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Monday, Sep 27 - AWHONN's Block Party

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Monday, September 27, 2010 : 2:00 PM

Title: A Collaborative Approach for the Identification and Treatment of Obstetrical Hemorrhage

Venetian
Shirley Scott, MS, RNC, APN , University of Illinois at Chicago, Evanston, IL
Laurie Deihs, RN, MS, MPH , University of Chicago, Evanston, IL

Discipline: Professional Issues (PI), Childbearing (CB)

Learning Objectives:
  1. Review the development and implementation of the Obstetric Hemorrhage Education Project.
  2. Analyze the outcomes of the Obstetric Hemorrhage Education Project.
  3. Discuss how to implement the lessons learned from the Obstetric Hemorrhage Education Project.
Submission Description:
In the United States, 2-3 women die every day due to pregnancy-related complications.  The three leading causes of maternal death nationally are: eclampsia/pre-eclampsia, embolism, and hemorrhage.  Of these causes, obstetric hemorrhage is known as the most preventable cause of maternal mortality (World Health Report 2007).
It is important to study maternal mortality and morbidity for two reasons:  First, evidence suggests that at least half of pregnancy-related deaths may be preventable through changes in patient, provider, or system factors; and second, mortality rates are disproportionately high among certain racial and ethnic groups. In addition, deaths are only the tip of the iceberg: maternal morbidity also represents a huge burden of disease for women and their families.
The Illinois Department of Public Health (IDPH) Maternal Mortality Review Committee (MMRC) reviewed fifty-two cases of maternal death between the years 2001-2006.  Of those fifty-two cases, thirty-eight percent (n=20) of the maternal deaths were due to hemorrhage.  The MMRC found that the majority of mortality cases occurred while women were hospitalized.  Mortalities occurred at every level of care throughout the state, and impacted all socioeconomic groups.
The Obstetric Hemorrhage Education Project (OHEP) (2009) is a response to the MMRC’s past and continued findings of a leading cause of maternal morbidity and mortality in Illinois being hemorrhage related and preventable.
Developed by the Obstetric Hemorrhage Education Project (OHEP) Workgroup, the goal of this educational program is to reduce maternal morbidity and mortality due to obstetric hemorrhage in all birthing hospitals within the state.  The program emphasizes a multidisciplinary approach requiring all providers (MD, RN, CNM, Anesthesia and Residents) to attend education and simulation drills on obstetric hemorrhage.   The focus of the project includes risk assessment and preparation for possible hemorrhage, estimation of blood loss, recognition and treatment of hemorrhage/hypovolemia, development and implementation of a Rapid Response Team specific for obstetric hemorrhage.   The educational requirements of each provider include the completion of a pre and post-program Benchmark Assessment Validation, Didactic presentation, Skill station and Simulation drill.   Maternal mortality in the United States remains a pressing issue for multiple reason, the simplest and perhaps most important of which is the reality of an infant and child without a mother, and the consequences for the family as a whole.  Improving maternal mortality involves a committed and long lasting effort on behalf of many individuals along with medical and social organizations to better appreciate the scope of and risk associated with maternal mortality.