The meeting with the decision-makers at the practicum site, the hospital, allowed discussing the current problems that are encountered by the chosen healthcare organization. Among other issue, postpartum hemorrhage was noted as the key traumatic event that can appear in the process of delivery. In New York City, maternal mortality rate was estimated at 20.7 per 100,000 live births in 2013-2015, among which hemorrhage counts for 23% of deaths (Pugh & Schafer, 2018).
In the hospital, clinical care plays a vital role in addressing and preventing maternal hemorrhage. During the meeting, it was suggested that staff training, clear guidelines, and consulting opportunities can significantly decrease the problem (Dahlke et al., 2015). In particular, it was stated that the failure to recognize the signs and properly manage the caesarian sections are the key staff-related challenges. In consistence with the Healthy People 2020 initiative, it is expected to reduce the number caesarian sections for low-risk mothers.
In the view of the identified practicum site and problem, it is important to develop skills and knowledge of nurses who are engaged in the delivery process, playing a critical role in potential changes. The PICOT question can be formulated as follows: In registered nurses working in delivery units, what is the effect of an educational program on reducing postpartum hemorrhage in patients compared to a traditional approach within six months? Currently, there is no special training to improve the ability of nurses to impact the discussed problem. The participants of the DNP project should be offered testing before and after the program, and their expertise will also be measured based on patient data.
The project implementation is expected to take six months, of which the first month will be devoted to the preparation and education. The identified period seems to be sufficient to allow nurses to implement newly obtained skills and knowledge into practice. This PICOT question may change to test the results on different settings or timeframe.
Lewin’s change model seems to be relevant to apply in the DNP project as there is a need to create the sense of change necessity in the hospital. The first stage of this model is defrosting that involves understanding the situation, determining the driving forces, and a description of the desired final state. The second stage of changing marks the process of transition from one state to another. Lewin compared this stage with the movement or the journey that is made to overcome problems. This stage involves the participation and involvement of the organization’s staff. Management needs to maintain employees’ belief in success and a clear picture of the image of their desired future.
The ultimate stage of refreezing is the stabilization of the organization and strengthening of a new position. At the third stage, it is proposed to use such tools as the institutionalization of new approaches, including new standards, norms, policies, and a remuneration system.
The fact that a lot of women decease or have complications after delivery in the given hospital prioritizes the proposed PICOT question. Staff education is an effective intervention that requires minimal expenses and organizational accommodations. Therefore, the development of this project is likely to lead to the decrease in the number of maternal hemorrhage, which is beneficial for patients, the hospital, and healthcare in the broader context. The support of decision-makers will be provided since they approved its key goal and recognized its potential value to addressing the discussed health problem.
References
Dahlke, J. D., Mendez-Figueroa, H., Maggio, L., Hauspurg, A. K., Sperling, J. D., Chauhan, S. P., & Rouse, D. J. (2015). Prevention and management of postpartum hemorrhage: A comparison of 4 national guidelines. American Journal of Obstetrics and Gynecology, 213(1), 76-86.
Pugh, T., & Schafer, P. (2018). Recent and ongoing initiatives in New York To reduce maternal mortality. Web.