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Student nurses' project becomes part of state program

Tuesday, March 03, 2009  
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By Mike DeDoncker
HealthyRockford.com
Mar 03, 2009 @ 11:35 AM

In college parlance, what Alexandra Westen and Judith Ferguson-Hauser did for their community nursing course last fall amounted to a class project.

In public health terms, what the Rockford College nursing students did was to work with staff at Rockford Memorial Hospital to develop an obstetric hemorrhage emergency kit and worksheets on which an emergency-response team can document treatment for such emergencies. It will become part of a state-backed Obstetric Hemorrhage Education Project to prevent maternal deaths caused by bleeding during and after pregnancy.

“It was a great experience,” Westen said. “They’re actually using things that we created in a program that’s implemented and working in the hospital — that they train their nurses to use.”

The project was defined for Westen and Ferguson-Hauser by Barb Prochnicki, the perinatal network administrator for the Rockford Regional Perinatal Center at Rockford Memorial, who said committees of the Illinois Department of Public Health started formally reviewing maternal deaths throughout the state in 1992 and discovered enough deaths by hemorrhaging to want further analysis.

“The deaths could be anywhere from real early pregnancy all the way through after she’s had the baby and gone home,” Prochnicki said. “They found that most of those deaths had some preventable factors. There were things we could have done better.”

Ferguson-Hauser said the two worked with Rockford Memorial nurses from September to about mid-November as they learned to monitor bleeding after a woman has delivered and determine when the blood loss had become an emergency situation.

Their post-hemorrhage worksheet provides space for a member of the emergency-response team to record the patient’s blood pressure, pulse, respiration and medications along with a visual estimate of how much blood has been lost, total fluid intake by the patient and any blood products that have been infused.

Their teacher, Associate Professor of Nursing Wealtha Helland, said the design of the forms means their information can be used as part of the state project’s statistical documentation of obstetric hemorrhage events.

“These forms were tailored for Rockford Memorial, which is a Level 3 perinatal hospital,” Ferguson-Hauser said, “but some other hospitals might not be able to perform all of the items on the list because they wouldn’t have some of the items because of lack of staff or quick access to blood supply.”

Their emergency kit was planned to hold in one place all the items essential to treating and stopping the hemorrhaging.

“It’s kind of like a tackle box,” Prochnicki said, “but it means that you have everything you need when you go into the room, and you don’t have to go over here for one item and somewhere else for another.”

Westen and Ferguson-Hauser also took part in exercises designed for those who will become trainers in the state project and said they learned an important lesson about measuring blood loss.

“You cannot visually estimate blood loss,” Westen said. “You have to weigh it. If you weigh it, you’re going to get much more accurate results.

“You might look at it and say this looks like 50 milliliters of blood and it’s really 100 milliliters. It was quite an eye-opening experience to see how far off you are.”
Prochnicki confirmed that the students’ project already has been put to use at Rockford Memorial.

“We now have a rapid response team and they have had several times where moms have started to bleed,” she said. “When that happens, they call this rapid response team, which means there are all these people who will gather such as an anesthesiologist, an obstetrician and nurses — one of them is always bringing the kit and another is assigned to do the charting.

“Their project was a small part, but a very key part to it.”

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