الفهرس 
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Abstract
The postpartum period is considered one of the difficult and important periods in a woman’s life, as it is possible to save her life from exposure to many dangers and therefore it has led to some government agencies and institutions that develop plans that preserve the life of the woman. All obstetric women’s hospitals in order to prevent everything that threatens the women’s life. Pregnancy, childbirth and the postpartum period are a natural and important event in the life of a women. Therefore, up to date the nursing knowledge and practice play an important role in standard precautions. The postpartum nurses should implement standard precautions continuity as an essential part of women’s care.
The study aimed to: Assess postpartum nurse’s compliance with safety measures.
To fulfill the study aim:
The study was conducted at all postpartum units in five hospitals in Alexandria that are randomly selected from each health agency in Alexandria.Subjects: All nurses working at the previously mentioned settings and providing direct care for postpartum women (approximately 100 nurses) will be included in the study.
Tools used in this study:Two tools were used to collect the necessary data:
Tool one:Nurses’ knowledge about safety measures during the postpartum period. This tool will be developed by the researcher after a review of recent and relevant literature and divided into two parts: Part I: Socio-demographic data. Part Two: Nurses’ knowledge about safety measures during the postpartum period. The knowledge items were comprising 30 items it included 2 main groups of questions as follows: General knowledge about the postpartum period (12 items) and safety measures during postpartum (18 items). Tool two: Postpartum nurses’ compliance with Safety measures guidelines observational checklist: This tool was adapted by the researcher from the ministry of health and WHO. to assess nurse’s compliance with guidelines for safety measures during the postpartum period. Tools were tested for content validity by a jury of 5 experts in the related field. A pilot study was carried-out on 10 nurses (excluded from the selected subjects) to test the feasibility of the study.
The main findings of the present study were:
Socio-demographic data
• Age demonstrates that the same percent of the study sample (23%) age was 20 to less than 30 years old and were 30 to less than 40 years old. (37%) of the age was forty to less than fifty years old.
• More than three fifths (68%) of them had a diploma from secondary school of nursing. Only (12%) of the nurses had bachelor’s degree of nursing. Less than two third (68%) of them worked as staff nurse.
• Years of experience since graduation display that more than one half of the subject (53%)years of experience was twenty years. (13%) of them years of experience was ten years and fifteen years. More than one third (38%) of nurse’s years of experience in post-partum department were twenty years.
Knowledge about postpartum period
• Three quarters (70%) answeredcorrectly but incomplete forcomponents of postpartum nursing care. And causes of death for women in the postpartum period respectively.
• Less than two third (62%)answered correctly but incomplete about theprevention of complications in the postpartum period. Less than two third (66%) answered correct
• Less than two third (62%) of them answered correctly but incomplete forminor discomfort during the postpartum period and three fifths of the nurses (80%) answered correctly and complete for warning signs during the postpartum period.
• Three quarters of them (74%)answered correctly but incomplete for elements of nursing care for women in the postpartum period.
• The majority of the nurses (85%&89%) answered correctly and complete for nursing care to prevent uterine Bleeding andnursing care to prevent puerperal sepsis respectively. More than three quarters of the participants (79%) answered correctly and complete fornursing care to prevent deep vein thrombosis.
Knowledge of safety measures during postpartum period.
• The majority of the nurses’ (87%)responses were incorrectly or don’t know about the meaning of safety measures.
• Less than three quarters (71%)of an answer was incorrectly or don’t know about the components of safety procedures in the postpartum stage.
• The vast majority (91%) of them mentioned correctly and complete Identifying the patient in the correct way.
• Less than half (56%)of them mentioned incorrectly or don’t know for improve effective communication. Less than two third (61%)of them mentioned incorrectly or don’t know fordefinition of high-risk medications.
• More than half (54%) of them mentioned correctly and incomplete for safety procedures followed when using high-risk medications. More than three quarters (87%)of them mentioned correctly and complete for new nurses are trained on where and how to use high-risk medicines. Less than two third (61%) of them mentioned incorrectly or don’t know for ways to verify the correct location / the right patient.
• More than three quarters (77%)of them mentioned incorrectly or don’t know forhealth care associated infection. More than two third (65%)of them mentionedcorrectly and incomplete for methods of infection transmission associated with health care. The majority (88%)of them mentioned incorrectly or don’t know forthe risk of infection associated with health care is reduced. More than half (57%)of them mentioned correctly and incomplete the hospital provides tools to help reduce the risk of postnatal care-related infection.
• Less than two third (66%) of them mentioned correctly and incomplete forpatients at risk of falling. Less than two third (61%) of them mentioned correctly and incomplete forways to reduce the risk of patient harm from falling. Less than three quarters (70%)of them mentioned correctly and incomplete tools the hospital provide to help reduce the risk of a patient falling.
Nurses compliance with safety measures guidelines.
• More than 41% of the nurses incompletely followed the standardize patient identification during the first observation compared to more than three quarters (78%) of the subject completely followed them during the second observation.
• Communication of patient’s need information to the care team was incompletely done by more than half (53%) of the subjects in the first observation and completely done by (64%) of the subjects in the second observation.
• Identifying look-alike, sound-alike was not done by three quarters (75%) of the studied nurses in the first observation while incompletely done by 65% by them during the second observation.
• More than three quarters (78%) of them did not check the medication label in the first observation while was checked it incompletely by 92% of them in the second observation.
• Establishment of a culture of safety that provides an environment of open and safe communication among the surgical team, it was incompletely done by 59% of the studied nurses in the first observation and completely done by 51% of the them during the second observation.
• Monitoring changes in dietary needs or restrictions that may have an impact on patient’s care was incompletely done by 53% of the studied nurses first observation while completely done by more than half (59%) of them during the second observation.
• Identifying look-alike, sound-alike was not done by three quarters (75%) of the studied nurses in the first observation while incompletely done by 65% by them during the second observation.
• Documentation of the administration after giving the ordered medication, was not done by (94% &55%) of the studied nurses during the first and second observation respectively.
• Establishment of a system of surgical site infection data was incompletely done by about more than half (55%) of the studied nurses during the first observation while completely done by 59% of them in the second observation.
• Conducting falls and injury risk assessment upon admission was done completely by (100% &98%) of the studied nurses during the first and second observation.
• Efforts to prevent falls, incompletely done in the first observation while 81% efforts to prevent falls completely done in the second observation.
• Implement patient-specific intervention to prevent falls and injury, it was incompletely done by (78%) of the studied nurses in the first observation and completely done by 53% of them in the second observation.
Recommendations
Based on the findings of the present study, the following recommendations are suggested:
• The nursing curriculum should be revised and update to include guidelines about postpartum period and safety measures guidelines.
• Ministry of Health should provide nurses with hand out guidelines to improve women health and safety during postpartum period.
• Periodic participation of nurses in training programs about postpartum to improve their knowledge, skills and ensuring from their compliance with guidelines for patient safety.
• Reinforce regular supervision of nurses in the postpartum to ensure that they comply with patient safety guidelines.