12:18,18,Aug,2008 | (694/0/0) | Original

risk of postpartum hemorrhage

Abstract Objective: To care for the implementation of risk management of postpartum hemorrhage to evaluate the effects. Methods: The change in management philosophy, risk education in nursing, and strengthen risk awareness; ways to improve care, increase in human input; strengthen the capacity of emergency stress; identification and evaluation of risk factors for postpartum hemorrhage, early treatment to predictability; increased obstetric emergency management, establishment of emergency plans. Implementation of risk management before and after effects, the results U-test. Results: After implementation of risk management, reduction of maternal postpartum hemorrhage, nursing records to improve quality and maternal satisfaction with the implementation of risk management before and there were statistically significant differences (P <0.01). Conclusion: The implementation of nursing risk management of postpartum hemorrhage, which can effectively enhance the medical and nursing staff awareness of risk prevention of postpartum hemorrhage and improve the quality of obstetric care, and effective risk event occurs, reduce medical disputes.
Key words delivery care of postpartum hemorrhage
Evaluation of effect of risk management for the postpartum hemorrhage nursing
HUANG Lan  ying
(Department of Nursing, Wuhua County Maternal and Child Health Hospital, Guangdong Province Wuhua 514400, China)
[ABSTRACT] Objective: To evaluate the effect of risk management for the postpartum hemorrhage nursing. Methods: Changing philosophy of management, carrying out nursing risk education, elevating risk awareness, improving nursing methods, increasing nurses, strengthening emergency stress ability, recognizing and evaluating risk factors of postpartum hemorrhage, practicing preventive management, increasing management of obstetric emergency, establishing plans for emergency, comparing the nursing effect of risk management before and after the implementation. The U  test was used for the statistical analysis. Results: Maternal postpartum hemorrhage decreased after the implementation of risk management, quality of nursing records were raised, the degree of maternal satisfaction increased, compared with the results before the implementation of risk management, there was significant difference (P
Postpartum hemorrhage is a major cause of maternal mortality in China, but also the serious maternal complications during delivery, the highest cause of maternal death in China first. Now with the launching of decreasing items, national maternal mortality rate declined, but with urban-rural divide, the key to reducing maternal mortality is to reduce postpartum hemorrhage deaths [1]. Therefore, in the nursing management of postpartum hemorrhage, respond to high-risk maternity ward, change management philosophy, to take practical management methods to reduce the incidence of nursing risk to a minimum, which for the protection of mother and child saf
ety and improve the quality of obstetric care, prevention care the incidence of disputes and medical significance. Is the implementation of postpartum hemorrhage in 2007, the effect of nursing risk management is as follows.
1 Clinical data
1.1 General Information
0.05), comparable.
1.2 Methods
â‘  regular care and risk education, and strengthen risk awareness. Clinical cases and learn lessons, learn a lesson; care and safety analysis will be held every month to find out affecting the quality, there are hidden factors and these factors, recommend corrective measures to check the implementation. Respect for maternity rights, and effectively fulfill the obligations of the risk and signed an informed delivery of books and when the post-production transcript.

â‘¡ way to improve care, increase in human input. Undergraduate admissions for emergency room the night of maternal and more busy, and previous delivery room problems and lessons for the care and services in place to ensure the abolition of duty over the past 1 system, increase the midwifery human input, full implementation of midwifery accompany delivery, the implementation of 2 night shift system, each class with a reasonable attention to personnel.

â‘¢ identification and assessment of risk factors for postpartum hemorrhage. Risk management, risk identification is the first step, first possible to identify risk factors for postpartum hemorrhage. For multiple pregnancy, fertility, has repeatedly uterine surgery, history of postpartum hemorrhage, scarring the uterus, uterine fibroids, uterine malformations, blood disease, uterine inertia prolonged labor, fetal head to attract the line, forceps vaginal delivery and other high-risk factors predictable, preventive work, such as when the fetus was delivered before the shoulder, the intramuscular injection of oxytocin 10 U, or the baby is delivered immediately after the rapid intravenous injection of normal saline 20 mL, addition of 10 U oxytocin to prevent postpartum hemorrhage; when maternal vaginal bleeding of more than 300 mL, the immediate establishment of an intravenous access, early good deal of preparation, before they occur.

â‘£ establish emergency plans, strengthen risk disposal. Strengthen the emergency equipment and materials, drug administration, all kinds of rescue goods, equipment, the person responsible for maintenance of a regular weekly disinfection times, faulty timely maintenance to ensure integrity of backup equipment. On-site rescue personnel rational division of labor, clearly the job responsibilities, nursing process, prepared by Guangdong Province, postpartum hemorrhage aid process. Case of postpartum hemorrhage, and start the emergency plan immediately.
1.3 Evaluation results
1.3.1 Statistics of postpartum hemorrhage
According to "Chinese Obstetrics and Gynecology" [2] Measurement of volume 24 h post-partum hemorrhage. When the baby is delivered after device placed in the maternal blood using poly buttocks access the amount of vaginal bleeding, by volume measurement 24 h post-partum hemorrhage.
1.3.2 the quality of nursing records
The implementation of three quality control, quality control staff have families checked by hospital medical records for scoring rate the initial evaluation by one by one, as a quality control; midwives long review, the two quality control; Care Division final, the three quality control to calculate percentile scores.
1.3.3 maternal satisfaction
1 d before each payment of maternity hospital discharge patient satisfaction surveys, fill out by the mothers, midwives is responsible for recovery of statistical scores to percentile scores calculated.
1.4 Statistical Methods
SPSS10.0 software was handled by using the U test. Measurement data were (
risk of postpartum hemorrhage

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