Development of Nursing Practice Guidelines for The Prevention of Early 2 Hours Postpartum Hemorrhage in The Delivery Room, Loei Hospital

Abstract

Introduction: The delivery room patient ward in Loei hospital, the incidence of postpartum hemorrhage in 2019-2021 were 0.68%, 1.83%, and 2.11%, respectively which tend to increase, due to occur the results of shock and the death of the mother after giving birth.

Objectives: To develop a nursing practice guideline to prevent the first 2 hours of postpartum hemorrhage in the delivery room, Loei hospital as well as to study the outcomes of nursing guideline practice.

Methods: The study was action research. The research participants were 14 professional nurses in the delivery room. The sample consisted of 360 mothers who gave birth through vaginal birth. There were admitted to the delivery room from April - September 2022. The measurements to collect data used in-depth interviews/group discussions/brainstorming guidelines, reflection sessions, Nursing Practice Assessment Form assessment with Kuder-Richardson Reliability was 0.94 and Nursing satisfaction assessment with Cronbach’s Alpha Reliability was 0.77.

Results: After applying the guideline the group of nurses had all activities towards the initial stage, waiting for delivery, during delivery, and 2 hours after delivery. The incidence of hemorrhage 2 hours after delivery decreased from 6.7% to 0.0 (p=0.007). There was no incidence of shock. blood loss, hysterectomy, and death. Nurses were highly satisfied scores in the nursing practice.

Conclusion: Nursing practice guidelines to prevent hemorrhage after 2 hours can increase nursing standards and the nursing effectiveness of midwifery nurses and prevent postpartum hemorrhage.