D02-a Peripartum Pre-transfusion Testing and Transfusion Risk: A Quality Improvement Project
To disseminate findings of a risk assessment tool evaluation, identifying women at highest risk of postpartum transfusion to provide evidence-based recommendations for peripartum pre-transfusion testing.
1. Recognize how peripartum transfusion risk can be used to identify women at highest risk of peripartum hemorrhage.
2. Identify women at risk of requiring blood transfusion using a risk assessment tool at or before her delivery admission.
3. Define pre-transfusion testing (i.e. group & screen, crossmatch) and articulate its role in postpartum hemorrhage prevention.
4. Analyze local barriers and facilitators to accessing blood in obstetric emergencies by recognizing the chronology of Transfusion Medicine Lab processes from request for blood to receiving blood on the unit.
5. Evaluate peripartum transfusion risk factors relevant to patient populations served by another hospital or health authority by employing the methods used and lessons learned.
6. Describe how third trimester hemoglobin can impact postpartum transfusion risk and the role of nurses in acute and community care in preventing postpartum transfusion for anemia.
7. Explain how the role of the perinatal nurse as an advocate for individualized safe care of women at all levels of transfusion risk and when risks arise during the course of her care so that:
- unnecessary interventions (i.e. routine admission lab investigations on all patients) can be safely avoided;
- pre-transfusion testing is requested where risks are present.
Sarah Kaufman, MSN, BSN, RN, Clinical Nurse Specialist, Fraser Health, Delta, BC, Canada
Darlene Mueller, MA ART, Medical Laboratory Technologist, Fraser Health, Canadian Society of Transfusion Medicine, Surrey, BC, Canada
D02-b Wait Another Chorio Case?: The Influence Nursing Can Have on Medical Diagnosis and Treatment
Emphasize the influence the nursing profession can have on the diagnosis and management of women in labour presenting with clinical chorioamnionitis criteria.
Following this session, participants will be able to:
1. Identify nursing screening recommendations allowing differentiation between intrapartum maternal fever and clinical chorioamnionitis.
2. Value the importance of screening labouring mothers and the influence the results this screening can have on medical practice.
3. Recognize how the use of simple clinical tools such as algorithms can influence culture change, professional practice and ultimately improve patient outcomes.
Jennifer Marandola, RN, MN, IBCLC, PNC(C), Advanced-Practice Nurse Consultant, CIUSSS West-Island of Montreal, Sainte-Catherine, QC, Canada