Standard operating procedure for the management and prevention of post-partum haemorrhage in a public general hospital in rural South India: a quality improvement project

Authors

  • Arkadeep Dhali St. John’s National Academy of Health Sciences, Bangalore, Karnataka, India http://orcid.org/0000-0002-1794-2569
  • Christopher D'Souza St. John’s National Academy of Health Sciences, Bangalore, Karnataka, India
  • B. Rathna Roger St. John’s National Academy of Health Sciences, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20211991

Keywords:

Postpartum haemorrhage, Standard operating procedure, Maternal mortality rate, Quality improvement project

Abstract

Background: The Obstetrician stationed in a Public General Hospital noticed that there were no standard guidelines nor any assessment tool for the management of post-partum hemorrhage (PPH). This developed the idea to prepare a standard protocol.

Methods: Aiming to ensure prevention and proper management of PPH in the Maternity ward, a team was formed to perform a Quality improvement project (QIP). A Standard operating procedure (SOP) was formulated referring to the National Health Mission (NHM). Outcome indicators were defined. A series of interventions were implemented and assessed using Plan-Do-Study-Act (PDSA) cycles. The findings from the PDSA cycle of a previous intervention were used to implement change in the next intervention. The data was analysed to accept the change or to further modify it.

Results: At the end of 3 months, percentage of patients with PPH reduced by 3%, percentage of patients diagnosed with PPH within the 1st hour increased by 50%, percentage of patients with PPH treated appropriately increased by 20% and percentage of patients requiring referral due to PPH decreased by 15%. Thus, at the end of 3 months there was significant improvement in the values of the outcome indicators.

Conclusions: In the span of few months, we were able to implement an SOP and bring a significant improvement in the management of PPH in the maternity ward.

 

Author Biographies

Arkadeep Dhali, St. John’s National Academy of Health Sciences, Bangalore, Karnataka, India

MBBS intern , St. John's National Academy of Health Sciences , Bangalore , India

Christopher D'Souza, St. John’s National Academy of Health Sciences, Bangalore, Karnataka, India

MBBS intern , St. John's National Academy of Health Sciences , Bangalore , India

B. Rathna Roger, St. John’s National Academy of Health Sciences, Bangalore, Karnataka, India

MBBS intern , St. John's National Academy of Health Sciences , Bangalore , India

References

Postpartum haemorrhage. National Health Portal Of India. Available at: https://www.nhp.gov.in/ disease/gynaecology-and-obstetrics/postpartum-haemorrhage. Accessed on 24th March 2021.

Prendiville W, O’Connell M. Postpartum Hemorrhage – Vouch. 2006:18.

Reduction in Maternal Mortality Rate. Available at: pib.gov.in/Pressreleaseshare.aspx?PRID=1656242. Accessed on 24th March 2021.

Available at: https://www.nhm.gov.in/images/ pdf/program-mes/maternal-health/guidelines/ Guidance_Note_on_Prevention_&_Management_ of_Postpartum_Haemorrhage.pdf. Accessed on 26th March 2021.

Available at: https://www.who.int/maternal_child ado-lescent/documents/newsletter/mps_newsletter _issue4.pdf. Accessed on 26th March 2021.

Amare G. Review Reviewing the values of a stabdard operating procedure. Ethiopian journal of health sciences. 2012;22(3).2):1-5.

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Published

2021-05-25

How to Cite

Dhali, A., D’Souza, C., & Roger, B. R. (2021). Standard operating procedure for the management and prevention of post-partum haemorrhage in a public general hospital in rural South India: a quality improvement project. International Journal Of Community Medicine And Public Health, 8(6), 2897–2902. https://doi.org/10.18203/2394-6040.ijcmph20211991

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Section

Original Research Articles