The effects of using nursing practice guidelines for prevention of postpartum hemorrhage within two hours after delivery

Abstract

This study aimed to investigate the effects of nursing practice guidelines for prevention of postpartum hemorrhage within 2 hours after delivery on incidence of postpartum hemorrhage and postpartum complications, and to assess feasibility of applying nursing practice guidelines in the delivery room, as well as nurses’ satisfaction toward nursing practice guidelines for prevention of postpartum hemorrhage within 2 hours after delivery.This study applied a two-group quasi-experimental designs to compare outcomes in different time periods (Interrupted time series design). The study population were; first, 396 pregnant women who had normal delivery. The control group received regular care from September 2019 to January 2020; and experimental group received care according to the nursing practice guidelines which implemented during September 2020 to January 2021. Second, nine registered nurses working in delivery room. Two questionnaires used for assessing feasibility of the guideline and nurses’ satisfaction were validated by five experts (IOC=0.80-1). Quality of the guideline was assessed using Appraisal of Guideline for Research & Evaluation II with each domain received scores over 50 %. Data were analyzed using frequency, percentage, means, standard deviation, and chi-square. Relative risk regression was used to test the effects of using nursing practice guidelines for prevention of postpartum hemorrhage. Findings revealed that the experimental group had significant lower incidence of postpartum hemorrhage than the control group (p=0.01). Relative risk regression analysis revealed that the nursing practice guideline could reduce postpartum hemorrhage by 77% (RR 0.23, 95% CI 0.07-0.71, p=0.01). Comparisons of complications, hysterectomy and shock from postpartum hemorrhage, showed no significant difference between the two groups. Feasibility of applying nursing practice guidelines was 95.45%, and nurses’ satisfaction toward nursing practice guidelines was at good level (mean=4.20, SD.=0.67).