Nurses' Knowledge and Teaching of Possible Postpartum Complications.

PURPOSE: The purpose of this study was to assess postpartum nurses' knowledge of maternal morbidity and mortality, and information they shared with women before discharge about identifying potential warning signs of postpartum complications. STUDY DESIGN & METHODS: Registered nurses (RNs) who care for women during postpartum (N = 372) completed an electronic survey. Descriptive statistics and bivariate analyses were used for data analysis. RESULTS: Fifty-four percent of nurse participants were aware of the rising rates of maternal mortality in the United States and 12% accurately reported the correct percentage of deaths that occurred during the postpartum period. Ninety-three percent of nurses were more likely to identify hemorrhage as a leading cause of maternal mortality. On the day of discharge, 67% of RNs spent less than 10 minutes focusing on potential warning signs. Ninety-five percent of RNs reported a correlation between postpartum education and mortality; however, only 72% strongly agreed it was their responsibility to provide this education. Nurse respondents who were over the age of 40 were significantly more likely to report feeling very competent when providing education on all of the postpartum complication variables measured (p values <0.001-0.003). CLINICAL IMPLICATIONS: The majority of nurses in this study were not up-to-date on the rates and timing of maternal mortality during the postpartum period in the United States. They did not always provide comprehensive education to all women prior to discharge from the hospital after childbirth. There is a need for nurses to provide consistent messages about potential warning signs that may ultimately reduce maternal death and severity of maternal complications.

Improving Postpartum Education About Warning Signs Of Maternal Morbidity and Mortality.

Maternal morbidity and mortality rates remain high in the United States compared with other developed countries. Of particular concern is the rise in postpartum deaths, because many of the risk factors for complications associated with maternal morbidity and mortality may not be clearly identified before a woman's discharge after birth. Although nurses provide some form of postpartum discharge education to all women who give birth, the information women receive on common potential complications is not always consistent or evidence based. By improving postpartum education, nurses may be better poised to teach women how to recognize and respond to warning signs. This article describes a project intended to increase women's access to predischarge education about the risks for postbirth complications.

Discharge Education on Maternal Morbidity and Mortality Provided by Nurses to Women in the Postpartum Period.

OBJECTIVE: To explore what types of educational materials and discharge information are currently used by postpartum nurses to educate women about the warning signs of postpartum complications to determine what key messages should be presented to women after birth and before discharge. DESIGN: Exploratory qualitative. SETTING: Six hospitals located in New Jersey and Georgia. PARTICIPANTS: Fifty-two nurses. METHODS: Six focus group discussions were conducted using a semistructured interview guide to elicit data on how and what nurses taught women about maternal post-birth warning signs. The focus group discussions were audiotaped, transcribed, coded, and clustered into categories. RESULTS: Most nurses described some of the warning signs related to maternal morbidity and mortality to the women; however, these elements were not the primary focus of the education throughout the hospital stay and were most often discussed on the day of discharge. Nurses also did not consistently describe the same signs and symptoms of the warning signs with each and every woman. The primary mechanism for education consisted of individualized instruction with booklets or folders of information. CONCLUSION: These data indicate that improvements may be needed in how nurses educate women who just gave birth about the most common post-birth warning signs before they are discharged from the hospital. These findings also suggest that nurses need more information and guidance on how to teach all women about the post-birth warning signs.

National Initiatives to Improve Systems for Postpartum Care.

Purpose To showcase several current national initiatives that focus on reducing maternal mortality and severe maternal morbidity and promote postpartum health and wellness for all women. Description Maternal injuries and deaths are a serious public health concern with tremendous impact on families, communities, and healthcare providers. Over the past two decades, it has become apparent that the timing of serious maternal complications has shifted, with more than half of deaths occurring in the immediate postpartum period up to 1 year following birth. Many of these reported deaths could have been prevented, and the number of "near misses" of maternal morbidity cases continues to grow exponentially. In addition, postpartum women experience substantial unmet health needs, compromising their wellbeing. Assessment The American College of Obstetricians and Gynecologists and the Association of Women's Health, Obstetric, and Neonatal Nurses have thoroughly assessed the significance of the rising trends in maternal morbidity/mortality and are leading efforts to reduce these rates and improve overall health and wellbeing for all women during the postpartum period. Conclusion Developing national initiatives to improve postpartum health are vital to increasing the effectiveness of postpartum discharge education, and improving the participation in and the quality of postpartum care. Hopefully, evidence-based practice and widespread dissemination of these efforts will lead to a reduction in preventable post-birth maternal morbidity and mortality.