Date of Award

Spring 2020

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice (DNP)



Committee Chairperson

Veronica Wilbur, Ph.D., APRN, CNE, FAANP

Committee Member

Rita Linus, DNP, RNC-BC

Committee Member

Cheryl D. Schlamb, DNP, CRNP



A visual estimation has been the standard measurement for blood loss post vaginal or cesarean section delivery. Research has shown that visual estimation also known as estimated blood loss has led to an underestimation of total blood loss volume. This results in over 100,000 women per year in the United States that experience an adverse effect due to delayed recognition and treatment for postpartum hemorrhage. By quantifying blood loss, the volume is measured by a one to one ratio; one-gram weight is equal to one-milliliter blood volume. To promote the evidence-based practice of quantifying blood loss, a quality improvement project was designed and implemented in a labor and delivery department of a suburban, community-based hospital on the city limits of Philadelphia, Pennsylvania. Data were collected via a retrospective record review before and following the implementation of quantifying blood loss measurement during the recovery period of all deliveries. Results: Clinical significance was noted utilizing quantified blood loss during the recovery period following vaginal and cesarean section deliveries. The rate of postpartum hemorrhage did decrease from 7.6% pre-intervention to 5.6% post-intervention, although this result was not statistically significant.

Keywords: Postpartum hemorrhage, postpartum blood loss, maternal mortality, maternal morbidity, estimated blood loss, quantified blood loss