Week 1: Discussion

General Instructions

Over the next eight weeks, the primary goal is to develop the ability to integrate evidence into advanced nursing practice. This process will culminate in the creation of an evidence-based practice (EBP) project composed of interrelated assignments that build upon each other. During Week 1, students are expected to identify a clinical or practice-related issue relevant to their future advanced nursing role. The issue should be one where a master’s-prepared nurse can lead evidence-based improvements. Additionally, students will conduct a literature review to examine existing research on the topic. This foundational step will help refine and develop a focused clinical question for the Week 2 assignment.

Initial Post

a. Identify a practice problem related to your future practice role

A significant practice problem I have identified for my future role as a master’s-prepared nurse leader is the timely management of severe hypertension in obstetric patients. Hypertensive disorders are among the most frequent complications during pregnancy, affecting approximately 5–10% of pregnancies globally. These conditions greatly contribute to both maternal and neonatal morbidity and mortality if not promptly recognized and treated (Awaludin et al., 2022).

b. Describe the scope and impact of the problem

Severe hypertension in pregnancy, defined as systolic blood pressure ≥160 mmHg or diastolic blood pressure ≥110 mmHg, is a medical emergency requiring immediate pharmacologic intervention. Without timely management, it may result in life-threatening complications such as maternal stroke, placental abruption, preterm delivery, intrauterine growth restriction, and fetal death.

The following table summarizes the scope and impact of the problem:

This evidence highlights the urgent need for consistent, evidence-based interventions in maternity units to reduce both maternal and neonatal complications.

c. Discuss the role of the master’s-prepared nurse in addressing the problem

The master’s-prepared nurse holds a key leadership position in addressing hypertensive disorders during pregnancy by shaping policies, improving care protocols, and fostering interdisciplinary collaboration. Their responsibilities include:

Through these roles, master’s-prepared nurses establish a clinical culture that values rapid, evidence-driven decision-making, thereby improving outcomes for mothers and infants.

d. Explain why the problem is of interest to you

This issue resonates deeply with me on both a personal and professional level because of its severe impact on maternal and neonatal health. Hypertensive disorders remain a leading cause of preventable maternal mortality globally, particularly in low-resource settings. Research shows that maternal mortality increases significantly when blood pressure exceeds 160/110 mmHg (Awaludin et al., 2022).

As a nurse leader, I am motivated to drive evidence-based initiatives that reduce preventable maternal deaths. My passion for maternal health and belief in the transformative potential of standardized emergency protocols reinforce my commitment to improving outcomes through consistent EBP interventions. Implementing such strategies can significantly enhance maternal safety and ensure better neonatal care.

Responsive Post

Thank you for your thoughtful discussion on communication strategies. In our unit, we recently participated in the TeamBirth initiative, a grant-supported program designed to strengthen communication between patients and healthcare teams during labor. This model introduces structured “huddles”, where patients and clinicians jointly discuss care plans, clarify expectations, and promote collaborative decision-making.

The TeamBirth program has yielded promising results, improving teamwork, empowering patients, and enhancing satisfaction with the birthing experience. According to Ariadne Labs (2024), initiatives like TeamBirth have improved patient-provider relationships, minimized communication errors, and promoted safer care delivery.

As master’s-prepared nurses, it is essential that we model such effective communication practices and cultivate a culture of accountability and teamwork. Integrating structured tools—such as bedside handoffs and huddles—can help reduce sentinel events, promote safer care, and strengthen patient-centered approaches. Ultimately, communication-focused strategies enhance team performance and result in better patient outcomes.

References

Ariadne Labs. (2024, June 6). TeamBirth. Ariadne Labs. https://www.ariadnelabs.org/delivery-decisions-initiative/teambirth/

Awaludin, A., Rahayu, C., Daud, N. A., & Zakiyah, N. (2022). Antihypertensive medications for severe hypertension in pregnancy: A systematic review and meta-analysis. Healthcare, 10(2), 325. https://doi.org/10.3390/healthcare10020325

NR 585 Week 1 Discussion

Melnyk, B. M., & Fineout-Overholt, E. (2023). Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

Miller, M. J., Butler, P., Gilchriest, J., Taylor, A., & Lutgendorf, M. A. (2018). Implementation of a standardized nurse-initiated protocol to manage severe hypertension in pregnancy. The Journal of Maternal-Fetal & Neonatal Medicine, 33(6), 1008–1014. https://doi.org/10.1080/14767058.2018.151438