Purpose for the program: According to ACOG, 140,000 maternal deaths occur each year and approximately 25% of those deaths are due to postpartum hemorrhage.   One of The Healthy People 2020 goals is to decrease maternal deaths from 13.3 deaths per 100,000 live births to 11.4 per 100,000 live births. The purpose of our project was to develop a method of obtaining necessary supplies for prompt treatment of a postpartum hemorrhage.  

Proposed change: Our plan was to develop a multidisciplinary team to discuss the best approach and supplies needed to promptly manage a postpartum hemorrhage.  Our multidisciplinary team consisted of staff nurses, nurse educators, a nurse practitioner, ancillary staff, management and resident physicians.  Current literature and available products were reviewed by the team.  The product chosen to best meet our needs was a medical supply cart.  

Implementation, outcomes and evaluation: Once a consensus of the team was reached regarding cart style and specific features required, the cart was purchased and assembled with the supplies as identified by the team.  The cart was displayed on the postpartum unit for 2 weeks, allowing staff the opportunity to become familiar with the contents.  Feedback from staff was encouraged.  The team evaluated the feedback and changes to the cart were made. Data regarding the frequency of use of the hemorrhage cart, along with staff feedback is being collected and shared with the multidisciplinary team.  Anecdotally, staff state response time to postpartum hemorrhage has decreased significantly.  Instead of spending time gathering needed supplies, staff members are able to respond and assist in prompt patient treatment.  Ongoing education needs regarding cart contents, layout and restocking procedures have been identified, and therefore, continual education occurs through one-on-one discussion and weekly newsletters.  

Implications for nursing practice: Future emergency simulations on our unit will incorporate the use of the postpartum hemorrhage cart.  These simulations will not only allow staff to practice their skills in caring for a patient with a postpartum hemorrhage but will also encourage staff to re-familiarize themselves with the cart contents.  Our hope is that future sharing of our experiences with other maternity centers, will foster collegiality and improve patient outcomes across the country.  

Keywords:  Postpartum Hemorrhage, Process Improvement Initiative, Patient Safety