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Drill Kit

Delayed Postpartum Hemorrhage with Nurse and Doula Present

Introduction

Step Up Together Drill Kits support interdisciplinary clinical teams to run emergency drills involving patient hand-offs and/or transport to a higher level facility.

Each Drill Kit can be used to run a Full Transfer Drill that tests the full, interdisciplinary process of care or a Partial Transfer Drill that involves running just one segment of the scenario (e.g. before transfer or after hospital hand-off). The toolkit includes a standardized high-fidelity case designed to test the process of transferring a birthing person or newborn from one location to another with an interdisciplinary team involved in the care. Observation criteria and a Debriefing and Action Guide are provided to elicit continuous improvement of interdisciplinary care processes and promote respectful care along the continuum.

 

Drill Description

This Drill Kit tests the emergency response to a delayed postpartum hemorrhage in a community birth setting after departure of the primary provider, with care being provided by a nurse (or other clinical birth assistant) and a doula (or other non-clinical birth assistant.) The scenario includes initiating emergency postpartum transfer to a higher level of care for ongoing management of postpartum hemorrhage. 

It is appropriate for:

  • Home birth practices
  • Birth centers
  • Community hospitals that may initiate emergency care and/or transport when providers are not on site

And may further engage:

  • Community-based doula organizations and trainers
  • EMS or other emergency transport partners
  • Labor & Birth unit and other relevant units at the referral hospital

To test the process of:

  • Postpartum emergency transport
  • Emergency care with the initial absence of licensed midwives or physicians to direct management

Learning Objectives:

  • Identify and respond to a delayed postpartum hemorrhage in a manner consistent with the respective scopes of practice of interdisciplinary learners.
  • Identify opportunities to strengthen preparedness for perinatal emergencies when licensed midwives and physicians are not initially available to direct management.
  • Review ways to promote person-focused care during emergencies.
  • Use debriefing skills to promote equity and ensure integration of individual and collective learning.
Publish Data

Authored by:

Amy Romano, MBA, MSN, CNM, FACNM and Jennifer Johnson, MS, CNM

Reviewed by:

Alexa Dougherty, MSN, PHN, CNM
Jess Brennan, MA, CD, LCCE, C-VBACS, LMT
Beth McGovern, DNP, RNC-OB

Last updated: December 2024

Will you be coordinating a partial or full transfer drill?

Set up for the Step Up Together drills depends on whether you plan to run a Partial Transfer Drill or a Full Transfer Drill. Select which type of drill you will be coordinating and follow the instructions in the following sections.

Need help deciding which type of drill to run? Watch our video on Running Full or Partial Transfer Drills.

Partial Transfer Drill

What is it?

An emergency drill of a clinical scenario that requires transfer, but participants are only practicing part of the scenario: either the part that happens in the community before hospitalization, or the arrival at the hospital and post-transfer management.

Who's involved?

Minimum of two individuals from a practice, up to the full practice/facility, with or without collaborating partners present.

Planning Needs

Can be impromptu with a small group or scheduled in advance at regular times, for which participation should be compensated.

Full Transfer Drill

What is it?

An emergency drill of a clinical scenario that requires transfer and participants practice all phases of the transfer: care in the community, emergency transport, and arrival and management at the hospital.

Who's involved?

Full practice/facility team from the community birth setting, plus transport and hospital personnel.

Planning Needs

Requires coordination and advanced planning with community practice, EMS, and hospital teams. Compensate for time to participate.

Sign up to coordinate this drill.

Access everything you need to run a Delayed Postpartum Hemorrhage with Nurse and Doula Present drill.

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