Evidence map›Paper›PMID 38816006›Full record

ArticleBMJ open quality2024

Rapid implementation of blood pressure self-monitoring in pregnancy at a UK NHS Trust during the COVID-19 pandemic: a quality improvement evaluation.

Layla Lavallee, Cristian Roman, Emily Brace, Lucy Mackillop, Yaling Yang, Alexandra Cairns, Samuel Dockree, Lionel Tarassenko, Richard J McManus, Hannah Wilson and 1 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open quality, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Layla LavalleeNuffield Department of Primary Care Health Sciences, University of Oxford Medical Sciences Division, Oxford, UK layla.lavallee@phc.ox.ac.uk.ORCID 0000-0002-3823-9311
Cristian RomanDepartment of Engineering Science, Institute of Biomedical Engineering, University of Oxford Mathematical, Physical and Life Sciences Division, Oxford, UK.
Emily BraceMaternity Safety Support Program, NHS England and NHS Improvement London, London, UK.
Lucy MackillopNuffield Department of Women's & Reproductive Health, University of Oxford Medical Sciences Division, Oxford, UK.
Yaling YangNuffield Department of Primary Care Health Sciences, University of Oxford Medical Sciences Division, Oxford, UK.
Alexandra CairnsOxford University Hospitals NHS Foundation Trust, Oxford, UK.
Samuel DockreeOxford University Hospitals NHS Foundation Trust, Oxford, UK.
Lionel TarassenkoInstitute of Biomedical Engineering, University of Oxford Mathematical, Physical and Life Sciences Division, Oxford, UK.
Richard J McManusNuffield Department of Primary Care Health Sciences, University of Oxford Medical Sciences Division, Oxford, UK.
Hannah WilsonKing's College London Faculty of Life Sciences and Medicine, London, UK.
Katherine TuckerNuffield Department of Primary Care Health Sciences, University of Oxford Medical Sciences Division, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis service evaluation describes the rapid implementation of self-monitoring of blood pressure (SMBP) into maternity care at a tertiary referral centre during the COVID-19 pandemic. It summarises findings, identifies knowledge gaps and provides recommendations for further research and practice.

interventionPregnant and postpartum women monitored their blood pressure (BP) at home, with instructions on actions to take if their BP exceeded pre-determined thresholds. Some also conducted proteinuria self-testing. DATA COLLECTION AND ANALYSIS: Maternity records, app data and staff feedback were used in interim evaluations to assess process effectiveness and guide adjustments, employing a Plan-Do-Study-Act and root cause analysis approach.

resultsBetween March 2020 and August 2021, a total of 605 women agreed to self-monitor their BP, including 10 women with limited English. 491 registered for telemonitoring (81.2%). 21 (3.5%) took part in urine self-testing. Engagement was high and increased over time with no safety issues. Biggest concerns related to monitor supply and postnatal monitoring. In December 2020, SMBP was integrated into the standard maternity care pathway.

conclusionsThis project demonstrated successful integration of SMBP into maternity care. Early stakeholder engagement and clear guidance were crucial and community midwifery support essential. Supplying BP monitors throughout pregnancy and post partum could improve the service and fully digitised maternity records would aid data collection. More research is needed on SMBP in the postnatal period and among non-English speakers. These findings support efforts to implement app-supported self-monitoring and guide future research.

Indexed as

COVID-19Quality ImprovementSARS-CoV-2AdultBlood Pressure Monitoring, AmbulatoryFemaleHumansPandemicsPregnancySelf CareState MedicineTelemedicineUnited KingdomCOVID-19Healthcare quality improvementHealth services researchImplementation scienceObstetrics and gynecology

Identifiers

PMID38816006
PMCPMC11141177

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.