Obstetric Hemorrhage: Improving Readiness and Response in a Community Hospital

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Abstract

BACKGROUND:

The rates of PPH in the US have steadily increased over the years up to almost 3% in 2006. In order to improve the safety of patient care and decrease the rates of morbidity from PPH, a QI project was designed.

METHODS:

The planning phase of our PDSA cycle assessed current deficits including lack of provider skill with procedures like Bakri balloon and B lynch suture placement and systems errors like a lack of a specific PPH reporting form. An intervention was designed including lectures, on site simulation drills and skills workshops to address these deficiencies. A severe maternal morbidity reporting form has been proposed. A mobile based app was developed as a quick reference tool for providers to aid in the management of PPH. The results of this intervention were studied using paired t tests for analysis of pre and posttest questionnaires judging knowledge and provider comfort with procedures.

RESULTS:

A statistically significant difference was noted between provider comfort in diagnosing PPH, calculating estimated blood loss, placing a Bakri balloon, placing a B-lynch suture and requesting blood products for management of PPH with P<.05.

DISCUSSION:

A simple, low-cost intervention including simulation drills, skills workshops and a free mobile app, can improve provider knowledge and comfort with management of PPH, impacting patient safety.

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