The Effects of a Postpartum Hemorrhage Checklist on Provider Self-Efficacy

The United States has seen an increase in postpartum hemorrhage (PPH) rates in recent years from 2.3% (n = 85,954) to 2.9% (n = 124,708). In an effort to reduce the incidence of PPH, checklists are being used with increased frequency in many hospitals in the United States and worldwide. The purpose of this project was to determine if a PPH checklist would impact maternal care provider's self-efficacy at Naval Hospital Camp Pendleton (NHCP). This quality improvement project took place on the Labor & Delivery Unit and the Mother/Infant Unit at NHCP. This project assessed provider self-efficacy levels prior to and after the training and implementation of a PPH checklist. Prior to implementation of the PPH checklist, training was provided to obstetricians, certified nurse midwives, family practice doctors (staff and residents), Labor & Delivery Unit and Postpartum Unit nurses, and corpsmen. After completing the training and pre- and post-implementation surveys, data on self-efficacy levels were compared. Over a five-day training period, 64 maternal care providers participated in the training and surveys. The project used a pre- and post-implementation survey questionnaire consisting of ten questions and an open-ended query. The ten questions were designed to determine the level of self-efficacy for maternal healthcare providers in treating a postpartum hemorrhage. The results obtained showed a difference of 0.15 between the pre-implementation mean and the post-implementation mean. The data showed a statistically significant difference with a p-value <0.05, resulting in an overall increase in maternal healthcare provider self-efficacy. This increase to self-efficacy occurred after training and implementation of the PPH checklist. Implementation of a postpartum hemorrhage checklist increased the self-efficacy of maternal healthcare providers at NHCP. Having access to job-specific tools such as a checklist enhances provider self-efficacy. Further studies are needed to determine the impact a PPH checklist has on patient outcomes.