To investigate the effectiveness of evidence-based intervention strategies in managing postpartum hemorrhage following vaginal delivery. This was a prospective, observational quality-improvement evaluation conducted among 120 women who experienced postpartum hemorrhage after vaginal delivery. Two nursing strategies were compared consecutively: a conventional nursing routine and a structured evidence-based nursing protocol developed from current literature and clinical guidelines. Outcomes assessed included postpartum blood loss, coagulation indicators prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), and fibrinogen (FIB), adverse events, self-care ability, nursing satisfaction, emotional status Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), and quality of life. Compared with the routine nursing phase, the evidence-based nursing phase was associated with lower bleeding volume at 0.5, 2, 12, and 24 h postpartum (P < 0.05). After 5 days of nursing care, PT, TT, and APTT were shorter, and FIB levels were higher (P < 0.05). The frequency of adverse events was lower (10.0% vs. 23.3%), while self-care ability, nursing satisfaction, and quality-of-life scores were higher. Both phases showed decreases in SAS and SDS scores, with greater improvement observed in the evidence-based phase (P < 0.05). An observational study of quality-improvement demonstrated a significant association between the implementation of a standardized evidence-based nursing protocol and reduced postpartum hemorrhage, improved coagulation profiles, lower incidence of adverse events, and improved psychosocial outcomes. These results should be validated in future randomized controlled trials.
Chen et al. (Thu,) studied this question.