Admission Screening for Postpartum Hemorrhage Risk Factors: A Quality Improvement Project

BACKGROUND: Postpartum hemorrhage (PPH) is the leading cause of maternal morbidity. Recognizing PPH risk factors is important to prevent its occurrence. METHODS: Using the Model for Healthcare Improvement, a screening tool for PPH risk factors was implemented for women admitted to labor and delivery at a small community hospital. During the pre-implementation and project implementation periods, chart audits measuring number of PPHs, blood transfusions, emergency hysterectomies, and transfers to higher levels of care were conducted on all deliveries. INTERVENTION: Utilizing the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) tool, nursing staff assessed patients for risk factors of PPH, assigned the patient a PPH risk level, and communicated the risk level during patient hand-offs. Evaluation methods included descriptive statistics on identified risk levels and quantitative and narrative feedback from nursing staff. RESULTS: Seven instances of PPH occurred during the three months prior to the project and six instances during the project implementation period. Only 20% of women had admission risk screenings completed, and none of these experienced a PPH or aforementioned complication. Of the women screened for PPH risk factors during the project, 46% were assessed as low risk, 42% as medium risk, and 12% as high risk. Feedback from staff indicated that the paper screening tool was easy to use and did increase staff awareness of a patient’s risk for PPH on the postpartum unit. CONCLUSION: As PPH screening will be a practice standard, the project site should determine how to make screening easy and effective for all staff members to implement.

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Work Title Admission Screening for Postpartum Hemorrhage Risk Factors: A Quality Improvement Project
Access
Open Access
Creators
  1. Jennifer E. Wissemann, M.S.N., RNC-LRN, RNC-OB, CNE
Keyword
  1. postpartum hemorrhage
  2. DNP Project
  3. obstetrics
  4. nursing
  5. quality improvement
  6. PPH
License All rights reserved
Work Type Project
Acknowledgments
  1. Michael Evans, Ph.D., M.S.Ed., RN, ACNS, CMSRN, CNE
  2. Lorah Dorn, Ph.D., CPNP
  3. Kelly A. Wolgast, D.N.P., RN, FACHE, FAAN
Publication Date April 25, 2020
DOI doi:10.26207/f6rw-pd24
Deposited April 25, 2020

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