Uptake and Adherence to National Guidelines on Postpartum Haemorrhage in Italy: The MOVIE before-after Observational Study

Int J Environ Res Public Health. 2023 Mar 28;20(7):5297. doi: 10.3390/ijerph20075297.

Abstract

Translating evidence-based guidelines into clinical practice is a complex challenge. This observational study aimed to assess the adherence to the Italian national guidelines on postpartum haemorrhage (PPH) and describe the clinical management of haemorrhagic events in a selection of maternity units (MUs) in six Italian regions, between January 2019 and October 2020. A twofold study design was adopted: (i) a before-after observational study was used to assess the adherence to national clinical and organisational key recommendations on PPH management, and (ii) a cross-sectional study enrolling prospectively 1100 women with PPH ≥ 1000 mL was used to verify the results of the before-after study. The post-test detected an improved adherence to 16/17 key recommendations of the guidelines, with clinical governance and communication with family members emerging as critical areas. Overall, PPH management emerged as appropriate except for three recommended procedures that emphasise different results between the practices adopted and the difference between what is considered acquired and what is actually practised in daily care. The methodology adopted by the MOVIE project and the adopted training materials and tools have proved effective in improving adherence to the recommended procedures for appropriate PPH management and could be adopted in similar care settings in order to move evidence into practice.

Keywords: guideline adherence; postpartum haemorrhage; practice guideline.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biological Transport
  • Cross-Sectional Studies
  • Female
  • Humans
  • Italy / epidemiology
  • Motion Pictures
  • Postpartum Hemorrhage* / epidemiology
  • Postpartum Hemorrhage* / therapy
  • Pregnancy

Grants and funding

This research was funded by the National Centre for Disease Prevention and Control of the Italian Ministry of Health. Project title: “Monitoraggio e valutazione dell’implementazione delle raccomandazioni cliniche e organizzative per la gestione delle emergenze ostetriche emorragiche peripartum (MOVIE)”.