The Use of Clinical Practice Guideline in Nursing Care for Postpartum Mother who have Postpartum Hemorrhage and Shock

บทคัดย่อ

Introduction: Data from previous study shown that severe complication leading to the death of postpartum mother was postpartum hemorrhage in which poor uterine contraction was the cause. In 2012-2014, incidence rate of postpartum hemorrhage with shock was 28.60% and 29.40%, consecutively. This rate was increasing and higher than target; therefore, clinical practice guideline should be revised.

Objectives:    To determine the output of clinical practice guideline (CPG) in nursing care for postpartum mother who have postpartum hemorrhage and shock and to determine satisfaction toward on this CPG.

Methodology: This study is research and development study composed of three steps. First was situation study in which relevant information were reviewed from document and in-depth interviewed from obstetricians and nursing working in labor and delivery unit. Second, CPG was designed based on the data from first step. Developed CPG was reviewed by nurse teams before pilot study for two months. Lastly, revised CPG was evaluated both with quantitative and qualitative method.

Findings: CPG for nursing care postpartum mother with postpartum hemorrhage and shock composed of four main components. Firstly is the capacity budding in nursing care skills among nurses working in labor and delivery unit.  Second, initiate CPG. Third, initiate monitoring for complication among laboring women. Lastly, initiate guideline for notify obstetrician and team. After, this CPG was utilized, incidence rate of postpartum hemorrhage and shock was decrease from 32.00% to 9.09%. Nurses were satisfied with this CPG at 92.50%.

Conclusion:  the developed CPG from the situation analysis then used that information in planning with clearly inform health team were lead to the participation with the leading to the good outcome of stakeholders.