Variations in Care Bundle Practices Among Participating Hospitals, May 2019 to October 2021
| Care Bundle | Items in the Care Bundle | Reporting Hospitals (N) | Initial Control-Line (%) | Final Control-Line (%) | Variation (percentage points) |
|---|---|---|---|---|---|
| MEOWS | N/A | 19 | 78 | 98 | +20 |
| PPH prevention actions | Assess hemorrhage risk | 16 of 19b | 92 | 92 | 0 |
| Quantify blood loss | 57 | 90 | +33 | ||
| 10 IU oxytocin after delivery | 80 | 99 | +19 | ||
| PPH first response care bundle | Tranexamic acid | 6 of 7 | 63 | 90 | +27 |
| IV fluids | 76 | 84 | +8 | ||
| Oxytocic drugs (higher dose) | 76 | 87 | +11 | ||
| Uterine massage | 74 | 89 | +15 | ||
| HDP care bundle | Magnesium sulfate (loading dose) | 4 of 8 | 86 | 86 | 0 |
| Magnesium sulfate (maintenance dose) | 54 | 75 | +21 | ||
| Treat high blood pressurea | 87 | 87 | 0 | ||
| Sepsis care bundle | Measure lactate level | 3 of 4 | 42 | 88 | +46 |
| Obtain blood cultures prior to administration of antibiotics | 84 | 84 | 0 | ||
| Administer antibiotic | 92 | 92 | 0 | ||
| Rapidly administer 500 ml IV solution | 53 | 93 | +40 | ||
| Apply vasopressor after IV fluid to maintain mean arterial pressure ≥ 65 mmHg | 91 | 91 | 0 |
Abbreviations: HDP, hypertensive disorders of pregnancy; MEOWS, Modified Early Obstetric Warning Score; N/A, not applicable; PPH, postpartum hemorrhage.
a Hydralazine was the antihypertensive/vasodilator available in the participating hospitals.
↵b The reporting hospitals varied from 5 to 16, reaching 16 in the last 3 months of the BTS.