POSTPARTUM HEMORRHAGE RECOGNITION AND TREATMENT

Abstract

The purpose of this thesis is to explore how postpartum interventions impact the rate of maternal mortality and morbidity caused by postpartum hemorrhage and to provide evidenced based recommendations for postpartum hemorrhage interventions. Postpartum hemorrhage is the causal factor for 11% of maternal deaths in the country. Also, between 54% to 93% of deaths caused by obstetric hemorrhage may be prevented (ACOG, 2019). Evidenced based practice recommendations provide nurses and healthcare professionals with the knowledge and guidelines to treat postpartum hemorrhage. The best practice recommendations for postpartum hemorrhage prevention and treatment include providing standardized education for mothers on postpartum complications, assessing the readiness of nurses to treat a hemorrhage, providing annual training and protocol education, and educating nurses on PPH risk factors, so they can assess patients for risk factors on admission. Intervention specific recommendations are using quantitative methods for measuring blood loss, actively managing the third stage of labor with oxytocin administration and uterine massage, assessing the patient’s condition and vital signs during a hemorrhage, starting a second large bore IV, administering Lactated Ringers and medications for uterine atony, and ensuring the patient has an empty bladder. Finally, if the patient continues to hemorrhage, refractory PPH interventions should be initiated, and massive transfusion protocol should be activated. The final chapter includes a proposal for the implementation and evaluation of the best practice recommendations using the Plan-Do-Study-Act framework. Ultimately, nurse should continue to seek out updated journal articles and professional guidelines throughout their careers to ensure they provide quality patient care.