Describe the magnitude of the problem Demonstrate the
Describe the magnitude of the problem Demonstrate the difference between EBL vs QBL Take a look at the process, methods, and tools Give suggestions for how to effectively implement and utilize QBL in your organization
� The U. S. has the highest maternal mortality rate of any high resource country – and the rate is increasing. � HALF of maternal deaths are PREVENTABLE! AIM GOAL: is to eliminate preventable maternal mortality and severe morbidity across the U. S.
� Readiness – every unit � Recognition and Prevention – every patient � Response – every hemorrhage � Response Reporting/Systems Learning – every unit
�A leading cause of maternal morbidity and mortality is failure to recognize excessive blood loss during childbirth. � Women die from obstetric hemorrhage because effective interventions are not initiated early enough.
Every unit: Hemorrhage cart with supplies
� Every vaginal delivery
� Every C/S
q Computerized tracking – documentation (IT) q Keeping track of total – bedside card q Dry weight charts Note time of delivery Pause… Vaginal delivery – note volume in drape C/S – change suction tubing to 2 nd canister or note volume in canister Subtract before placenta delivery from total
� Develop a multidisciplinary taskforce with physician and nursing champions from OB and anesthesia � Don’t reinvent the wheel – use available resources to assist you in your hospital’s individualized QBL plan � Simulation is a great way to educate, practice new behaviors � Add QBL in your OB emergency drills and unit competencies � Debriefings are critical for continuous quality improvement
Mon Health Postpartum Hemorrhage Rate FBC QBL Project 120 4. 82% 104 # Patients 90 80 5. 00% 87 83 4. 00% 3. 45% 60 3. 00% 40 1. 92% 20 0 Total Deliv. # Hemorr. % 2. 00% 1. 00% 4 83 4 4. 82% 0 90 0 0. 00% 3 2 87 3 3. 45% 0. 00% 104 2 1. 92% Hemorr. Rate (%) 100 6. 00%
� Quantification of blood loss for all � Active management of the 3 rd stage for all � Vital sign triggers � “Move along” on uterotonic medications � Intrauterine balloon/B-Lynch suture � A new approach to blood products � The value of a formal protocol � Toolkit at www. cmqcc. org/ob_hemorrhage
QBL and Early Recognition saves lives
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