Esan Deborah Tolulope, Imene Peace Oritseweyinmi, Akingbade Oluwadamilare, Ojo Elizabeth Funmilayo, Ramos Carlos
Department of Nursing Science, College of Medicine and Health Sciences, Afe Babalola University, Ado- Ekiti, Ekiti State, Nigeria.
Department of Nursing Science, College of Medicine and Health Sciences, Afe Babalola University, Ado- Ekiti, Ekiti State, Nigeria.
Enferm Clin (Engl Ed). 2023 Mar-Apr;33(2):93-101. doi: 10.1016/j.enfcle.2022.09.001. Epub 2022 Oct 10.
Maternal mortality continues to pose a critical challenge in obstetric practice, with postpartum haemorrhage as one of the major causes. This study aimed to explore the lived experiences of midwives regarding the management of postpartum haemorrhage (PPH).
The study employed a qualitative phenomenological approach. Participants were selected using purposive sampling technique, and 15 participants were recruited for the study. Data collection was done using a semi-structured interview guide for in-depth interviews. The interviews were audio-recorded, and data analysis was done using thematic analysis.
Two themes emerged from the analysis, including 1) management practices adopted against PPH and 2) hospital protocol for the management of PPH. The major management practices adopted by the midwives were using uterotonics, especially oxytocin, and other management practices such as anti-shock garments, stimulation of contractions by rubbing the uterus, and assessment of the cause of bleeding and suturing of lacerations. It was also deduced that different healthcare facilities had policies for managing postpartum haemorrhage. Barriers affecting the effective management of PPH were understaffing, unavailability of suitable facilities and equipment, restrictions on nurses/midwives in managing PPH, unfavourable hospital policy and lack of communication among the healthcare team.
The participants' experiences suggest they are somewhat satisfied with PPH management in their facilities. However, barriers such as understaffing, unavailability of equipment, poor communication among healthcare teams and restrictions on nurses in PPH management should be addressed to improve midwives' experiences in PPH management.
孕产妇死亡率在产科实践中仍然是一项严峻挑战，产后出血是主要原因之一。本研究旨在探讨助产士在产后出血管理方面的生活经历。
本研究采用定性现象学方法。使用目的抽样技术选取参与者，共招募了15名参与者。通过半结构化访谈指南进行深入访谈来收集数据。访谈进行了录音，并采用主题分析法进行数据分析。
分析得出两个主题，包括1）针对产后出血采取的管理措施和2）产后出血管理的医院方案。助产士采取的主要管理措施包括使用宫缩剂，尤其是催产素，以及其他管理措施，如抗休克衣、通过按摩子宫刺激宫缩、评估出血原因和缝合裂伤。还推断出不同的医疗机构有产后出血管理政策。影响产后出血有效管理的障碍包括人员配备不足、缺乏合适的设施和设备、护士/助产士在产后出血管理方面受到限制、不利的医院政策以及医疗团队之间缺乏沟通。
参与者的经历表明，他们对所在机构的产后出血管理 somewhat 满意。然而，应解决人员配备不足、设备缺乏、医疗团队之间沟通不畅以及护士在产后出血管理方面受到限制等障碍，以改善助产士在产后出血管理方面的体验。
