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Perceptions of Safety Improvement Among Clinicians Before and After Participation in a Multistate Postpartum Hemorrhage Project.

OBJECTIVE: To measure whether implementation of a comprehensive, 18-month, multihospital, multiregion postpartum hemorrhage (PPH) project influenced intrapartum clinicians' perceptions of patient safety.

DESIGN: Pre- and post-survey design.

SETTING: Survey results from eight hospitals in Georgia, New Jersey, and Washington that participated in the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) PPH Project were included in the final analysis. The number of annual births at the hospitals ranged from 1,290 to 3,567.

PARTICIPANTS: There were 473 respondents for the pre-implementation survey: 50.5% (239) were registered nurses, 27.1% (128) were physicians, and 22.4% (106) were other intrapartum clinicians. The post-implementation survey included 426 respondents: 62.9% (268) registered nurses, 18.5% (79) physicians, and 18.6% (79) other intrapartum clinicians.

INTERVENTION/MEASUREMENTS: A paired t test was used to compare Safety Attitudes Questionnaire (SAQ) domain scores. Pearson's chi-square test was used to analyze perceptions before and after the intervention.

RESULTS: Baseline SAQ scores were high in all six domains. Improvements were noted in five of the six domains measured; none reached statistical significance. A significant improvement was found in reported perception of the quality of nursing care after implementation of the PPH Project.

CONCLUSION: SAQ scores remained high and showed some improvement among participating hospitals. Participation in the PPH Project increased overall perceptions of safety among the clinicians at these hospitals.

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