Background: Postpartum hemorrhage (PPH) is the primary cause of global maternal mortality. The majority of deaths from PPH can be avoided easily with early detection and treatment by using a new care bundle (E-MOTIVE). Aim of this study was to evaluate the effect of a new care bundle on enhancing nurses' Knowledge, practice and self-efficacy regarding primary postpartum hemorrhage. Research design: A quasi-experimental design (pretest, posttest and follow up) was used. Setting: This study was carried out in Al Sharkia Governorate, Egypt, at the Maternity and Childhood Hospital of Zagazig University Hospitals. Subjects: A purposive sample of all nurses (125 nurses). Tools: A structured interviewing questionnaire, a new primary postpartum hemorrhage care bundle checklist and maternity nurses' self-efficacy questionnaire regarding primary PPH. Results: There was a high significant statistical positive correlation between total nurses' knowledge, total practices and their total self-efficacy at pre, post and follow-up. Conclusion: Nurses' knowledge, practice and self-efficacy related to early detection and first response to primary PPH were improved after implementation of new care bundle. Recommendations: Utilizing anew care bundle by nurses is a crucial in maternity hospitals for early detection and treatment of primary postpartum hemorrhage as it led to lower risk of sever PPhge and maternal death from bleeding.