Date of Graduation

Summer 8-8-2025

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

David Ainsworth

Abstract

Abstract

Background: Postpartum hemorrhage (PPH) remains a critical challenge in maternal care. It shows a 13% PPH incidence rate in a high-risk labor and delivery unit in a northern California medical center, exceeding the national benchmark of 5%–10% based on 2021 ACOG data from 150 patient records.

Problem: There is inconsistent adherence to oxytocin administration guidelines, with only 60% of 100 audited charts documenting fetal and uterine activity, contributing to the elevated rate. The team is looking for a target rate of 90%.

Intervention: This involves implementing a checklist, providing training for 25 clinicians, and conducting two 30-minute simulation scenarios over 3 months.

Outcome measures: This included PPH rates, documentation completeness (target 90%), labor duration, and cesarean rates, assessed via electronic health record (EHR) audits and surveys. The PPH rate was targeted to decrease from 13% to 10%, measured weekly via EHR audits.

Results: This project saw a PPH rate decrease to 10% and documentation adherence reaching 90% post-intervention, reducing costs by an estimated $90,000 annually from 50 to 38 PPH cases at $7,500 each.

Conclusion: This project supports sustained training and protocol integration to maintain these outcomes, validated by 85% of staff confidence in post-intervention surveys.

Keywords: Postpartum hemorrhage, oxytocin administration, guideline adherence, maternal safety, quality improvement

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