Hospital Spotlight -
Pella Regional Health Center
Addressing Post-Partum Hemorrhage in a Community Hospital
Obstetrical staff at Pella Regional Health Center encountered a difficult patient situation in the spring of 2015. The patient experienced a post-partum hemorrhage and some of the needed responses were delayed. The outcome for the patient was good, but after investigation the OB team knew that several processes needed revision.
The OB staff consulted one of the OB GYN physicians who had practiced at other locations, most recently a University setting. She was able to provide much information about post-partum hemorrhage and current evidence for the staff and physicians. As a result the staff dove further into the research material available to learn how to be more effective in preventing and controlling post-partum hemorrhage for our patient population.
Using Lean Methodology, they gathered all disciplines involved in potential care of the at-risk OB patient: blood bank staff, OB nurses, OB physicians, information technology staff, surgery staff and general surgeons. All reviewed the current literature and discussed assessment criteria and warning signs as well as potential interventions. Physicians felt that the hospital needed to invest in equipment, changes in blood bank protocol and staff response times. In addition nurses needed to be educated in the appropriate assessment criteria, early interventions, communication and treatment.
Much information was gleaned from the California Maternal Quality Care Collaborative (2015). The OB manager and key staff leaders in the department reviewed information available from that source as well as other literature. The OB GYN champion physician led the education for our medical staff on interventions and equipment the hospital needed to obtain. Some of the equipment included an ultrasound unit, which was newly obtained earlier in the year. Another was the Bakri Balloon which was new for several physicians.
The OB staff needed to accurately account for blood loss, which was another education issue. A scale was obtained and proper methodology outlined according to literature sources. Additional materials needed such as packing, speculums, banjo curette, and selected medications were necessary -- so a cart was obtained that could house all materials in one location that would be wheeled to the patient room when needed...
*This spotlight feature was composed by Yvonne O'Brien-Evans, Chief Nursing Officer, Pella Regional Health Center and Karen Westercamp, Pella Regional Health Center