Postpartum hemorrhage (PPH) has been identified as one of the leading risks of maternal mortality worldwide, with the United States rate rising from 7.9 – 13.3 from 1996 to 2006.  The purpose of the postpartum nurse response team project is to prevent poor outcomes of this obstetric emergency situation. The project includes having a PPH response team with identified roles, a PPH emergency bag and continued education using simulation to update nurses on the current evidence based practice for responding to women experiencing postpartum hemorrhage.                    

Proposed change:  

     Nurses working in birthing and postpartum units need to have strong assessment skills and a thorough understanding of the life saving interventions needed for a women experiencing PPH.  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 demonstrate 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 and hospital policy and protocol for managing a PPH. 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 PPH response team was formed with defined roles. 

Implications for nursing practice:  

     By instituting an educational program, emergency PPH bag, and a PPH response team, nurses demonstrated increased knowledge of PPH response.  Being prepared for the 3^rd 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 six 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, incorporate an annual competency assessment on PPH, and update education to reflect evidence based recommendations to PPH response.

Keywords:

Postpartum Hemorrhage

Obstetric emergency

Quality Improvement

Patient Safety