evidence-based teaching points and postpartum-specific discharge protocols. This PowerPoint will include the signs and symptoms of hypertension, the importance of home blood pressure monitoring, the risk of readmission, and clear instructions on when and how the patient should contact their provider if concerns arise. The PowerPoint will also highlight the role of telehealth and the need for early follow-up care when appropriate. In addition to the PowerPoint presentation, a patient handout will be created to reinforce the critical postpartum hypertension education provided by nurses. This will serve as both a structured guide for nurses during discharge teaching and a helpful reference for patients when they return home. It will provide clear, understandable information for patients without a medical background. Both the PowerPoint and the patient handout will be reviewed by the unit manager for approval and by a content expert to ensure accuracy and relevance. After the PowerPoint presentation and patient handout are shared with the nurses via their work email, they will be asked to complete a pre-implementation survey at the end of the presentation. This survey will establish a baseline by assessing nurses’ confidence in providing postpartum hypertension education, identifying perceived barriers, and evaluating the usefulness of educational aids. Nurses will then implement this education and utilize the handout during their discharge teaching over a two-week implementation period. Upon completion of the implementation period, participating nurses will complete a postimplementation survey. The survey will ask nurses whether they found it helpful when teaching patients to have a handout, whether their confidence grew after receiving the education, and whether there is anything else the nurse would find helpful in the handout or education. This feedback will be gathered and will help assess the nurses' confidence in their postpartum 13 hypertension discharge teaching, as well as identify strengths and weaknesses of the PowerPoint and handout. Interdisciplinary Team This project will require a team to collaborate and implement the discharge teaching. Interdisciplinary teamwork will help ensure continuity of patient care, promote patient-centered care, improve patient outcomes, and reduce preventable readmissions. This team must collaborate on this project as a cohesive unit, addressing issues and striving to implement it effectively. Postpartum Nurses. Postpartum nurses are at the center of this project and plan. Nursing staff will undergo training and be responsible for delivering standardized education to postpartum patients, emphasizing the importance of recognizing and managing postpartum hypertension. Nurses will use the information from the PowerPoint to enhance their confidence and knowledge in delivering the best education to their patients. Nurses are also responsible for providing patients with the handout and ensuring understanding prior to discharge. These clinicians will also participate in the pre- and post-implementation surveys, which will help provide data regarding the intervention and its effectiveness. Nurse Manager. The nurse manager will play a crucial role in supporting this project. Responsibilities include approving the PowerPoint presentation and patient handout and assisting in distributing these tools to her nursing staff. Endorsement of this change is critical to cultivating a supportive environment. The nurse manager will also help sustain this project in the long term by providing patient handouts as needed and ensuring that the education is incorporated into onboarding for future nurses on the unit. 14 Content Expert. The content expert will provide expert opinion and provide feedback on the PowerPoint and patient handout. This team member will also conduct a thorough review of the survey tools to assess validity and reliability. Input from the content expert will ensure that the information provided is accurate, appropriate, and aligns with existing guidelines for postpartum hypertension. Patients. Postpartum mothers are the direct beneficiaries of the project. This population is most affected by this education as effective implementation provides knowledge that empowers postpartum self-care. Access to this comprehensive education will support early recognition of hypertension and subsequent consequences. Description and Development of Project Deliverables Staff Development Lesson Plan. A lesson plan will be created to aid in long-term sustainability and guide implementation at other healthcare facilities in the future (See Appendix A). This lesson plan includes the educational purpose, learning objectives appropriate for postpartum nurses, and a course outline. PowerPoint Presentation. A PowerPoint presentation (See Appendix B) will be the deliverable used to educate nurses on standardized postpartum hypertension during discharge teaching. This PowerPoint highlights the nurse’s role in educating patients about postpartum hypertension. It focuses on essential information such as common signs and symptoms, how to monitor their blood pressure at home, and when to contact their healthcare provider. Patient Handout Infographic. A patient handout (See Appendix C) will be given to the patient to refer to before they are discharged. This handout references the main points of the PowerPoint. It emphasizes how to check the patient’s blood pressure at home, key blood pressure readings to monitor, signs and symptoms of hypertension, when to seek medical help, and the 15 importance of follow-up care. Research shows that having a written document for patients to refer back to increases their adherence to discharge teaching (McCarter, 2022). Pre- and Post- Implementation Surveys. Lastly, the pre- and post-implementation surveys (See Appendix D) include several questions for the nurse to answer. The preimplementation survey will be embedded in the PowerPoint and will include 4 statements for the nurse to rate on a 1-5 Likert scale and two free-response questions. This survey aims to assess nurses’ confidence in postpartum hypertension education before they implement the PowerPoint and patient handout into their discharge teaching. The responses will be anonymous and provide management with a better understanding of how they can support their nurses during project implementation. The post-implementation survey will include eight statements for the nurse to rate on a 1-5 scale, followed by two free-response questions. The post-survey will measure nurses’ self-reported confidence after they receive standardized education training, utilizing the patient handout, and completing two weeks of implementation of the new process. Timeline This project will span four weeks and include preparation, education, implementation, and evaluation phases. During Week 1, approval will be obtained from the nurse manager on the postpartum floor and hospital administration. The PowerPoint and patient handout will be sent to the content expert for their review and refined to ensure clarity and accuracy. This phase represents the unfreezing stage of Lewin’s Change Model because the problem is brought to the manager's attention, and the change is ready to be implemented. In Week 2, the PowerPoint, which includes the standardized teaching training, preimplementation survey, and the patient handout, will be emailed to the postpartum nurses. Weeks 3 and 4 will be the implementation phase, during which nurses will take the education and 16 incorporate the information into their discharge teaching. Nurses will also give the patient a handout and use it to reinforce teaching. At the end of Week 4, a post-implementation survey will be sent via email to assess the nurses' confidence and perceived effectiveness of the intervention. This project will be implemented over four weeks and use Lewin’s Change Model as a guide to create a smooth transition. This timeline allows adequate time for preparation, education, implementation, and evaluation. This timeline promotes the successful integration of this change (See Appendix E). Project Evaluation Program evaluation is a crucial step in implementing this project, as it determines if the project meets the established goals and helps identify opportunities for improvement. This MSN project will incorporate both formative and summative evaluation methods to assess the effectiveness of standardized nursing education on the women's and newborns' unit, specifically related to discharge teaching for hypertension. Formative evaluation will occur throughout the project's implementation phase. A preimplementation survey will be distributed to postpartum nurses to assess baseline confidence in postpartum nursing education, perceived knowledge, and potential barriers related to postpartum hypertension education. The results will be used to refine and improve the clarity of educational materials. Responses will be collected anonymously with no identifying information linked to the participant. Communication with the content expert to further clarify education will help support information accuracy. Summative evaluation will occur at the conclusion of the two-week implementation period. A post-implementation survey will be emailed to nurses to evaluate changes in 17 confidence, the perceived effectiveness of the standardized patient handout, and thoughts on integrating the education into the routine of discharge teaching. Comparing the pre- and postimplementation survey results will help evaluate nurse confidence and determine the overall effectiveness of the discharge teaching intervention. Ethical Considerations Ethical project management is key in supporting patient safety when implementing changes. This MSN project will present evidence-based education to reduce postpartum readmissions, specifically postpartum hypertension readmissions. This project will be implemented to ensure that all postpartum nurses have equal access to education and training resources. Participation in this project is entirely voluntary, and nurses can choose to implement the training or not. Nurses who choose not to participate will not receive any negative consequences, and it will not impact their employment. The education materials will be sent out to all employees regardless of participation status. The privacy of the nurses who participate will be protected by collecting all survey responses anonymously. No personal or other information will be linked to their response. Data will be stored securely and accessed only by the project manager and the floor manager. Discussion This section highlights how this information will be disseminated to nursing staff and how it is supported by evidence-based research. The findings of this research will be presented to a group of students and faculty and reviewed by the unit’s manager through implementation surveys. Additionally, this section explains how this project supports the standardization of discharge teaching and ensures patients receive the proper tools and knowledge when discharged 18 from the hospital after childbirth. The strengths and limitations of the intervention are highlighted and reviewed. Lastly, recommendations include helping nurses improve time management during discharge teaching on postpartum hypertension. Evidence-Based Solutions for Dissemination The findings from the pre- and post-implementation surveys will be presented to the unit manager to support evaluation and decision-making. In addition, the project will be presented as a poster to peers and faculty. Significance to the Advancement of Nursing Practice Postpartum hypertension is a prevalent problem in the healthcare setting and is a leading cause for hospital readmissions (Kitt et al., 2024). Discharge teaching is a critical component of patient care, as it equips patients with the knowledge and skills needed to monitor blood pressure and recognize common signs and symptoms of hypertension. Early recognition can lead to prompt treatment and improved outcomes. This project will provide nurses with a practical reference tool to support discharge education, thereby enhancing both confidence and consistency in delivering discharge teaching. In addition, a PowerPoint presentation further supports this practice change by offering a framework for comprehensive discharge instructions. Standardized teaching has been shown to improve adherence to discharge recommendations and reduce readmissions for postpartum hypertension (Clapp et al., 2024). Implications The strengths of this project include the ease of disseminating teaching materials through the staff email, making them readily accessible. The use of clear, straightforward educational 19 tools benefits both nurses and patients by improving understanding and confidence in postpartum care. Potential obstacles to this project’s implementation include gaining staff buy-in and ensuring consistent availability of printed materials. These barriers can be mitigated by soliciting feedback through surveys and by encouraging leadership to model support for the initiative. Ensuring printed handouts are included in discharge paperwork and that extra copies are readily available on the unit can help maintain accessibility. Recommendations This project provides a structured approach to standardizing postpartum teaching with a goal of reducing readmissions. Overall, the evidence supports that this project will have a positive impact; however, time constraints during discharge may present a challenge, and further research on this topic may be needed (Clapp et al., 2024). Conclusions Postpartum hypertension remains an issue as it leads to mostly preventable hospital readmissions and is a significant contributor to maternal health issues post-partum. This is mainly due to delayed symptom recognition and gaps in patient education at discharge. The literature demonstrates that structured discharge teaching can improve early detection and help reduce adverse patient outcomes related to postpartum hypertension. The project proposes the implementation of standardized postpartum hypertension education that includes evidence-based discharge instructions and written materials. Key findings from the literature indicate that patients who receive targeted education are more likely to recognize hypertension signs and symptoms and know when and how to seek medical help. By focusing on patient-centered 20 education, this project addresses a critical gap in postpartum care and supports maternal safety and enhances long-term health outcomes affected by postpartum hypertension. 21 References Chang, C. W., Tsai, Y. J., Hsu, Y. Y., Hou, T. W., Kuo, S. C., & Lee, C. Y. (2023). Selfmanagement system for postpartum women with hypertension disorders: An eHealth application intervention study. BMC Pregnancy and Childbirth, 23, 512. https://doi.org/10.1186/s12884-023-05483-y Clapp, M. A., Ray, A., Liang, P., James, K. E., Ganguli, I., & Cohen, J. L. (2024). Postpartum primary care engagement using default scheduling and tailored messaging: A randomized clinical trial. JAMA Network Open, 7(7), e2422500. https://doi.org/10.1001/jamanetworkopen.2024.22500 Corlin, T., Comer, A., Savitz, S. M., & Garabedian, L. F. (2023). Postpartum remote home blood pressure monitoring: Program design, implementation, and lessons learned. Journal of the American Heart Association, 12(15), e029334. http://doi.org/10.1016/j.xagr.2023.100251 de los Reyes, M. M., Campbell, S. H., & Gallis, J. A. (2022). AWHONN postpartum discharge education: Patient knowledge and sustainability. Journal of Obstetric, Gynecologic & Neonatal Nursing, 51(6), 563–573. https://doi.org/10.1136/bmjoq-2021-001528 Hauspurg, A., Lemon, L. S., Quinn, B. A., & Catov, J. M. (2024). Report from a text-based blood pressure monitoring prospective cohort trial among postpartum women with hypertensive disorders of pregnancy. BMC Pregnancy and Childbirth, 24, Article 6511. https://doi.org/10.1186/s12884-024-06511-1 Hussain, S.T., Lei, S., Akram, T., Haider, J. M., Hussain, S. H., & Ali, M. (2022). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in 22 organizational change. Journal of Innovation & Knowledge. 13(2), 233-278. https://doi.org/10.1016/j.jik.2016.07.002 Kitt, J., Krasner, S., Barr, L., Manwengwe, J., Youssef, N., Hubel, C., … & Khalil, A. (2024). Physician-Optimized Postpartum Hypertension Treatment (POP-HT): A randomized controlled trial. Journal of the American College of Cardiology, 83 (9), 870–882. https://doi.org/10.1161/CIRCULATIONAHA.123.067597 Lemon, L. S., Quinn, B., Binstock, A., Larkin, J. C., Simhan, H. N., & Hauspurg, A. (2024). Clinical outcomes associated with a remote postpartum hypertension monitoring program. Obstetrics & Gynecology, 144(3), 377–385. https://doi.org/10.1097/AOG.0000000000005665 Lovgren, T., Connealy, B., Yao, R., & Dahlke, J. D. (2023). Postpartum medical management of hypertension and risk of readmission for hypertensive complications. Journal of Hypertension, 41(2), 351–358. https://doi.org/10.1097/HJH.0000000000003340 Mei, J. Y., Corry-saavedra, K., Nguyen, T. A., & Murphy, A. (2023). Standardized clinical assessment and management plan to reduce readmissions for postpartum hypertension. Obstetrics & Gynecology 142(2), 384–392. https://doi.org/10.1097/AOG.0000000000005248 McCarter, S. A., Brown, M. J., Scott, K., & Gray, M. J. (2022). Scoping review of postpartum discharge education provided by nurses. Nursing for Women’s Health, 26(3), 184–196. https://doi.org/10.1016/j.jogn.2022.03.002 Niu, B., Mukhtarova, N., Alagoz, O., & Hoppe, K. (2021). Cost-effectiveness of telehealth with remote patient monitoring for postpartum hypertension. The Journal of Maternal-Fetal &amp; Neonatal Medicine, 35(25), 7555–7561. 23 https://doi.org/10.1080/14767058.2021.1956456 Stanz, L., Silverstein, S., Vo, D., & Thompson, J. (2021). Leading through rapid change management. National Library of Medicine. 48(6), 456-479 https://doi.org/10.1177/00185787211046855 Viswanathan, R., Little, S.E., Wilkins-Haug, L. Seely, E. W., & Berhie, S. B. (2024). The patient experience of a postpartum readmission for hypertension: A qualitative study. BMC Pregnancy Childbirth, 24, 358. https://doi.org/10.1186/s12884-024-06564-2 Zhu, H., Chen, Y., & Wang, L. (2023). Self-management system for postpartum women with hypertensive disorders: An eHealth application intervention study. BMC Pregnancy and Childbirth, 23, Article 483. https://doi.org/10.1186/s12884-023-05483-y 24 Appendix A Staff Development Lesson Plan Staff Development Lesson Plan: Postpartum Hypertension Discharge Teaching Purpose: The purpose of this education is to improve nurses’ knowledge and confidence in providing standardized discharge education to postpartum patients, specifically education regarding postpartum hypertension. Learning Objectives After this lesson, postpartum nurses will be able to: 1. Identify the main signs and symptoms of postpartum hypertension. 2. Describe the importance of home blood pressure monitoring after discharge. 3. Teach patients when and how to contact their doctor for abnormal symptoms and/or blood pressure readings. 4. Utilize a standardized patient handout to support discharge education. Course Outline 1. Overview of postpartum hypertension and the risk and rate of readmissions 2. Signs and symptoms requiring medical attention 3. Home blood pressure monitoring, including technique and frequency 4. When and how patients should contact their provider 5. Use of standardized patient handout during discharge teaching 25 Appendix B Presentation for Employee Education 26 27 28 29 30 31 Appendix C Unit Flyer/Infographic 32 Appendix D Pre- and Post-implementation Surveys Postpartum Hypertension Discharge Teaching: Pre-Education Survey These responses are anonymous and will be used to improve postpartum hypertension education and help us know how we can better support you. Please rate your level of agreement using the following scale: 1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree 1. I feel confident explaining the pathophysiology of postpartum hypertension to patients. 2. I feel confident educating patients on signs and symptoms of postpartum hypertension. 3. I feel confident teaching patients when to contact their provider and seek emergency care regarding blood pressure concerns. 4. I feel that the current discharge education adequately prepares patients to manage postpartum hypertension at home. Free Response 5. What barriers do you experience when teaching postpartum hypertension? 6. What would help you feel more confident or effective when teaching postpartum hypertension at discharge? Postpartum Hypertension Discharge Teaching: Post-Education Survey 33 These responses are anonymous evaluate the impact of the postpartum hypertension education and patient handout after implementation. Please rate your level of agreement using the following scale: 1 = Strongly Disagree 2 = Disagree 3 = Neutral 4 = Agree 5 = Strongly Agree 1. I feel confident explaining postpartum hypertension to patients. 2. I feel confident educating patients on signs and symptoms of postpartum hypertension. 3. I feel confident teaching patients when to contact their provider and seek emergency care regarding blood pressure concerns. 4. I feel that the current discharge education adequately prepares patients to manage postpartum hypertension at home. 5. The PowerPoint education increased my understanding of postpartum hypertension discharge teaching. 6. The standardized patient handout made discharge teaching easier. 7. I feel more confident providing hypertension education now than before this education. 8. Patients appeared to better understand hypertension education after using the handout. Free Response 9. What aspects of the education or handout were most helpful? 10. What improvements or changes would you recommend? 34 Appendix E Timeline