SLIDE 1
POST-PARTUM HAEMORRHAGE ON THE RISE , WHY?
- Worldwide 1
- Australia 1, United Kingdom5, America 4
- Victoria2
- Mercy Hospital for Women6
HAEMORRHAGE MICHAELLA TATLAH, SUZZANNE GROUNDS & JACQUI - - PowerPoint PPT Presentation
HAEMORRHAGE MICHAELLA TATLAH, SUZZANNE GROUNDS & JACQUI - - PowerPoint PPT Presentation
AN EDUCATION FOCUSED RESPONSE TO REDUCING THE INCIDENCE OF POST-PARTUM HAEMORRHAGE MICHAELLA TATLAH, SUZZANNE GROUNDS & JACQUI MCGREGOR MERCY HOSPITAL FOR WOMEN POST-PARTUM HAEMORRHAGE ON THE RISE , WHY? Worldwide 1 Australia 1 ,
SLIDE 2
SLIDE 3
MERCY HOSPITAL FOR WOMEN STATISTICS6
5 10 15 20 25 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18
Vaginal Births with PPH
SLIDE 4
WHAT IS THE CAUSE?
The causes of PPH are often summarised as the four Ts:
- tone
- trauma
- tissue
- thrombin
An additional T has frequently been added to emphasise the utility
- f an operating theatre in the management of severe PPH7
SLIDE 5
WHY DOES THIS MATTER?
- Morbidity and Mortality
- Staff to Patient Ratio
- Organisation
- Department of Health
SLIDE 6
HOW COULD THIS BE IMPROVED?
- Establishment of PPH Working Group
- Audits conducted to identify trends
- Recommendations for improvement in practices and education
- Government Initiatives
SLIDE 7
Issues identified at Mercy Hospital for Women
- Reluctance to call codes
- Local practices leading to delays in
both identifying and treating PPH
- Lack of awareness of protocols
Midwife BJ supporting a hospital birth
SLIDE 8
EDUCATIONAL FOCUS
- Face to Face
- Workshops
- Obstetric Simulation
- Case Studies
SLIDE 9
OBSTETRIC SIMULATION
SLIDE 10
SLIDE 11
EDUCATIONAL FOCUS
- PPH Drug Box
- Hand Over
SLIDE 12
EDUCATIONAL FOCUS
- Code Education
- PPH Tool
SLIDE 13
OUTCOMES FOR MERCY HOSPITAL FOR WOMEN
5 10 15 20 25 30 35 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19
Vaginal Births with PPH
SLIDE 14
WHERE TO NOW?
- New Focus for Simulation
- Continue Audits
- Implement Ongoing Evidence Based Practice
SLIDE 15
WHERE TO NOW FOR VICTORIA?
VPDC – new fields to record more accurate data 3
- Blood loss assessment indicator
- Blood loss in mls
- Main reason for excessive blood loss during childbirth
SLIDE 16
ANY QUESTIONS?
SLIDE 17
1.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (2017), Management of Postpartum Haemorrhage, https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG- MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Management-of-Postpartum- Haemorrhage-(C-Obs-43)-Review-July-2017.pdf?ext=.pdf
2.
Flood, M, McDonald, SJ, Pollock, W, Cullinane, F and Davey, M (2018) Incidence, trends and severity of primary postpartum haemorrhage in Australia: A population-based study using Victorian Perinatal Data Collection data for 764 244 births, Australian New Zealand Journal of Obstetric Gynaecology: 1-7
3.
Victorian Perinatal Data Collection (2019) Postpartum haemorrhage (PPH) – prevention, assessment and management, https://www.bettersafercare.vic.gov.au/resources/clinical-guidance/maternity-ehandbook/postpartum-haemorrhage-pph- prevention-assessment-and-management
4.
Smith, RJ (2018), What is the prevalence of postpartum haemorrhage (PPH) in the US?, Medspace, https://emedicine.medscape.com/article/275038-overview
5.
Quinn, MJ (2014), Rising rates of postpartum haemorrhage in the UK, British Medical Journal, 2014;349:g4984
6.
Mercy Hospital for Women (2019), Post-partum haemorrhage statistics, adapted from Decision Point
7.
Lee, RM (2017), Postpartum Haemorrhage, Obstetric and Gynaecology Magazine, 19:2