Authors: Kimberley Agbo, Woojin Chong.
Objectives: The primary objective of this study was to determine the provider's awareness of the postpartum hemorrhage risk assessment tool at the time of admission. In addition, in keeping with the organization’s continual performance improvement philosophy, education on postpartum hemorrhage risk was provided to survey respondents who self-reported that they were unaware or requested additional resources.
Methods: This cross-sectional study utilized an anonymous survey methodology. We distributed a postpartum hemorrhage awareness risk assessment questionnaire and collected participant responses without personal identifiers over a 3 month time period, January 2023 – March 2023. Analysis was completed using Fischer’s exact test. Alpha level was set to 0.05.
Results: 39 participants completed the questionnaire attending physicians: n=10 (25.6%), nursing staff: n=15 (38.5%), and resident physicians: n=14 (35.9%). 7 of the 10 attending physicians (70%) and 9 of the 15 nursing staff (60%) have worked over 10 years in their profession, while 11 of the 14 resident physicians (78.6%) have worked in their profession for 1-5 years (p=<0.0001). 5 of the 10 attending physicians (50%) and 7 of 15 nursing staff (46.7%) were 36-50 years old, while 13 of 14 resident physicians (93%) were 25- 36 years old (p=<0.0001). Majority of the participants were White; 5 attending physicians (50%), 11 nursing staff (73.3%), and 9 resident physicians (64.3%). Nursing staff had the most awareness of the postpartum hemorrhage awareness risk assessment tool at the time of admission (100%) in comparison with attending physicians (50%) and resident physicians (64.3%), (p=0.005). Nursing staff had the most knowledge of where to access the assessment (93.3%) in comparison to attending physicians (10%) and resident physicians (0%), (p=<0.0001).
Conclusions: Our study revealed a statistically significant difference in awareness of the postpartum hemorrhage risk assessment tool at the time of admission amongst the 3 groups of providers; attending physicians, nursing staff, and resident physicians. The nursing staff had the most awareness in comparison with other providers. The data also highlighted the inconsistencies with accessing the risk assessment and with communication of information obtained through the assessment among providers. A quality improvement project should involve notifying providers of patients that are stratified to high risk, developing a simpler method for all providers to readily access the risk assessment tool, and increasing preparedness by creating an algorithm or bundle.
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