The Nursing Impact: Analyzing the Effects of Nursing Education on the Quantification of Blood Loss and Postpartum Hemorrhage

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Authors

Truesdale, Kellye

Issue Date

2025-04

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Thesis

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en_US

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Research Projects

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Background: Postpartum hemorrhage (PPH) is an obstetric medical emergency, which is effectively managed when blood loss is accurately measured for total volume. Quantitative blood loss (QBL) is the most accurate measurement tool used to quantify the amount of blood lost during and following cesarean section delivery. Methods of QBL measurement should be standardized for all patients and should be easily translatable to ensure accuracy and timely PPH intervention methods. Ensuring that nurses are educated on QBL measurement practices is paramount to ensuring accuracy in recording blood loss and implementing timely interventions. Purpose: This quality improvement (QI) project aimed to impact patient outcomes by improving upon the current quantification methods of blood loss to promote greater accuracy and increased recording of QBL, as well as improved management of obstetrical hemorrhage in the Post Anesthesia Care Unit (PACU). It further aimed to assess and improve the education level of nurses who are responsible for quantifying and reporting blood loss, allowing for improvements in QBL recording and interventions (when medically necessary). Methods: This QI project used randomized chart auditing methods to assess blood loss measurement and interventions prior to, and subsequently following a nurse educational intervention session focused on accuracy of QBL measurement in the PACU. The education provided nurses with understanding and a demonstration of standardized QBL measurement methods and appropriate intervention practices based on the amount of blood loss. Following a three-month implementation period, a comparative analysis was performed to assess for improvements in QBL measurement and interventions in the PACU. Intervention: Education was provided to staff nurses to evaluate the effects of an evidence-based in-person educational session on improvement in the practice of utilizing and reporting quantitative blood loss and interventions in the Post Anesthesia Care Unit following cesarean section deliveries. Results: There was an increase in the number of instances in which PACU QBL was measured and recorded from 20% (pre-intervention) to 33% (post-intervention). However, this improvement did not reflect a significant improvement (x2 = 1.14; p = 0.285). Conclusion: The educational intervention provided to PACU nurses increased nurse awareness and knowledge of QBL measurement, but did not greatly improve the consistency of nurse likelihood to consistently perform these measures during the PACU recovery period.

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