Development of a holistic maternity nursing model to prevent and reduce early postpartum hemorrhage in the context of Yangsisurat Community Hospital, Maha Sarakham Province.

Abstract

     This action research aimed to 1) analyze the existing situation of maternity nursing care to prevent and reduce early postpartum hemorrhage, 2) develop a holistic maternity nursing model, and 3) evaluate the developed model in the context of Yangsisurat Hospital, Maha Sarakham Province. The study was conducted from July 2024 to September 2025. The sample consisted of 35 maternity patients and 19 nursing personnel and multidisciplinary team members involved in maternity care. Research instruments included the holistic maternity nursing model, nursing practice guidelines, a personnel capacity building program, data recording forms, competency assessment forms, and satisfaction assessment forms. Quantitative data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation, and qualitative data were analyzed using content analysis.

     The research findings revealed that 1) the existing situation had problems with unsystematic risk assessment, inconsistent monitoring of abnormal symptoms, and unstandardized communication within the team. Some personnel lacked confidence in managing postpartum hemorrhage. 2) A holistic maternity nursing model was developed, comprising six key components: systematic risk assessment, monitoring and follow-up of abnormal symptoms, preparedness of emergency medications and equipment, communication and coordination within the multidisciplinary team, personnel capacity building, and family and relative involvement. 3) Following the implementation of the model, the incidence of postpartum hemorrhage decreased from 5.71% in fiscal year 2023 to 2.86% in fiscal year 2025. The completeness of risk assessment increased from 65.00% to 97.00%. Postpartum symptom monitoring according to guidelines increased from 68.00% to 100.00%. The availability of emergency medications and equipment increased from 80.00% to 100.00%, and patient satisfaction improved. The number of deliveries increased from 82.00% to 97.00%, while the competence of emergency and trauma nurses rotating through the delivery room was at a high level (Mean = 4.43, S.D. = 0.51), and the satisfaction of the nursing team and multidisciplinary team with the model was at the highest level (Mean = 4.74, S.D. = 0.45).