Date of Degree

12-2021

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Laura R. Muñoz

Advisor

Irene Sandate

Abstract

Background. Maternal hemorrhage is a significant cause of worsening maternal morbidity and mortality in the United States. If timely, effective, and compassionate communication is not provided during and following traumatic birth events, negative mental health problems may result that affect maternal well-being, bonding with the baby, and family relationships. A gap analysis carried out at the clinical site showed that a written, evidence-based guidance on communication with patients and families during and after a maternal hemorrhage event was needed. Compliance through documentation is required by the Joint Commission. Trauma-Informed Care is an evidence-based communication approach that incorporates principles of safety, choice, collaboration, trustworthiness, empowerment, cultural/historical/gender that can address traumatic stress developed during or following traumatic events (Morton et al., 2020). Purpose. The aim is to implement best practice for addressing the psychological aspect of maternal hemorrhage events and to meet Joint Commission safety and communication requirements. Goals. Develop and implement communication guidance with greater than 50% documentation adherence. Methods. Using a quality improvement approach, maternal patients meeting hemorrhage criteria received timely communication developed in collaboration with an interprofessional healthcare team. Obstetric staff was educated on the communication approach and a process to prompt obstetric providers to document communication in the medical record was instituted. Results. A post-intervention review of 36 records of maternal hemorrhage patients occurring over an 8-week period revealed 52% documentation of the communication. Implications. An evidence-based communication approach can be implemented to avoid retraumatizing maternal patients and potentially decrease the incidence of future psychological issues.

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