Decision making by auxiliary nurses to assess postpartum bleeding in a Dominican Republic maternity ward.
OBJECTIVE
To understand the process of decision making by auxiliary nurses regarding postpartum bleeding among women in the Dominican Republic.


METHODS
An ethnographic qualitative design of semistructured interviews and participant observation.


METHODS
Twenty four auxiliary nurses on a maternity unit of a referral hospital in the Dominican Republic.


RESULTS
Auxiliary nurses use specific criteria and logic to decide if postpartum maternal bleeding is excessive. However, systematic postpartum assessments are not routinely conducted on every woman.


METHODS
A decision tree that traces how auxiliary nurses evaluate postpartum bleeding indicates that they have knowledge of contemporary obstetric nursing care, but the organization of care delivery is not structured for them to apply it routinely.


CONCLUSIONS
A collaboration of U.S. midwives and Dominican nurses will build on the assets of the auxiliary nurses. Rather than focusing the content of educational conferences on current knowledge of labor and delivery, an important next step is modeling woman- and family-centered care. The U.S. midwives and Dominican nurses are committed to finding empowering and effective ways to improve maternity care.
Foster
Jennifer
J
School of Nursing, University of Massachusetts, Amherst, MA 01003, USA. jwfoster@nursing.umass.edu
Regueira
Yadira
Y
Heath
AnneMarie
A
D000328:Adult; D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D003657:Decision Making; D003663:Decision Trees; D032022:Delegation, Professional / Q000458:organization & administration; D004293:Dominican Republic / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006757:Hospital Units; D006801:Humans; D008128:Logic; D008428:Maternal Mortality; D016389:Maternal-Child Nursing / Q000193:education / Q000458:organization & administration; D016294:Models, Nursing; D024802:Nurse's Role / Q000523:psychology; D009730:Nursing Assessment / Q000458:organization & administration*; D009728:Nursing Assistants / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration; D011181:Postnatal Care / Q000458:organization & administration / Q000523:psychology; D006473:Postpartum Hemorrhage / Q000175:diagnosis / Q000401:mortality / Q000451:nursing*; D036301:Qualitative Research; D011795:Surveys and Questionnaires