Graduation Date
Summer 8-7-2026
Submission Type
Dissertation/Thesis
Degree Name
Doctor of Nurse Anesthesia Practice
Department
Doctor of Nurse Anesthesia Practice (DNAP) Program
School
School of Nursing
Faculty Mentor
Catherine Johnson
Keywords
postpartum hemorrhage, maternal morbidity, CMQCC, obstetric hemorrhage risk assessment, quality improvement, nurse anesthesia
Abstract
Abstract Background: Postpartum hemorrhage (PPH) remains a leading cause of preventable maternal morbidity and mortality in the United States, despite advances in obstetric care and the availability of evidence-based management strategies (American College of Obstetricians and Gynecologists [ACOG], 2017; Federspiel et al., 2023). Standardized tools, such as the California Maternal Quality Care Collaborative (CMQCC) Obstetric Hemorrhage Risk Assessment Tool, have been shown to improve early identification of at-risk patients and enhance team preparedness when consistently implemented (Main et al., 2017; CMQCC, 2022). However, variability in clinical utilization limits their effectiveness. Purpose: The purpose of this quality improvement project was to evaluate utilization of the CMQCC Obstetric Hemorrhage Risk Assessment Tool within the labor and delivery unit at West Penn Hospital, identify barriers to consistent use, and develop recommendations to improve workflow integration and interdisciplinary communication. Methods: A Plan-Do-Study-Act (PDSA) framework guided the project, incorporating workflow observations, staff surveys, and stakeholder engagement. Results: Findings demonstrated inconsistent utilization of the risk assessment tool among nursing staff, with reported challenges related to usability, lack of reassessment, and gaps in education and communication. In contrast, anesthesia providers reported that the tool positively influenced clinical decision-making and preparedness when utilized. These results highlight a disconnect between tool availability and effective integration into clinical workflow. Implications: This project emphasizes the importance of aligning evidence-based tools with clinical processes through targeted education, workflow standardization, and interdisciplinary collaboration. Improving reliability in hemorrhage risk assessment has the potential to enhance early recognition, optimize team response, and reduce preventable maternal morbidity (Berens et IMPROVEMENT OF CMQCC HEMORRHAGE RISK ASSESSMENT 3 al., 2023; White et al., 2019). Keywords: postpartum hemorrhage, maternal morbidity, CMQCC, obstetric hemorrhage risk assessment, quality improvement, nurse anesthesia
Recommended Citation
Hobbs, Emily and Beiswenger, Karla, "Improving Implementation of the CMQCC Obstetric Hemorrhage Risk Assessment Tool to Improve Maternal Hemorrhage Response and Outcomes" (2026). Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts. 9.
https://dsc.duq.edu/dnap/9