NURSES KNOWLEDGE ON PREVENTION OF POST PARTUM

HEMORRHAGE AT DHULIKHEL HOSPITAL, KATHMANDU

UNIVERSITY HOSPITAL, KAVRE, NEPAL

by
Rina Lakhemaru(Shrestha)
PBBN 2nd Year

A research report submitted for the partial fulfillment of the

requirements of Post Basic Bachelor of Nursing in midwifery
nursing major

in

Om Health Campus Pvt. Ltd.

Gopikrishnanagar, Chabahil, Kathmandu
Affiliated to Purbanchal University
October 2010 (2067B.S)

APPROVAL SHEET
This is the bonafide research work of Ms. Rina Lakhemaru(Shrestha) in the
title Nurses knowledge on prevention of post partum hemorrhage at
Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre and
submitted for the partial fulfillment of the requirements of post basic bachelor
of nursing (Major in Midwifery), 2010, for the certification.

Rina Lakhemaru(Shrestha)
Student

Assoc. Prof. Ms. Milan Lopchan

Research advisor
TU/IOM, Maharajgunj Nursing Campus
Kathmandu, Nepal

Ms Kiran Dawadi
Principal
Om Health Campus
Gopikrishnanagar
Chabahil, Kathmandu, Nepal

Date:

Date:

ACKNOWLEDGEMENT
It is with sincere gratitude and pleasure that researcher acknowledge to Om Health
Campus Pvt. Ltd. for providing her an opportunity to conduct this study as a part of
partial fulfillment of Post Basic Bachelor of Nursing.
Researcher would like to express her gratitude to research advisor Asso. Prof. Ms.
Milan Lopchan, TU/IOM, MNC for introducing to the topic and constructive
suggestion throughout the work. Therefore, she is highly obligued to her kind help,
support and supervision during the completion of this work.
Researcher wish to express her deep and cordial gratitude to Campus Chief Ms. Kiran
Dawadi, Om Health Campus Pvt. Ltd. for inspiration support, supervision and
valuable suggestions.
Researcher deep and cordial gratitude goes to all BN faculty for their inspiration and
valuable suggestion.
Researcher also thankful to librarian of Om Health Campus, Dhulikhel Hospital,
National Health Research Center who helped her to find the related literature for
study.
Researcher appreciation goes to director of Dhulikhel Hospital Dr Rajendra Koju,
Matron, ward in-charge and all the nursing staff who help her to complete this
research study.
Finally, researcher would like to thank all respondents and those who gave their
valuable time in preparing this study directly and indirectly.

Rina Lakhemaru(Shrestha)
PBBN 2nd Year

ABSTRACT
This research has been undertaken as a partial fulfillment of requirement for the
degree of Bachelor of Nursing at Om Health Campus. The study was conducted on
Nurses Knowledge on Prevention of Post Partum Hemorrhage at Dhulikhel
Hospital, Kathmandu University Hospital, Dhulikhel, Kavre.
Title: Nurses Knowledge on Prevention of Post Partum Hemorrhage at Dhulikhel
Hospital.
Objective: The objective of this study was to assess the knowledge about prevention
of Post Partum Hemorrhage among nurses.
Methodology: Descriptive design and non probability purposive sampling technique
was used to select 50 sample and study was conducted at Dhulikhel Hospital, KUH,
Dhulikhel, Kavre. Pre-testing was done at Nepal Medical College, Jorpati
,Kathmandu. The data was collected by using semi-structured questionnaire (both
open and close ended) for required information. The obtained data were analyzed and
interpreted according to the objective. The data were presented in table and figure.
Findings: The findings of the study revealed that, the majority of the respondents 38
(76%) were between 20-25years of age and 43 (86%) respondents had less than
5years of total working experience. Half of the respondents (50%) were experienced
working in (specific ward) labour room. Majority of the respondents 38 (76%) have
completed PCL Nursing and majority of respondents 45 (90%) had not taken inservice education (training) about BOC.
Cent percent of respondents 50 (100%) gave the correct definition of PPH. 50(100%)
of the respondents gave the correct answer on causes of PPH. Majority of the
respondents 47 (94%) answered that the different methods used in delivering placenta
helps to prevent PPH, that is deliver the placenta as a means of CCT. Cent percent of
the respondents 50 (100%) gave the correct answer that it is necessary to empty
bladder before placenta delivery. Most of the respondents 43 (86%) answered
oxytocin is the most commonly used uterogenic drug. Majority of the respondents 45
(90%) were known about the therapeutic dose of oxytocin during labour (1 min after
birth of the baby). Cent percent of respondents have knowledge that uterine massage
after delivery minimize the chances of PPH. Cent percent of the respondents have
knowledge that it is important for the carefully inspection of the perineum after
delivery. Cent percent of the respondents have knowledge that it is necessary to
examine the placenta and membrane for its completeness to prevent PPH. Minority of
respondents 10 (20%) are knew about Maatri Surakchhya Chakki (Misoprostol).
Majority of the respondents 8 (80%) who had heard about MSC answered as the
chemical name of MSC is PGE1.Cent percent of the respondents who knew about
MSC were known about the purpose of giving it to the mother. Majority of
respondents 7 (70%) who knew about MSC answered as its doses to the mother is 2-3
or 3 doses. Majority of the respondents 9 (90%) who knew about MSC were unknown
about the time (months) that the mother can have MSC. Cent percent of respondents
answered that from the skilled health person the mother can receive MSC.

ABBREVIATIONS
ANM:
AMTSL:
BN:
BOC:
CCT:
DH:
I/D:
I/M:
I/V;
KUH:
MMR:
MOH:
MSC:
PCL:
PPH:
S/C:
NHRC:
WHO:

Auxillary Nurse Midwife

Active Management of Third Stage of Labour
Bachelor of Nursing
Basic Obstetric Care
Controlled Cord Traction
Dhulikhel Hospital
Intradermal
Intramuscular
Intravenous
Kathmandu University Hospital
Maternal Mortality Rate
Ministry of Health
Maatri Surakchhya Chakki
Proficiency Certificate Level
Post Partum Hemorrhage
Subcutaneous
National Health Research Center
World Health Organization

TABLE OF CONTENTS
Contents

Page No.

Acknowledgementi
Abstract.ii
Table of contents...iii
List of tables..vi
List of figures........vii
Abbreviation.........viii
CHAPTER-ONE
Introduction
1.1 Background of the study1
1.2 Rational of the study..4
1.3 Research question...4
1.4 Objectives of the study...5
1.5 Variables.5
1.6 Hypothesis of the study......5
1.7 Operational definition.5
1.8 Limitation of the study5
CHAPTER-TWO
Review of Literature
2.1 Review literature related to variables..6
2.2 Summary of review literature.10
CHAPTER-THREE
Research Methodology
3.1 Research design....11
3.2 Study population/Sample area/Sample size..11
3.3 Sampling technique...11
3.4 Instrumentation.11
3.5 Validity and Reliability of instrument..11
3.6 Ethical consideration.....11
3.7 Procedure for data collection.12
3.8 Data generation, processing and analysis procedure.. 12
3.9 Time/budget...12

CHAPTER-FOUR
Data Analysis and Interpretation
4.1 Demographic information.......13
4.2 Knowledge on prevention of PPH...14
CHAPTER-FIVE
Summary, Conclusion and Recommendation
5.1 Summary of the study.29
5.1.1 Socio-demographic findings.29
5.1.2 Knowledge on prevention of post partum hemorrhage.29
5.2 Conclusion of the study..31
5.3 Implication of the study..32
5.4 Recommendation.33
5.5 Difficulties faced during the study..33
5.6 Strength of the study...34
5.7 Limitation of the study....34
5.8 Plan for dissemination.....34

References...35
APPENDICES
Work plan.37
Questionnaire38
Consent form.?
Completion letter?

LIST OF TABLES
Page no.
Table 1: Distribution of the respondents according to demographic
Characteristic

14

Table 2: Respondents knowledge on definition of PPH

15

Table 3: Respondents knowledge on causes of PPH

16

Table 4: Respondents knowledge on different methods of delivering the

placenta helps to prevent PPH

17

Table 5: Respondents knowledge about necessity to check or empty bladder

before placenta delivery
18
Table 6: Respondents knowledge according to the route for oxytocin

21

Table 7: Respondents knowledge on necessary to add syntocin during

labour for the prevention of PPH

23

Table 8: Respondents knowledge on uterine massage after delivery minimize

the chances of PPH
24
Table 9: Respondents knowledge on importance of inspection of the perineum
after delivery
25
Table 10: Respondents knowledge on heard about Maatri Surakchhya
Chakki(Misoprostol)

27

LIST OF FIGURES
Page no.

Figure 1: Respondents knowledge about the most commonly used uterogenic

drug

19

Figure 2: Respondents knowledge about the therapeutic dose of oxytocin during

labour (1 min after birth of the baby)

20

Figure 3: Respondents knowledge on oxytocin be given as an I/V bolus

specially for the prevention of PPH

22

Figure 4: Respondents knowledge about necessary to examine the placenta for

its completeness to prevent PPH

26