Dissertation
Improving Postpartum Hemorrhage Management in a Critical Access Hospital
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
Abstract
Background: Postpartum hemorrhage (PPH) remains a leading cause of maternal mortality. Rural hospitals face unique challenges due to more limited resources and lower birth volumes. Simulation-based education is an effective strategy to improve clinical readiness, teamwork, and adherence to evidence-based protocols for high-risk, low-frequency events. Purpose: The purpose of this project is to enhance patient safety and improve healthcare delivery in a rural setting by standardizing practices, boosting teamwork, and increasing overall preparedness to manage PPH through evidence-based simulation training. Methods: Interdisciplinary simulations were conducted with obstetric, nursing, anesthesia, and ancillary healthcare staff (n = 44). Participants completed retrospective self-assessment surveys assessing knowledge, confidence, and teamwork. Team performance was evaluated using the Perinatal Team Response Assessment (PETRA) Scale, and the American College of Obstetricians and Gynecologists (ACOG) PPH checklist was used to outline critical actions. Findings: Post-simulation results demonstrated significant improvements in perceived knowledge and confidence in PPH management, along with consistently strong interdisciplinary teamwork, as measured by the PETRA scale. Analysis of the ACOG PPH checklist’s critical actions showed that the majority of simulation groups met or exceeded the benchmark of completing at least 75% of the recommended actions. These findings indicate improved protocol adherence with opportunities for continued practice refinement. Discussion: The findings demonstrate that simulation-based training is an effective intervention for improving preparedness, teamwork, and adherence to protocols in a rural obstetric setting. Standardized simulations may serve as a sustainable strategy to mitigate maternal safety risks.
Details
- Title: Subtitle
- Improving Postpartum Hemorrhage Management in a Critical Access Hospital
- Creators
- Rachael Enderson - University of Iowa
- Contributors
- Heather Bair (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Nurse Anesthesia
- Date degree season
- Spring 2026
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright © 2026 Rachael Enderson
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9985217064702771
Metrics
1 Record Views