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

Serena Donati, Marta Buoncristiano, Paola D’Aloja, Alice Maraschini, Edoardo Corsi Decenti (), Ilaria Lega and The ItOSS MOVIE Working Group
Additional contact information
Serena Donati: National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità-Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
Marta Buoncristiano: National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità-Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
Paola D’Aloja: National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità-Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
Alice Maraschini: Servizio Tecnico Scientifico di Statistica-Italian National Institute of Health, 00161 Rome, Italy
Edoardo Corsi Decenti: National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità-Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
Ilaria Lega: National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità-Italian National Institute of Health, Viale Regina Elena 299, 00161 Rome, Italy
The ItOSS MOVIE Working Group: The members of the ItOSS MOVIE Working Group are listed in Appendix A.

IJERPH, 2023, vol. 20, issue 7, 1-13

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: postpartum haemorrhage; guideline adherence; practice guideline (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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