Jiranee Panyapin. Factors influencing the implementation of evidence-based practices for prevention and management of postpartum hemorrhage among nurse-midwives in Thailand : a multilevel analysis. Doctoral Degree(Nursing Science). Burapha University. Library. : Burapha University, 2020.
Factors influencing the implementation of evidence-based practices for prevention and management of postpartum hemorrhage among nurse-midwives in Thailand : a multilevel analysis
Abstract:
Postpartum hemorrhage [PPH] remains one of the leading causes of maternal mortality and morbidity. The evidence-based practices [EBPs] have been developed and implemented to improve the quality of care for PPH and reduce variation in practice. This cross-sectional study aimed to examine the relationship between the influencing factors at the individual- and organizational-level on implementing of EBPs for prevention and management of PPH among nursemidwives in Thailand. A multi-stage sampling technique was used to recruit 298 nurses from 50 delivery units of community hospitals from March to June 2019. Data were collected using self-report questionnaires. Descriptive statistics and multi-level modeling [MLM] were carried out to analyze data. The results revealed that the majority of participants regularly implemented all EBPs recommendations for PPH prevention and management in daily practice. Results showed at individual- level (year of experience, personal innovativeness, perceived barriers, and perceived characteristics of CPG) and organizational-level (large community hospital and organizational climate) had significantly influenced the implementation of EBPs for prevention and management of PPH (β = 3.74, 2.93 respectively, p < .01), and also found the second interaction between individual- and organization-level variables were significantly. Accounting for 32 % of variance had varied within the organization level, and 68 % of variance had varied within an individual level on implementing of EBPs for PPH. This study may thus help facilitate the development of strategies for promoting EBPs implementation in obstetric care.