Postpartum hemorrhage prevention and management in women in an inpatient postpartum unit: a best practice implementation project

Abstract

ABSTRACT Introduction and objectives: Ninety percent of maternal deaths are attributed to postpartum hemorrhage, with 50% being preventable. Annually, University of Mississippi Medical Center staff have more than 20,000 obstetrical encounters and deliver thousands of infants, with ∼75% being high-risk. The mother/baby unit, 3 Wiser, experienced two postpartum hemorrhage events in August 2022. Post-event debriefings revealed opportunities for improvement. This project aimed to promote evidence-based practices regarding the prevention and management of postpartum hemorrhage in 3 Wiser. Methods: The project was guided by the JBI Model of Evidence-Based Healthcare and used the JBI Practical Application of Clinical Evidence System together with the Getting Research into Practice audit and feedback strategy. Four evidence-based practices were selected as audit criteria. After baseline audits were conducted, strategies to improve compliance with evidence-based practices were implemented. Finally, a follow-up audit was conducted, and the results of both audits were compared. Results: The baseline audits revealed 84% average compliance with the four evidence-based practices. Strategies to improve compliance included a simulation event for nursing staff with a review of postpartum hemorrhage policies and skills. Post-implementation audits revealed 98% average compliance with the four evidence-based practices, a 14% increase from the baseline audits. Conclusions: This evidence implementation project utilized a clinical audit process, which led to improvements in practice related to the prevention and management of postpartum hemorrhage in the inpatient postpartum unit.