Reducing Postpartum Hemorrhage: Evidence-Based Nursing Practices in the Immediate Postpartum Period

Jacqueline Marchese, Verrazzano Class of 2026, completed major in Nursing

 

My capstone project focused on reducing postpartum hemorrhage (PPH), which is excessive bleeding after childbirth, through evidence-based nursing practices during the immediate postpartum period. PPH is one of the leading causes of maternal complications and death worldwide, yet it is often preventable with early recognition and timely intervention. The goal of my research was to examine how specific nursing actions - such as accurately measuring blood loss, following standardized care protocols, and working collaboratively with the healthcare team—can improve patient outcomes and reduce the severity of hemorrhage.

Through reviewing current research, I found that nurses play a critical role in identifying early warning signs because they are continuously at the patient’s bedside. Interventions like quantitative blood loss (QBL), which involves measuring rather than estimating bleeding, help detect complications sooner. Additionally, the use of structured care bundles ensures that all members of the healthcare team respond quickly and consistently. Simulation training and interprofessional education were also shown to improve communication and preparedness during emergencies. Another key finding was that postpartum care does not end after the first 24 hours. Complications such as delayed hemorrhage can occur up to six weeks after delivery, making patient education and awareness essential even after discharge. Overall, the research reinforced that strong nursing assessment skills, teamwork, and patient education are vital in preventing serious outcomes related to PPH.

I chose this research area because of my interest in maternal and newborn nursing, particularly the importance of safety during and after childbirth. During my clinical experiences, I saw how quickly postpartum conditions can change, and how essential it is for nurses to act promptly. I was motivated by the idea that improving education and awareness could directly impact patient outcomes and potentially save lives.

Before starting this capstone, I expected the process to be more straightforward, mainly involving gathering articles and summarizing information. However, it turned out to be much more in-depth and analytical than I anticipated. I had to carefully evaluate research studies, identify common themes, and connect findings in a meaningful way. It also required strong organization and time management skills to synthesize a large amount of information into a clear and cohesive paper.

One of the most challenging aspects was narrowing down the research and selecting the most relevant studies from thousands of available articles. It was also challenging to ensure that all information remained focused on nursing practice rather than becoming too broad or medical in general. On the other hand, one of the easier and more enjoyable aspects was connecting the research to real-life nursing practice. I found it rewarding to see how the evidence directly supports what nurses do in clinical settings. I was also surprised by how much of an impact non-pharmacological intervention, such as breastfeeding and patient education, can have on preventing complications.

In the future, this research could be expanded by exploring postpartum hemorrhage management beyond the hospital setting, such as in community health or telehealth follow-ups. It would also be valuable to examine how different hospitals implement postpartum safety protocols and how patient outcomes compare. Additionally, further research could focus on improving patient education tools, such as discharge instructions or identification methods for postpartum patients in emergency settings.

Overall, this capstone experience has strengthened my understanding of evidence-based practice and the importance of continuous learning in nursing. I have gained confidence in analyzing research and applying it to clinical care. Most importantly, I am taking away a deeper appreciation for the nurse’s role in patient advocacy, education, and safety. This experience has reinforced my commitment to providing high-quality, informed care and has prepared me to enter practice with a stronger foundation in both knowledge and critical thinking.