Date of Doctor of Nursing Practice Project Completion
Spring 5-1-2026
Faculty Advisor
Rashmi Momin
Abstract
Purpose: The purpose of this quality improvement project was to implement a standardized MTP documentation flowsheet in a Level IV maternal Labor and Delivery unit and increase documentation compliance to ≥80% within one month of implementation.
Results: One-month post-implementation, documentation compliance reached 82%, exceeding the established goal of 80%. Compliance remained stable across monitoring periods, suggesting early adoption and short-term sustainability. Staff reported high usability ratings, improved workflow efficiency, and increased confidence in documenting MTP events following simulation-based education. Minimal missing data and consistent survey responses supported reliability of findings.
Background: Obstetric hemorrhage is a leading cause of maternal morbidity. Inconsistent documentation of Massive Transfusion Protocol (MTP) events across multiple electronic record locations required manual audits and limited reliability, creating workflow inefficiencies and regulatory risk.
Methodology: Guided by the Model for Improvement using Plan-Do-Study-Act cycles, a multidisciplinary team developed a standardized paper flowsheet to address workflow gaps. The intervention included stakeholder collaboration, simulation-based pilot testing, staff education with post-test survey (n=84), and unit-wide implementation. Documentation compliance was evaluated through retrospective chart audits over one month. Process measures included perceived clarity, usability, workflow efficiency, and staff confidence. Descriptive statistics and compliance percentages were calculated. Limitations included small sample size and single-unit implementation.
Implications: Standardizing MTP documentation reduced variability, improved regulatory readiness, and strengthened interdisciplinary coordination during high-acuity obstetric emergencies. Simulation-supported education facilitated adoption and reinforced role clarity among team members. Although implementation was limited to a single unit and utilized a paper-based tool, results support scalability and future integration into the electronic health record. This structured documentation model may serve as a replicable framework for improving maternal safety processes in similar high-risk settings.
Keywords
massive transfusion protocol, obstetric hemorrhage, documentation compliance, quality
Recommended Citation
Kirstie Barrick, "Improving Documentation Compliance During Obstetric Massive Transfusion Events Through Implementation of a Standardized Flowsheet" (2026). Doctor of Nursing Practice Final Project Abstract. 184.
https://digitalcommons.library.tmc.edu/dnp_abstract/184