Maternal morbidity and mortality remain pressing issues in the United States, disproportionately affecting non-Hispanic Black and Indigenous women. Evidence indicates that over 80% of pregnancy-related deaths are preventable with timely, coordinated clinical interventions. This Doctor of Nursing Practice (DNP) project aimed to evaluate the effectiveness of implementing evidence-based checklists for managing obstetric emergencies, specifically postpartum hemorrhage (PPH) and amniotic fluid embolism (AFE), through simulation-based training. The project was conducted at a Level III maternity care teaching hospital and engaged multidisciplinary healthcare teams, including obstetricians, nurses, anesthesiologists, and neonatologists. Guided by the Model for Improvement framework, pre- and post-simulation surveys and observational data were used to assess participant confidence, task completion, and team communication.
The intervention involved structured simulations using standardized checklists from the AFE Foundation and CMQCC toolkits. Post-training assessments revealed significant improvements: 77% of participants reported increased confidence in managing critically ill perinatal patients, 82% demonstrated stronger communication using the SBAR model, and checklist adherence reached 100% in managing hypotension, bleeding, and cardiac arrest. However, areas such as equipment familiarity and structured handoff communication indicated room for continued development.
The project underscores the value of simulation training and checklists in standardizing clinical responses, reducing errors, and improving maternal outcomes. Findings support the integration of checklists as a sustainable strategy for obstetric emergency preparedness, offering a replicable model for broader quality improvement initiatives in maternal healthcare.