Objective <p>To investigate the effectiveness of evidence-based intervention strategies in managing postpartum hemorrhage following vaginal delivery.</p> Methods <p>This was a prospective, observational quality-improvement evaluation conducted among 120 women who experienced postpartum hemorrhage after vaginal delivery. Two nursing strategies were compared consecutively: a conventional nursing routine and a structured evidence-based nursing protocol developed from current literature and clinical guidelines. Outcomes assessed included postpartum blood loss, coagulation indicators [prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), and fibrinogen (FIB)], adverse events, self-care ability, nursing satisfaction, emotional status [Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS)], and quality of life.</p> Results <p>Compared with the routine nursing phase, the evidence-based nursing phase was associated with lower bleeding volume at 0.5, 2, 12, and 24&#xa0;h postpartum (<i>P</i> &lt; 0.05). After 5 days of nursing care, PT, TT, and APTT were shorter, and FIB levels were higher (<i>P</i> &lt; 0.05). The frequency of adverse events was lower (10.0% vs. 23.3%), while self-care ability, nursing satisfaction, and quality-of-life scores were higher. Both phases showed decreases in SAS and SDS scores, with greater improvement observed in the evidence-based phase (<i>P</i> &lt; 0.05).</p> Conclusion <p>An observational study of quality-improvement demonstrated a significant association between the implementation of a standardized evidence-based nursing protocol and reduced postpartum hemorrhage, improved coagulation profiles, lower incidence of adverse events, and improved psychosocial outcomes. These results should be validated in future randomized controlled trials.</p>

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Effectiveness of evidence-based nursing protocols in managing postpartum hemorrhage after vaginal delivery: a prospective observational quality-improvement evaluation

  • Yanting Chen,
  • Mengxue Ling,
  • Dandan Nan,
  • Zhenzhen Zhang,
  • Shanshan Liu,
  • Meijing Kou,
  • Xiaoyu Pan

摘要

Objective

To investigate the effectiveness of evidence-based intervention strategies in managing postpartum hemorrhage following vaginal delivery.

Methods

This was a prospective, observational quality-improvement evaluation conducted among 120 women who experienced postpartum hemorrhage after vaginal delivery. Two nursing strategies were compared consecutively: a conventional nursing routine and a structured evidence-based nursing protocol developed from current literature and clinical guidelines. Outcomes assessed included postpartum blood loss, coagulation indicators [prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), and fibrinogen (FIB)], adverse events, self-care ability, nursing satisfaction, emotional status [Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS)], and quality of life.

Results

Compared with the routine nursing phase, the evidence-based nursing phase was associated with lower bleeding volume at 0.5, 2, 12, and 24 h postpartum (P < 0.05). After 5 days of nursing care, PT, TT, and APTT were shorter, and FIB levels were higher (P < 0.05). The frequency of adverse events was lower (10.0% vs. 23.3%), while self-care ability, nursing satisfaction, and quality-of-life scores were higher. Both phases showed decreases in SAS and SDS scores, with greater improvement observed in the evidence-based phase (P < 0.05).

Conclusion

An observational study of quality-improvement demonstrated a significant association between the implementation of a standardized evidence-based nursing protocol and reduced postpartum hemorrhage, improved coagulation profiles, lower incidence of adverse events, and improved psychosocial outcomes. These results should be validated in future randomized controlled trials.