National Partnership for Maternal Safety Consensus Bundle on Obstetric Hemorrhage (original) (raw)
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Journal of Obstetric, Gynecologic, & Neonatal Nursing, 2018
Cesarean births and associated morbidity and mortality have reached near epidemic proportions. The National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care responded by developing a patient safety bundle to reduce the number of primary cesarean births. Safety bundles outline critical practices to implement in every maternity unit. This National Partnership for Maternity Safety bundle, as with other bundles, is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning. Bundle components may be adapted to individual facilities, but standardization within an institution is advised. Evidence-based resources and recommendations are provided to assist implementation.
Implementation of a Postpartum Hemorrhage Safety Bundle at an Urban Safety-Net Hospital
2020
Background Postpartum hemorrhage (PPH) is a leading cause of preventable maternal morbidity and mortality. Standardized response to obstetric hemorrhage is associated with significant improvement in maternal outcomes, yet implementation can be challenging. Objective The primary objective is to describe the methodology for program implementation of the Alliance for Innovation on Maternal Health Safety Bundle on PPH at an urban safety-net hospital. Methods Over an 18-month period, interventions geared toward (1) risk assessment and stratification, (2) hemorrhage identification and management, (3) team communication and simulation, and (4) debriefs and case review were implemented. Hemorrhage risk assessment stratification rates were tracked overtime as an early measure of bundle compliance. Results Hemorrhage risk assessment stratification rates improved to >90% during bundle implementation. Conclusion Keys to implementation included multidisciplinary stakeholder commitment, s...
Improving Childbirth and Maternal Care - How to Foster the Use of Good Practices for Patient Safety
Vignettes in Patient Safety - Volume 1, 2017
Despite the global effort toward improving childbirth and maternity care, there are still complications (hemorrhage, infections, and high blood pressure) that may arise unexpectedly. To end preventable mortality, every woman needs skilled care at birth. The aim of this chapter is to present some solutions implemented by Frontline professionals and healthcare organizations made available through the Italian Observatory on Good Practices for Patient Safety, a national program to improve patient safety by promoting diffusion and active dissemination of evidence-based practices.
Anesthesia & Analgesia, 2019
I n the United States, maternal mortality has increased during the past 2 decades in association with rising maternal age, preexisting comorbidities, and obesity. 1 With the aim of lowering preventable maternal morbidity and mortality, the National Partnership for Maternal Safety (NPMS) was formed. 2-4 The first NPMS consensus bundle KEY POINTS • Question: What barriers exist to the implementation of the national partnership for maternal safety obstetric hemorrhage bundle? • Findings: Six of the 13 bundle elements achieved multidisciplinary consensus as being deficient and were ranked for patient impact and implementation feasibility. • Meaning: The Delphi method identifies institutional deficiencies and promotes tangible, meaningful, and multidisciplinary systemic improvements.
The National Partnership for Maternal Safety
Obstetrics & Gynecology, 2014
Recognition of the need to reduce maternal mortality and morbidity in the United States has led to the creation of the National Partnership for Maternal Safety. This collaborative, broad-based initiative will begin with three priority bundles for the most common preventable causes of maternal death and severe morbidity: obstetric hemorrhage, severe hypertension in pregnancy, and peripartum venous thromboembolism. In addition, three unit-improvement bundles for obstetric services were identified: a structured approach for the recognition of early warning signs and symptoms, structured internal case reviews to identify systems improvement opportu nities, and support tools for patients, families, and staff that experience an adverse outcome. This article details the formation of the National Partnership for Maternal Safety and introduces the initial priorities.
Patient safety initiatives in obstetrics: a rapid review
BMJ Open
ObjectivesThis review was commissioned by WHO, South Africa-Country office because of an exponential increase in medical litigation claims related to patient safety in obstetrical care in the country. A rapid review was conducted to examine the effectiveness of quality improvement (QI) strategies on maternal and newborn patient safety outcomes, risk of litigation and burden of associated costs.DesignA rapid review of the literature was conducted to provide decision-makers with timely evidence. Medical and legal databases (eg, MEDLINE, Embase, LexisNexis Academic, etc) and reference lists of relevant studies were searched. Two reviewers independently performed study selection, abstracted data and appraised risk of bias. Results were summarised narratively.InterventionsWe included randomised clinical trials (RCTs) of QI strategies targeting health systems (eg, team changes) and healthcare providers (eg, clinician education) to improve the safety of women and their newborns. Eligible s...
National Partnership for Maternal Safety
Obstetrics & Gynecology, 2019
Recognition of the need to reduce maternal mortality and morbidity in the United States has led to the creation of the National Partnership for Maternal Safety. This collaborative, broad-based initiative will begin with three priority bundles for the most common preventable causes of maternal death and severe morbidity: obstetric hemorrhage, severe hypertension in pregnancy, and peripartum venous thromboembolism. In addition, three unit-improvement bundles for obstetric services were identified: a structured approach for the recognition of early warning signs and symptoms, structured internal case reviews to identify systems improvement opportunities, and support tools for patients, families, and staff that experience an adverse outcome. This article details the formation of the National Partnership for Maternal Safety and introduces the initial priorities.
Patient safety in obstetrics–the Hospital Corporation of America experience
American Journal of Obstetrics and Gynecology, 2011
We report an update on obstetric patient safety efforts and results in the nation's largest obstetric health care delivery system. The application of principles advocated by the Institute of Medicine a decade ago has resulted in reduced adverse outcomes, as reflected by claims experience. Particular progress has been made in standardization and documentation of critical processes, establishment of national quality benchmarks, reduction in elective deliveries Ͻ39 weeks' gestation, and reduction in fatal postcesarean pulmonary embolism. Our experience provides a useful blueprint for similar progress in other health care systems.
Anesthesia & Analgesia, 2018
BACKGROUND: In 2015, the National Partnership for Maternal Safety (NPMS) developed an obstetric hemorrhage consensus bundle to provide birthing facilities in the United States with consistent, validated practice guidelines for postpartum hemorrhage management. The process of implementing each bundle element at a large tertiary labor and delivery unit has not been described; we sought to identify practice deficiencies and perceived barriers to bundle implementation among multidisciplinary providers. METHODS: We conducted a prospective, cross-sectional, consensus-building study based on the Delphi method. A multidisciplinary expert panel comprised of anesthesiologists, obstetricians, nurses, and surgical technicians was assembled and participated in 4 sequential questionnaires. The first round identified bundle elements that experts determined as not currently adequate and perceived barriers to implementation. The second round established prioritization of elements within each profess...