The Effects of Nursing Care Guidelines Based on the APIE Model for the Prevention of Postpartum Hemorrhage on the Incidence of Postpartum Hemorrhage and Blood Loss among Normal Vaginal Delivery Women at Surin Hospital
Keywords:
Postpartum hemorrhage, APIE nursing model, Volume of blood lossAbstract
This quasi-experimental research with a one-group posttest design aimed to study the effects of nursing care guidelines for the prevention of postpartum hemorrhage based on the APIE Model on the incidence of postpartum hemorrhage and blood loss among normal vaginal delivery women at Surin Hospital. The study was conducted between Mayl 1 to June 30, 2025, with a purposive sample of 34 participants. The sample size was calculated using the G*Power program. The research instruments included the nursing care guidelines based on the APIE Model, a postpartum hemorrhage assessment form, and a blood loss recording form. The content validity was verified by three experts, yielding an IOC value of 1.00, while the reliability was determined using Cronbach’s alpha coefficients of .75 and .89, respectively. Data were analyzed using descriptive statistics and t-test. The results revealed that:
- After the implementation of the nursing care guidelines based on the APIE Model, 100% of normal vaginal delivery women at Surin Hospital did not experience postpartum hemorrhage.
- After the implementation of the nursing care guidelines based on the APIE Model, the amount of blood loss among normal vaginal delivery women was significantly less than 500 milliliters (p< .001).
The research results confirmed that using the ALPIE nursing model for preventing early postpartum hemorrhage in the delivery room can improve quality outcomes. The guidelines can be consistently applied and directly benefit laboring women because they receive standardized care. This reduces blood loss during labor, reduces labor room nurses' anxiety, and eliminates the need for agencies to prepare excessive blood reserves in the delivery room. This reduces the cost of providing services to maternal care costs.
References
Baramee, C. (2023). Statistics for Health Research and Data Analysis Using SPSS (5th ed.). Chiang Mai: Chiang Mai University Press. (In Thai)
Boonyakiat, S., Somchue, P., & Panyapinijkun, C. (2022). Nursing Care in High-Risk Pregnant Women 1 (4th ed.). Bangkok: Sinthana Copy Center. (In Thai)
Bureau of Maternal and Child Health, Department of Health. (2024). Situation Analysis and Performance Results of the Indicator “Maternal Mortality Ratio per 100,000 Live Births”: Results from October 2023 - March 2024. Retrieved April 8, 2025, from https://hp.anamai.moph.go.th/th/opdc-2567-mihd/?reload (In Thai)
Chaisin, A. (2023). Effects of Clinical Practice Guidelines Toward the Prevention of Postpartum Hemorrhage Within Two Hours After Delivery During Normal Vaginal Delivery in Chokchai Hospital. Journal of Nursing and Health Sciences, Nakhon Phanom University, 1(1), 1-11. (In Thai)
Churos, S. (2019). Prevention of Postpartum Hemorrhage: The Role of Nurses. Regional Medical Journal 11, 33(1), 181–192. (In Thai)
Cohen, J. (2020). Statistical power analysis for the behavioral sciences (2nd ed.). Routledge. . Retrieved June 28, 2025, from https://doi.org/10.4324/9780203771587 (Original work published 1988)
Delivery Room Unit, Health Promotion Center 5 Ratchaburi. (2019). Statistical Report on Childbirth and Postpartum Hemorrhage Cases. Ratchaburi: Health Promotion Center 5 Ratchaburi. (In Thai)
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for Correlation and Regression Analyses. Behavior Research Methods, 41(4), 1149–1160. https://doi.org/10.3758/BRM.41.4.1149
Health Promotion Division, Department of Health, Ministry of Public Health. (2020). Guidelines for Maternal Death Surveillance System Implementation in Thailand. Retrieved April 8, 2025, from https://hp.anamai.moph.go.th/th/maternal-mortality-ratio/ (In Thai)
Jirawatkul, A. (2023). Health Science Statistics for Research (7th ed.). Bangkok: Aroonkanphim Publishing. (In Thai)
Plodrit, L., Vipavakarn, L., & Kinglek, A. (2016). Development of Clinical Nursing Practice Guidelines to Prevent Early Postpartum Hemorrhage in the Labor Room, Krabi Hospital. The Southern College Network Journal of Nursing and Public Health, 3(3), 127-141. (In Thai)
Rattanacho, W. (2024). Development of a Nursing Model for the Prevention of Postpartum Hemorrhage at Bangkaeo Hospital, Phatthalung Province. Retrieved March 23, 2025, from https://ptho.moph.go.th/hr/?cgr=7# (In Thai)
Rueangkanchanaseth, S., et al. (2022). Principles of Diagnosis and Management of Obstetric Emergencies for Physicians, Nurses, and Medical Personnel (3rd ed.). Khon Kaen: Department of Obstetrics and Gynecology, Faculty of Medicine, Khon Kaen University. (In Thai)
Sirimas, N., Somsripang, P., Padklang, S., & Jaksujinda, J. (2014). Development of a Care System for Pregnant Women to Prevent Postpartum Hemorrhage in Sakon Nakhon Hospital. Journal of Nursing and Health Care, 32(2), 37–46. (In Thai)
Srisupandit, K. (2019). Obstetric & Gynecologic Emergencies (3rd ed.). Chiang Mai: Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University. (In Thai)
The Royal Thai College of Obstetricians and Gynaecologists. (2020). Care and Management of Postpartum Hemorrhage Due to Uterine Atony. Retrieved March 20, 2025, from https://www.rtcog.or.th/photo/cpg/OB-63-020_summary.pdf (In Thai)
The Royal Thai College of Obstetricians and Gynaecologists. (2020). Clinical Practice Guideline: Prevention and Management of Postpartum Hemorrhage. Retrieved March 9, 2025, from http://www.rtcog.or.th/home/wpContent/uploads/2020/09/OB-63-020-Prevention-and-Management-of-Postpartum-hemorrhage.pdf (In Thai)
Yuming, R., Suenee, N., Chewae, R., & Waree, N. (2024). The Effect of “Raman PPH Model” to Prevent Postpartum Hemorrhage in Raman Hospital. TUH Journal online, 9(1), 68–80. (In Thai)
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