Development of Practice Guidelines for the Prevention and Treatment of Postpartum Hemorrhage in Mothers with Normal Labor at Narathiwas Rajanagarindra Hospital
Keywords:
Postpartum hemorrhage, Prevention and treatment of PPH in mothers with normal labor, Satisfaction, Effectiveness of obstetric practice guidelineAbstract
This research and development aimed to develop practice guidelines for the prevention and treatment of postpartum hemorrhage (PT-PPH) in mothers with normal labor and evaluate the effectiveness and satisfaction with the use of PT-PPH. The sample group consisted of 74 multidisciplinary obstetrics team members and 300 mothers with normal labor at Narathiwas Rajanagarindra Hospital. Research instruments included 1) a postpartum Hemorrhage (PPH) situation analysis form; 2) maternal data; 3) an AGREE II 2017 assessment form; 4) a PT-PPH usage checklist; and 5) satisfaction with the use of the PT-PPH practice guideline using the Likert Scale and Visual Analog Scale (VAS). Content validity of instrument number 3, 4, and 5 was tested by experts. Reliability of set 3 was .983, set 4 was .75, and set 5 of satisfaction with the Likert Scale = .915; VAS = .998. Situation data was analyzed by using the Colaizzi Technique. Other data were analyzed by using descriptive statistics and an F-test.
Results revealed that the interdisciplinary team jointly developed and designed the PT-PPH draft, dividing it into prevention groups: low-risk PPH and high-risk PPH. The treatment group included impending PPH, PPH, and severe PPH with shock. The researchers designed the PT-PPH form with 3 columns on a single sheet that included 1) "condition" characteristics of the risk group; 2) “order for one day”; 3) “order for continuation” that clearly separate the treatment plans for each group. The treatment results according to PT-PPH in the first 150 cases showed 2 instances of postpartum hemorrhage due to non-compliance with PT-PPH. The researchers adjusted PT-PPH to make it more user-friendly. In the subsequent 150 cases, no instances of postpartum hemorrhage were observed. The average satisfaction scores for the use of PT-PPH in all groups were at a high level. The results of this study will serve as data for the further development of the PPH prevention and treatment system.
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