Purpose for the Program
Every obstetric department works to provide safe outcomes for mothers and infants. Some smaller, community hospitals may not have optimal resources available around the clock to handle an obstetric emergency, such as a maternal hemorrhage, that requires massive transfusion. Increasing situational awareness can make a significant difference in preventing a crisis.
Collaboration within a multidisciplinary team that provides patient care can facilitate changes to improve staff preparedness. This is done by implementing protocols that identify patients at risk of hemorrhage and guidelines to improve teamwork and communication. The proposed change was to ask staff to estimate the blood loss of each patient by weighing all blood soaked items during the postpartum recovery period, use an effective communication tool, and document accurately on a standardized form.
Implementation, Outcomes, and Evaluation
With the support of management, a patient care model was implemented to provide better coverage where needs were identified. Department protocols provided guidelines that promote evidence-based care. A rapid response protocol was implemented that emphasized early activation, collaborative team response, and effective communication. Documentation was enhanced by the electronic medical record. Obstetric emergency drills, using patient simulators, were used to practice methods for accurately assessing blood loss.
Implications for Nursing Practice
Using a systematic approach of quantifying blood loss by weight helped to identify the inaccuracies of estimations. Once the problem was identified, staff were able to implement methods to facilitate the proposed change by supplying scales in all the postpartum recovery rooms and create a postpartum hemorrhage cart for rapid access to supplies needed in emergent situations.