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Hypertension During Pregnancy and Cardiovascular Disease Nicole Overstreet. RESULTS. INTRODUCTION. FRAMEWORK. ACE Star Model Discovery- Where knowledge is generated Summary- Summarizing the evidence into a single review
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Hypertension During Pregnancy and Cardiovascular Disease Nicole Overstreet RESULTS INTRODUCTION FRAMEWORK • ACE Star Model • Discovery- Where knowledge is generated • Summary- Summarizing the evidence into a single review • Translation- Putting the evidence summaries into practice recommendations • Integration- Incorporating the evidence into the clinical setting • Evaluation- Looks at patient outcomes, among others things, and investigates the impact of the evidence on practice. • The purpose of the ACE Star Model is to develop and implement the best evidence-based practices and therefore, improve patient outcomes. Background Hypertension disorders during pregnancy are one of the most prevalent pregnancy complications and affects 6-8% of all pregnancies. The possibility that hypertension disorders during pregnancy could have future implications for development of cardiovascular disease in women became the impetus for this project. Patients with cardiovascular conditions constitute a substantial portion of those using the healthcare system. Assessing for risk factors of cardiovascular disease could prevent or allow early management of the disease to occur.; since cardiovascular disease is the number one killer of women worldwide. PICO Question Are women who have had hypertension disorders during pregnancy compared with those without hypertension during pregnancy at an increased risk for cardiovascular disease later in life? METHODS • 93% (28) of pregnancy histories were collected after project implementation and 0% (0) were collected before project implementation • 7% (2) of pregnancy histories were never collected during project implementation • Any woman who has or had a hypertension disorder during pregnancy was the focus population for this study. In a medical practice in a southern city, healthcare providers were educated on how and why to assess for pregnancy histories. Data from medical records were extracted pre and post implementation and entered into the Statistical Package for the Social Sciences (SPSS) program for a statistical analysis. The analysis examinedthe following: the number of pregnancy histories taken before and after the project implementation, if the pregnancy history was inquired about, who the healthcare provider was (physician, nurse practitioner, or nurse), and if any risk factors of cardiovascular disease were identified. • Sample • Retrospective and Prospective • Sample size (n)= 30 • Inclusion criteria: • Female • Over the age of 20 years old CONCLUSIONS • Our findings suggest that: • There was a 93.3% increase in inquiring about pregnancy histories • Physicians were the healthcare provider that inquired about pregnancy histories the most • At least one cardiovascular disease risk factor was identified in the majority of participants • An increase in assessing for pregnancy histories occurred in this medical practice. More medical practices need to inquire about pregnancy histories and then routinely assess for cardiovascular disease risk factors before a possible decrease in cardiovascular disease occurrences are recognized. More time is required before long term results are known. REFERENCES • Edlow, A., Srinivas, S., & Elovitz, M. (2009). Investigating the risk of hypertension shortly after pregnancies complicated by preeclampsia. American Journal of Obstetrics & Gynecology, 200(5), e60-2. doi:10.1016/j.ajog.2008.10.01 • Robbins, C., Dietz, P., Bombard, J., & Valderrama, A. (2011). Gestational hypertension: A neglected cardiovascular disease risk marker. American Journal of Obstetrics & Gynecology, 204(4), 336.e1-9. Retrieved from http://xt5bv6dq8y.search.serialssolutions.com.spot.lib.auburn.edu/?genre=article&issn=00029378&title=American+Journal+of+Obstetrics+%26+Gynecology&volume=204&issue=4&date=20110401&atitle =Gestational+hypertension%3a+a+neglected+cardiovascular+disease+risk+marker.&spage=336.e1&pages=&sid=EBSCO:CINAHL&aulast=Robbins+CL • Stevens, K. R. (2004). ACE star model of EBP: Knowledge transformation. Academic Center for Evidence-based Practice. The University of Texas Health Science Center at San Antonio. Retrieved from www.acestar.uthscsa.edu
The ACE star model is a simple but thorough five stage process of organizing evidence on a topic for application to practice (Stevens, 2004). Discovery is where knowledge is generated. The summary stage consists of summarizing the evidence into a single review. Translation is putting the evidence summaries into practice recommendations. The integration stage is incorporating the evidence into the clinical setting. Evaluation is the final stage that looks at patient outcomes, among others things, and investigates the impact of the evidence on practice. The whole purpose of the ACE Star Model is to develop and implement the best evidence-based practices and therefore, improve patient outcomes.