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 severe maternal conditions. The aimed of the study were to examine the factors influencing the implementation of evidence-based practices (EBPs) for the prevention and management of PPH by explaining the variables at the individual and organizational levels and test the relationships and interactions between individual- and organization-level factors among nurse-midwives in Thailand. A multi-stage sampling technique was used to recruit a sample of 298 intrapartum nurses and 50 units of the delivery rooms from the community hospitals, Thailand from March to June 2019. Data were collected using a self-report questionnaire. Data were analyzed using descriptive statistics and the Multi-Level Modelling (MLM) analysis. These results revealed that the participants had majority always implementing all of the recommendation EBPs for prevention and management PPH in daily practice. The relationship between the set of independent variables at individual-level and organizational-level had effect influencing of implementation of EBP for prevention and management of PPH, significant of predictor (b = 3.741, 2.93 respectively, p < .001). Indicating 32% of variance of implementing of EBPs for PPH have varied between hospital, and 68 % of variance of implementing of EBPs for PPH have varied between nurses. Moreover, the analyses found second interaction between two-level of factor variables. The results of the study will be used to develop strategies to promote the use of EBPs in obstetric care and increasing the translation of evidence into practice. Future studies should be investigating this variance explained by a multi-level predictor.

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