Quantitative Blood Loss Interventions to Improve Assessment of Post-partum Hemorrhage

Background and Purpose: Estimations of blood loss in clinical practice have been found to be inaccurate which can lead to poor outcomes for post-partum women. These outcomes include: post-partum hemorrhage and even death. Studies suggest more accurate means of blood loss measurement in multiple quantitative blood loss (QBL) measurement techniques as a superior means of blood measurement over the current estimated blood loss (EBL) method. The purpose of this project was to increase accuracy of blood loss measurements in scheduled cesarean sections (CS) to initiate mass transfusion protocols faster and more efficiently. Methods: This quality improvement project sought to evaluate the implementation of QBL measurement techniques on a Labor and Delivery surgical suite of scheduled CS through measurement drapes and gravimetric measurement process. Results: The various goals displayed the following results reflecting inaccuracy in EBL measurement when compared to QBL measurement. EBL inaccuracy was 32.61% particularly in underestimation when compared to QBL. The amount that was underestimated averaged 265.2mLs. The PPH QBL cases and serum studies cases matched at 15 cases of PPH per definition; whereas, EBL PPH cases only matched at 11 cases. Staff was educated on measurement inaccuracy and showed an increased knowledge of 30.66% from pre to post tests. Conclusion: QBL measurement is a more accurate means in measuring blood loss than EBL and QBL techniques should be implemented to occur more accurate measurements in order to implement life saving interventions such as rapid response or mass transfusion protocols