Postpartum Hemorrhage: Are You Prepared?
Version of Record online: 14 JUN 2012
© 2012 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses
Journal of Obstetric, Gynecologic, & Neonatal Nursing
Special Issue: 2012 Convention Proceedings
Volume 41, Issue s1, pages S85–S86, June 2012
How to Cite
Retskin, C. M. (2012), Postpartum Hemorrhage: Are You Prepared?. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 41: S85–S86. doi: 10.1111/j.1552-6909.2012.01361_45.x
- Issue online: 14 JUN 2012
- Version of Record online: 14 JUN 2012
- postpartum hemorrhage;
- obstetric emergency;
- quality improvement;
- patient safety
Purpose for the Program
Postpartum hemorrhage has been identified as one of the leading risks of maternal mortality worldwide, with the rate in the United States increasing from 7.9% in 1996 to 13.3% in 2006. The purpose of the postpartum nurse response team project is to prevent poor outcomes resulting from this obstetric emergency. The project includes a postpartum hemorrhage response team with identified roles, a postpartum hemorrhage emergency bag, and continued education using simulation to update nurses on the current evidence-based practice for responding to postpartum hemorrhage.
Nurses working in birthing and postpartum units need to have strong assessment skills and a thorough understanding of the life-saving interventions needed for postpartum hemorrhage. Excessive blood loss after birth should set into motion evidence-based predetermined measures that provide the interventions necessary to restore the women's homeostasis. By creating a postpartum hemorrhage response team with identified roles, an emergency bag with necessary equipment to respond to the emergency, and continuing education that updates nurses on current evidence-based practice, nurses gain an understanding of the skills necessary to respond to postpartum hemorrhage.
Implementation, Outcomes, and Evaluation
A pretest was given to evaluate the current knowledge level of the nursing staff on the mother–baby unit in a large regional medical center. An education module was created that followed evidence-based practice, hospital policy, and protocol for managing a postpartum hemorrhage. A posttest was required at the end of the educational module. The total mean scores were significantly different between the pretest and posttest. In addition to the test, a team of nurses created the postpartum hemorrhage emergency bag, which was used in a required simulation drill for all nursing staff on the mother–baby unit. A postpartum hemorrhage response team was formed with defined roles.
Implications for Nursing Practice
With the implementation of an educational program, an emergency postpartum hemorrhage bag, and a postpartum hemorrhage response team, nurses demonstrated increased knowledge of postpartum hemorrhage response. Being prepared for the third leading cause of maternal mortality will enhance patient safety and improve quality of care. Longitudinal analysis of knowledge retention on response to postpartum hemorrhage is being completed in the next 6 months and will result in further reporting of outcome data related to retention of education. Recommendations from this program include incorporating response to postpartum hemorrhage into orientation to maternal services, incorporating an annual competency assessment on postpartum hemorrhage, and updating education to reflect evidence-based recommendations to postpartum hemorrhage response.