Development and Evaluation of a Clinical Nursing Practice Guideline for Pregnant Women at Risk of Preeclampsia in a Community Hospital: A Pilot Study

Abstract

         Preeclampsia is a major complication of pregnancy associated with significant maternal and neonatal morbidity and mortality. Systematic screening and management of at-risk pregnant women at the community hospital level are therefore essential. This research and development study employed a one-group pretest–posttest design to develop and examine the feasibility of a clinical nursing practice guideline (CNPG) for pregnant women at risk of preeclampsia in a community hospital setting. The study was guided by the Iowa Model and conducted in two phases: (1) development of the guideline based on evidence and local context, and (2) pilot implementation. Participants included 12 at-risk pregnant women attending the antenatal care clinic and 6 registered nurses providing antenatal services. Research instruments consisted of a preeclampsia knowledge questionnaire and a self-care behavior assessment. Data were analyzed using descriptive statistics and paired t-tests.

  The results showed that, after implementation of the guideline, pregnant women demonstrated a significant increase in knowledge scores (p < .001; Cohen’s d = 1.84) and significant improvements in self-care behaviors across all domains (p < .05). Nurses reported high levels of satisfaction and confidence in applying the guideline.

The developed guideline demonstrated feasibility for implementation in a community hospital and showed potential to enhance knowledge and self-care behaviors among at-risk pregnant women. However, this study was a pilot with a small sample size and was not designed to evaluate clinical outcomes. Further studies with larger samples and follow-up through delivery are needed to determine its impact on the incidence and severity of preeclampsia.