Doctor of Nursing Practice Program

• Committee Chair Name & Credentials:
  Melissa Davis, DNP, CNM
 

 

DNP Project Abstract

Promotion of Treatment of Antenatal Iron-Deficiency Anemia to Decrease Postpartum Blood Transfusion Risk

Purpose
The purpose of this project was to decrease the number of clinically inappropriate blood transfusions by 50% from 5-6 transfusions per month to less than 2-3 per month. Optimization of antenatal hemoglobin was utilized to decrease the risk for postpartum blood transfusion.

Methods
An educational intervention/clinical algorithm was created alongside a physician. Pre- and post-implementation data was collected to gauge change. Data was collected for three months prior to algorithm launch and three months post intervention.

Results
The results of this improvement project indicated that more patients were identified as being iron deficient after implementation of the protocol: 31% vs. 51%.

Analysis of ferritin level for diagnosis of iron deficiency anemia increased 325%!

No change in blood transfusion rates were seen after implementation of the protocol but secondary outcomes (increase in number of patients identified as being iron deficient) may be worth pursuing.

Implications for Practice
The clinical algorithm did identify those patients who had iron deficiency anemia and provided guidelines for treatment. Although blood transfusions carry risks, patients who are underdiagnosed and under treated for iron deficiency- anemia are at risk for other adverse events in pregnancy. Further work needs to be done to ensure that all clinicians are following the guidelines.