During the care of the obstetric (OB) patient throughout labor, delivery, and postpartum, obstetric departments work to provide safe outcomes for mothers and infants. To do so, nurses must be prepared to act upon any adverse event associated with increased maternal or neonatal morbidity or mortality. However, staff are challenged to implement evidence-based practice when these events occur so infrequently. This is especially challenging for nurses who are new to obstetric care and have little, if any, exposure to adverse scenarios or events. For these reasons, newly hired nurses who have less than 1-2 years’ experience in obstetrics nursing could benefit from a high-risk OB class that incorporates topics including postpartum hemorrhage (PPH) to assist in earlier recognition, response, and ultimately improved patient care.
According to the Association of Women’s Health, Obstetric and Neonatal Nurses [AWHONN] (2015), OB hemorrhage is the leading cause of maternal mortality and major cause of morbidity. Additionally, 54-93% of maternal hemorrhage-related deaths could have been prevented with better clinical response (AWHONN, 2015). Healthy People 2020 identified a goal to decrease maternal deaths from 12.7 deaths per 100,000 live
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A tired uterus from induction of labor, multiparity, general anesthesia, prolonged labor, or amnionitis also place a patient at higher risk for PPH (Oberg et al., 2014). Further risk factors include previous cesarean section, coagulation defects, fibroids, or placental issues. Lacerations from an instrumental delivery, precipitous delivery, or a manipulative delivery can also cause PPH. Finally, uterine inversion and hematomas can be complications leading to PPH. A greater knowledge of risk factors and possible causes can help providers in their care of OB