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Improving Early Recognition of Obstetric Hemorrhage

Braphia Land

NUR 462

Leadership & Management

April 1, 2026

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Introduction

National Patient Safety Goal: Early recognition of maternal hemorrhage
Major contributor to maternal morbidity and mortality
Relevant to L&D/postpartum nursing practice
Builds on prior literature review on maternal safety

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Background & Context

Leading cause of maternal mortality worldwide (~20%)
~70,000 maternal deaths annually (Begum et al., 2022)
Visual estimation → inaccurate → delayed treatment
Delays increase risk of shock and death

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Evidence Overview

Early recognition + rapid response improves outcomes
Objective blood loss measurement improves detection (Begum et al., 2022)
Risk factors increase severity (C-section, anemia)
Standardized protocols reduce complications
Level of Evidence:
Cohort studies (Level IV)
Clinical guidelines (Level I–II)

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Postpartum Cart & QBL Calculations and Dry Weight

Interdisciplinary Team Roles

Nurses: early recognition, monitoring, escalation
OB providers: diagnosis and interventions
Blood bank: transfusion support
Leadership: policy and resource allocation
Team collaboration improves safety

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Leadership Strategies

Staff education and simulation training
Standardized protocols/checklists
Leadership support and accountability
Use of data to drive change

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BSN Nurse Leadership Role

Advocate for patient safety
Lead quality improvement initiatives

Coordinate interdisciplinary communication
Promote evidence-based practice

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Proposed QI Intervention

Standardized hemorrhage protocol
Objective blood loss measurement
Early warning system triggers
Rapid response activation

QI Model:

Plan: Identify delayed recognition
Do: Implement protocol
Study: Monitor outcomes
Act: Improve process

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Impact Analysis

Earlier detection of hemorrhage
Reduced maternal morbidity/mortality
Improved patient safety
Stronger team communication

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Conclusion

Early recognition is critical
Standardization improves safety
Nurses are key leaders in change

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References

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Ceylan, Y., Çelen, Ş., & Soysal, Ç. (2025). Massive transfusion in obstetric

hemorrhage: What are the risk factors and can they be predicted? European

Research Journal, 11(2), 427–435. https://doi-

org.ezproxy.umary.edu/10.18621/eurj.1634732

Centers for Disease Control and Prevention. (2023). Pregnancy-related deaths: Data from

maternal mortality review committees.

Begum, F., Nieto-Calvache, A. J., Schlembach, D., Hofmyer, J., Palacios-Jaraquemada, J.,

Bhardwaj, A., Suarez, M. A., Burgos-Luna, J. M., Beyeza-Kashesya, J., Ubom, A. E.,

Wright, A., & FIGO Committee on Childbirth and PPH. (2022). FIGO

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detection of postpartum hemorrhage. International Journal of Gynecology &

Obstetrics, 157(S1), 3–7. https://doi.org/10.1002/ijgo.14187

Model Improves Implementation of Evidence-Based Practice, Healthcare Culture,

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https://doi-org.ezproxy.umary.edu/10.1111/wvn.12188

Murray, E. (2026). Nursing Leadership and Management for Patient Safety and Quality Care

(3rd ed.). F. A.Davis Company.

Rawal, S., & Rana, A. (2012). Second Intervention in Obstetric Hemorrhage. Journal of

Institute of Medicine Nepal (JIOMN), 34(1), 18–24. https://doi-

org.ezproxy.umary.edu/10.59779/jiomnepal.451

The Joint Commission. (2024). National patient safety goals for hospitals.