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Kenyon E, DeBoer S, El-Khoury R, La D, Saville B, Gillis H, Alcock G, Miller E, Sadi J. Identifying competencies in advanced healthcare practice: an umbrella review. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10349-9. [PMID: 38886319 DOI: 10.1007/s10459-024-10349-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/02/2024] [Indexed: 06/20/2024]
Abstract
The four pillars of advanced healthcare practice (AHCP) are clinical practice, leadership and management, education, and research. It is unclear, however; how competencies of AHCP as defined by individual health professions relate to these pillars. Addressing this knowledge gap will help to facilitate the operationalization of AHCP as a concept and help inform educational curricula. To identify existing competencies across AHCP literature and examine how they relate to the four pillars of a multi-professional AHCP framework. An umbrella review was conducted in accordance with JBI methodology. The electronic search for published and grey literature was completed using CINAHL, Scopus, Medline (OVID), Embase (OVID), ERIC (OVID) and Google. Secondary reviews and research syntheses of master level AHCP programs published after 1990 in either English or French were considered for inclusion and results were analyzed using a directed content analysis. Seventeen publications detailing 620 individual competencies were included. AHCP competencies were described across four professions and 22 countries, with many publications related to nursing and AHCP in the United Kingdom, Canada, and Australia. Many retrieved competencies were found to map to the four pillars of AHCP, although clinical practice and leadership and management pillars were addressed more often. Competencies of AHCP are generally consistent with the four pillars. However, the distribution of competencies is unequal across pillars, professions, and geographical regions, which may provide direction for further research. Doi: 10.17605/OSF.IO/KV2FD Published on March 07, 2023.
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Affiliation(s)
- Emily Kenyon
- Advanced Health Care Practice Program - Faculty of Health Sciences, Western University, London, ON, Canada.
| | - Sarah DeBoer
- Advanced Health Care Practice Program - Faculty of Health Sciences, Western University, London, ON, Canada
| | - Rosy El-Khoury
- Advanced Health Care Practice Program - Faculty of Health Sciences, Western University, London, ON, Canada
| | - Denise La
- Advanced Health Care Practice Program - Faculty of Health Sciences, Western University, London, ON, Canada
| | - Brendan Saville
- Advanced Health Care Practice Program - Faculty of Health Sciences, Western University, London, ON, Canada
| | - Heather Gillis
- Advanced Health Care Practice Program - Faculty of Health Sciences, Western University, London, ON, Canada
| | - Greg Alcock
- Advanced Health Care Practice Program - Faculty of Health Sciences, Western University, London, ON, Canada
| | - Erin Miller
- Advanced Health Care Practice Program - Faculty of Health Sciences, Western University, London, ON, Canada
| | - Jackie Sadi
- Advanced Health Care Practice Program - Faculty of Health Sciences, Western University, London, ON, Canada
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Kranz A, Schulz AA, Weinert K, Abele H, Wirtz MA. A narrative review of Master's programs in midwifery across selected OECD countries: Organizational aspects, competence goals and learning outcomes. Eur J Midwifery 2024; 8:EJM-8-30. [PMID: 38873232 PMCID: PMC11171422 DOI: 10.18332/ejm/188195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 04/30/2024] [Accepted: 05/10/2024] [Indexed: 06/15/2024] Open
Abstract
Shifting midwifery education to a university level is of great importance for healthcare systems worldwide by preparing graduates for current and future challenges. Some of them referring to management, research and teaching tasks as well as advanced practitioner roles, require competences that can only be acquired in a Master's program. The objectives of this narrative review are to outline the differences and commonalities of organizational aspects of Master's programs in selected OECD countries and to point out the competence goals and learning outcomes they are based on. Fifteen Master's programs in twelve OECD countries were identified and analyzed. Considering the organizational characteristics, differences are found in admission requirements and qualification levels, while similarities relate to the awarded title (MSc). All programs aim to develop abilities for research to advance midwifery practice. Leadership and management abilities are addressed through effective teamwork and communication. The programs' aims are to develop abilities for midwifery education tasks. Whereas competence goals mostly align across the programs, they are addressed differently through various learning outcomes. Development and enhancement of Master's programs in midwifery are needed by focusing on core elements, such as common competence goals. It is equally important to adapt them to national healthcare and educational systems.
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Affiliation(s)
- Angela Kranz
- Section of Midwifery Science, Institute of Health Sciences, University of Tübingen, Tübingen, Germany
| | - Anja A. Schulz
- Research Methods in the Health Sciences, University of Education Freiburg, Freiburg, Germany
| | - Konstanze Weinert
- Section of Midwifery Science, Institute of Health Sciences, University of Tübingen, Tübingen, Germany
| | - Harald Abele
- Section of Midwifery Science, Institute of Health Sciences, University of Tübingen, Tübingen, Germany
- Department for Women’s Health, University Hospital Tübingen, Tübingen, Germany
| | - Markus Antonious Wirtz
- Research Methods in the Health Sciences, University of Education Freiburg, Freiburg, Germany
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Ndirangu-Mugo E, Kimani RW, Onyancha C, Mutwiri BD, May B, Kambo I, Tallam E, Koech N, Mukuna A, Henderson C, Shumba CS. Scopes of practice for advanced practice nursing and advanced practice midwifery in Kenya: A gap analysis. Int Nurs Rev 2024; 71:276-284. [PMID: 38488333 DOI: 10.1111/inr.12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 02/08/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND There is increasing global evidence on the impact of advanced nursing and midwifery practitioners, and Kenya's healthcare system has an excellent opportunity to develop scopes of practice and other regulatory frameworks for the integration of these roles. OBJECTIVE The primary purpose of this gap analysis was to explore the existing evidence on opportunities and threats toward the integration of the advanced practice nursing (APN) and advanced practice midwifery (APM) roles in Kenya's healthcare system. METHODS The study team conducted a structured electronic database search of PubMed, CINAHL, Scopus, EBSCOhost Academic Search Complete, and PsycINFO to retrieve articles and credible websites for reports highlighting the opportunities and threats toward the integration of the APN and APM roles in Kenya's healthcare systems. The retrieved articles were screened for relevance and synthesized for reporting using the traditional literature review approach. RESULTS The Kenya Health Policy Framework 2014-2030, growing population needs, and implementation of universal health coverage provide an opportunity to harness and leverage advanced practice roles in nursing and midwifery. There is also momentum to develop advanced practice because of strategic alliances and global evidence showing the contributions and quality of services offered by advanced practice nurses and advanced practice midwives. However, lack of financial support, structural challenges, and lack of national policies, regulations, and legislation continue to obstruct progress. CONCLUSION AND IMPLICATIONS FOR NURSING POLICY Developing scopes of practice for APN and APM in Kenya will benefit the professions, the country's healthcare delivery system, and the population. Achieving universal health coverage depends on a health workforce trained and practicing at optimal levels in tandem with education and training to deliver quality care.
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Affiliation(s)
| | | | - Catherine Onyancha
- School of Nursing and Midwifery, Aga Khan University, Nairobi, Kenya
- Nursing Council of Kenya, Nairobi, Kenya
| | | | - Beatrice May
- School of Nursing and Midwifery, Aga Khan University, Nairobi, Kenya
| | - Isabel Kambo
- School of Nursing and Midwifery, Aga Khan University, Nairobi, Kenya
| | | | - Nicholas Koech
- School of Nursing and Midwifery, Aga Khan University, Nairobi, Kenya
| | - Ann Mukuna
- Nursing Council of Kenya, Nairobi, Kenya
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Cignacco E, Schlenker A, Ammann-Fiechter S, Damke T, de Labrusse CC, Krahl A, Stocker Kalberer B, Weber-Käser A. Advanced Midwifery Practice in Switzerland: Development and challenges. Eur J Midwifery 2024; 8:EJM-8-15. [PMID: 38650967 PMCID: PMC11034162 DOI: 10.18332/ejm/185648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 04/25/2024] Open
Abstract
Midwifery is undergoing increasing complexity attributed to global epidemiological, socio-economic and technological shifts. Coupled with a shortage of workforce and the imperative for cost-effectiveness and high-quality care, there is an ongoing international discourse and establishment of new care models and specialized roles, notably Advanced Midwifery Practice (AMP). While countries like the UK and Ireland have embraced AMP roles, Switzerland lags behind with only a few pioneering roles. The absence of regulatory frameworks for AMP within the Swiss legal and healthcare system, hinders the evolution of APM roles necessary to address contemporary needs in perinatal healthcare provision. To effectively harness the midwifery workforce and mitigate premature attrition, Switzerland must formulate distinct career trajectories for postgraduate midwives, particularly for Advanced Practice Midwives (APM). This involves establishing legal standards for educational and clinical prerequisites, delineating guidelines for APM responsibilities and competencies, and devising compensation schemes that mirror the autonomy and leadership competencies integral to these advanced roles within inpatient and outpatient perinatal care models. The incorporation of evaluation and research into AMP is indispensable, contributing to improved patient outcomes and the ongoing professionalization of midwifery. In conjunction with the Swiss Federation of Midwives, all Universities of Applied Sciences in Switzerland have collaboratively drafted a national position paper underscoring the significance of developing APM roles to ensure the provision of high-quality perinatal care. This article aims to elucidate current developments in perinatal care within the Swiss context, providing a comprehensive definition for AMP, delineating its contribution to enhancing and sustaining the quality of care.
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Affiliation(s)
- Eva Cignacco
- School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Anja Schlenker
- School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Silvia Ammann-Fiechter
- Institute of Midwifery and Reproductive Health, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Therese Damke
- School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Claire C. de Labrusse
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Astrid Krahl
- Institute of Midwifery and Reproductive Health, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
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Díaz Blasco JB, Labajos Manzanares MT, Flores García MDLÁ, Morente Morente L. [Design of a nursing assessment instrument during pregnancy monitoring in Primary Health care and the validation of its content]. Aten Primaria 2024; 56:102932. [PMID: 38615551 PMCID: PMC11031718 DOI: 10.1016/j.aprim.2024.102932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/15/2024] [Accepted: 03/04/2024] [Indexed: 04/16/2024] Open
Abstract
OBJECTIVE This research aims to develop a nursing assessment tool, based on Gordon's Health Functional Patterns, through a content validation by a committee of experts, applying a Delphi technique. DESIGN An assessment instrument with 53 items has been designed. SITE: It is carried out within the framework of a doctoral thesis, for its implementation by midwives of Primary Health Care. PARTICIPANTS The committee was made up of 16 professionals with a hide clinical, teaching and research experience who all participated in the entire validation process. INTERVENTION It has been assessed as a whole and in each of the items through four rounds of consultations, establishing a positive assessment of more than 60% to accept each item, as well as incorporating the suggestions provided by the committee. The final version had to reach a unanimous consensus. MAIN MEASUREMENTS All items were accepted with a score higher than 60%. RESULTS There were no contradictions between the inputs provided by the experts, so all of them were integrated into the final version that has a 100% approval by the committee. CONCLUSION After this process, a new assessment tool is presented to be applied by primary care midwives in the pregnancy monitoring. The questionnaire has been piloted with 50 pregnant women, determining the most prevalent nursing diagnoses, establishing the workload for the midwife of her implementation of individualized care plans to improve some health indicators of pregnant women.
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Affiliation(s)
- Juan Bautista Díaz Blasco
- Centro de Salud Portada Alta y Carranque, Distrito Sanitario Málaga, Servicio Andaluz de Salud, Málaga, España; Facultad de Ciencias de la Salud, Universidad de Málaga, Málaga, España.
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Toll K, Sharp T, Reynolds K, Bradfield Z. Advanced midwifery practice: A scoping review. Women Birth 2024; 37:106-117. [PMID: 37845089 DOI: 10.1016/j.wombi.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/18/2023]
Abstract
PROBLEM There is no international standard for advanced midwifery scope of practice. BACKGROUND Globally, there is variance in how scope of midwifery practice is determined and regulated, with no consensus on extended or advanced scope. This can lead to under-utilised staff potential, un-met consumer need, and loss of professional skill. AIMS The aim of this scoping review was to synthesise and map what is reported in the international literature on the advanced scope of midwifery practice. METHODS A systematic scoping review methodology was adopted utilising Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A full search was conducted of databases including MEDLINE, CINAHL, Scopus, Google. Publications from 2019 to August 2022 that met criteria were included. Reported skills were mapped to the International Confederation of Midwives (ICM) competencies of pre-conception, antenatal, labour and birth, postnatal plus globally identified areas for midwifery investment. FINDINGS 28 articles met inclusion criteria. Reported skills included abortion care (n = 6), prescribing (n = 7), ultrasound (n = 2), advanced practice skills (n = 7), midwifery-led skills, primary health, post-graduate education, HIV/AIDS testing, advocacy, and acupressure (all n = 1). DISCUSSION This review presents a synopsis of publications describing what has been defined as advanced midwifery scope of practice in international contexts. CONCLUSION Establishing evidence of midwives working to the peak of professional scope is important to continue to develop professional capacity and support contemporary practice, regulation, governance, and policy while improving consumer access to equitable care. Findings aid service development, provision, and professional planning.
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Affiliation(s)
- Kaylie Toll
- School of Population Health, Curtin University, Perth, Western Australia, Australia.
| | - Tarryn Sharp
- WA Country Health Service, Western Australia, Australia
| | - Kate Reynolds
- WA Country Health Service, Western Australia, Australia
| | - Zoe Bradfield
- School of Nursing, Curtin University, Perth, Western Australia, Australia; King Edward Memorial Hospital, Bagot Rd, Subiaco, Perth, Western Australia, Australia
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Ramesh S, Chakraborty S, Adanu RM, Bandoh DAB, Berrueta M, Gausman J, Khan N, Kenu E, Langer A, Nigri C, Odikro MA, Pingray V, Saggurti N, Vázquez P, Williams CR, Jolivet RR. Authorization of midwives to perform basic emergency obstetric and newborn care signal functions in Argentina, Ghana, and India: A multi-country validation study of a key global maternal and newborn health indicator. PLoS One 2023; 18:e0283029. [PMID: 37079621 PMCID: PMC10118111 DOI: 10.1371/journal.pone.0283029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/28/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Midwives' authorization to deliver the seven basic emergency obstetric and newborn care (BEmONC) functions is a core policy indicator in global monitoring frameworks, yet little evidence supports whether such data are captured accurately, or whether authorization demonstrates convergence with midwives' skills and actual provision of services. In this study, we aimed to validate the data reported in global monitoring frameworks (criterion validity) and to determine whether a measure of authorization is a valid indicator for BEmONC availability (construct validity). METHODS We conducted a validation study in Argentina, Ghana, and India. To assess accuracy of the reported data on midwives' authorization to provide BEmONC services, we reviewed national regulatory documents and compared with reported country-specific data in Countdown to 2030 and the World Health Organization Maternal, Newborn, Child and Adolescent Health Policy Survey. To assess whether authorization demonstrates convergent validity with midwives' skills, training, and performance of BEmONC signal functions, we surveyed 1257 midwives/midwifery professionals and assessed variance. RESULTS We detected discrepancies between data reported in the global monitoring frameworks and the national regulatory framework in all three countries. We found wide variations between midwives' authorization to perform signal functions and their self-reported skills and actual performance within the past 90 days. The percentage of midwives who reported performing all signal functions for which they were authorized per country-specific regulations was 17% in Argentina, 23% in Ghana, and 31% in India. Additionally, midwives in all three countries reported performing some signal functions that the national regulations did not authorize. CONCLUSION Our findings suggest limitations in criterion and construct validity for this indicator in Argentina, Ghana, and India. Some signal functions such as assisted vaginal delivery may be obsolete based on current practice patterns. Findings suggest the need to re-examine the emergency interventions that should be included as BEmONC signal functions.
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Affiliation(s)
| | | | - Richard M. Adanu
- Department of Population, Family, and Reproductive Health, University of Ghana School of Public Health, Accra, Ghana
| | - Delia A. B. Bandoh
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Greater Accra, Ghana
| | - Mabel Berrueta
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Jewel Gausman
- Women and Health Initiative, Department of Global Health and Population, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | | | - Ernest Kenu
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Greater Accra, Ghana
| | - Ana Langer
- Women and Health Initiative, Department of Global Health and Population, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Carolina Nigri
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Magdalene A. Odikro
- Department of Epidemiology and Disease Control, University of Ghana School of Public Health, Accra, Greater Accra, Ghana
| | - Verónica Pingray
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | | | - Paula Vázquez
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
- Department of Health Science, Kinesiology, and Rehabilitation, Universidad Nacional de La Matanza, Buenos Aires, Argentina
| | - Caitlin R. Williams
- Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
- Department of Maternal & Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - R. Rima Jolivet
- Women and Health Initiative, Department of Global Health and Population, Harvard University T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
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Blanchet E, Chantry AA, Sauvegrain P, Anselem O. [Medical attitudes regarding the announcement of suspected foetal abnormality in ultrasound scans]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2022; 50:753-761. [PMID: 36108917 DOI: 10.1016/j.gofs.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/26/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study's primary objective was to analyse the personal experience of different ultrasonographers during the announcement of suspected foetal abnormalities, seen either in screening or diagnostic ultrasound. The secondary objectives aimed to explore the factors influencing the announcement of the foetal abnormality, whether they complicated or facilitated the consultation. These also comprised the analysis of the knowledge, practice and attitudes of the healthcare professionals as well as the different techniques used during the consultation. Finally, this study aimed to analyse the various tools and skills used by ultrasonographers to improve the quality of their announcement of the diagnosis. METHODS This qualitative study was based on both the observation of consultations and the results of semi-structured interviews with ultrasonographers, in a maternity hospital in France. RESULTS The results highlighted feelings of great discomfort for the ultrasonographers on discovering an abnormality on the scan. The different perceptions and practices regarding the announcement of a diagnosis varied between screening ultrasonographers and specialist doctors. The uncertainty of foetal prognosis seemed to complicate the announcement for specialist doctors. Qualities that made the communication of the diagnosis easier included the ultrasonographer's availability and their attitude. Although professional experience was considered a very powerful skill, training for the communication of a diagnosis accelerates the development of good medical practice. CONCLUSIONS The announcement of suspected foetal abnormalities is a difficult exercice, which impacts the ultrasonographer's personal experience and his attitude. Some professional practices are to be encouraged while others are to be put under question. A trust-based relationship between the healthcare professional and the patient is partly reinforced by the quality of the announcement and its follow-up, as well as the healthcare professional's thoroughness and humanity.
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Affiliation(s)
- E Blanchet
- Maternité Port-Royal, AP-HP, 123, boulevard de Port-Royal, 75014 Paris, France.
| | - A A Chantry
- Université Paris Cité, Centre de Recherche en epidémiologie et Statistiques, CRESS, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), INSERM, INRA, 75004 Paris, France; École de sages-femmes de Baudelocque, AP-HP, université Paris Cité, 75006 Paris, France
| | - P Sauvegrain
- Université Paris Cité, Centre de Recherche en epidémiologie et Statistiques, CRESS, équipe de recherche en épidémiologie obstétricale, périnatale et pédiatrique (EPOPé), INSERM, INRA, 75004 Paris, France; Maternité la Pitié Salepêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - O Anselem
- Maternité Port-Royal, AP-HP, 123, boulevard de Port-Royal, 75014 Paris, France
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Prosen M. A systematic integrative literature review of the factors influencing the professionalization of midwifery in the last decade (2009-2019). Midwifery 2021; 106:103246. [PMID: 35007977 DOI: 10.1016/j.midw.2021.103246] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 09/03/2021] [Accepted: 12/26/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The professionalization of midwifery is not only important for midwives themselves, but for women and society in general since professionalism is associated with high-quality services and moral and ethical standards. AIM This systematic integrative literature review seeks to investigate the factors that have affected the professionalization of midwifery in the last decade (2009-2019). METHODS Systematic searches were conducted in EBSCO, PubMed, ScienceDirect, SAGE and the Web of Science Core Collection. Critical appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). The findings were synthesised through a thematic analysis. The PRISMA statement was used to guide the reporting. FINDINGS Analysis of the 20 studies included detected two main themes: professionalization barriers and professionalization opportunities. The first theme includes issues concerning power imbalance, social recognition, conflicting perspectives on childbirth, professional autonomy, work characteristics, midwifery associations, and regulation. The second theme includes opportunity issues related to woman-centred care, expansion of professional competency, interprofessional collaboration, and education. KEY CONCLUSIONS Over the last decade, the midwifery profession has faced several barriers that seem to be historically entrenched in the professionalization of midwifery, yet changes in the professionalization process are visible in the shift towards elements of the 'new professionalism' that is rising to the surface during this process. IMPLICATIONS FOR PRACTICE The findings suggest the socialisation process of midwifery candidates must focus on raising their self-awareness, self-esteem and confidence in their professional role; woman-centred care needs to be further promoted and implemented; and interprofessional collaboration should be addressed in educational programmes for all health professionals.
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Affiliation(s)
- Mirko Prosen
- University of Primorska, Faculty of Health Sciences, Polje 42, 6310 Izola, Slovenia.
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Evans C, Poku B, Pearce R, Eldridge J, Hendrick P, Knaggs R, Blake H, Yogeswaran G, McLuskey J, Tomczak P, Thow R, Harris P, Conway J, Collier R. Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review. BMJ Open 2021; 11:e048171. [PMID: 34353799 PMCID: PMC8344309 DOI: 10.1136/bmjopen-2020-048171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/23/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES In response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK. DESIGN A scoping review was undertaken following JBI methodological guidance. METHODS 13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative. RESULTS 191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway. CONCLUSION This review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors.
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Affiliation(s)
- Catrin Evans
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Brenda Poku
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruth Pearce
- School of Education, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jeanette Eldridge
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Paul Hendrick
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roger Knaggs
- School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Gowsika Yogeswaran
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - John McLuskey
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Philippa Tomczak
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruaridh Thow
- Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Peter Harris
- Health Education England East Midlands, Leicester, UK
| | - Joy Conway
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Richard Collier
- Centre for Advancing Practice, Health Education England, Leeds, UK
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Hastings-Tolsma M, Temane A, Tagutanazvo OB, Lukhele S, Nolte AG. Experience of midwives in providing care to labouring women in varied healthcare settings: A qualitative study. Health SA 2021; 26:1524. [PMID: 34192066 PMCID: PMC8182560 DOI: 10.4102/hsag.v26i0.1524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 03/24/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Midwives are essential to timely, effective, family-centred care. In South Africa, patients have often expressed dissatisfaction with the quality of midwifery care. Negative interpersonal relationships with caregivers, lack of information, neglect and abandonment were consistent complaints. Less is known about how midwives experience providing care. AIM This research explored and described the experiences of midwives in providing care to labouring women in varied healthcare settings. SETTING Midwives practicing in the Gauteng province, South Africa, in one of three settings: private hospitals, public hospitals or independent maternity hospital. METHODS A convenience sample of midwives (N = 10) were interviewed. An exploratory and descriptive design, with individual semi-structured interviews conducted, asked a primary question: 'How is it for you to be a midwife in South Africa?' Transcribed interviews were analysed using thematic coding. RESULTS Five themes were found: proud to be a midwife, regulations and independent function, resource availability, work burden and image of the midwife. CONCLUSION Midwives struggle within systems that fail to allow independent functioning, disallowing a voice in making decisions and creating change. Regardless of practice setting, midwives expressed frustration with policies that prevented utilisation consistent with scope of practice, as well as an inability to practice the midwifery model of care. Those in public settings expressed concern with restricted resource appropriation. Similarly, there is clear need to upscale midwifery education and to establish care competencies to be met in providing clinical services. CONTRIBUTION This research provides evidence of the midwifery experience with implications for needed health policy change.
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Affiliation(s)
- Marie Hastings-Tolsma
- Louise Herrington School of Nursing, Faculty of Nursing/Midwifery, Baylor University, Dallas, Texas, United States of America
| | - Annie Temane
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Oslinah B. Tagutanazvo
- Department of Midwifery Science, Faculty of Health Sciences, University of Eswatini, Mbabane, Eswatini
| | - Sanele Lukhele
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Anna G. Nolte
- Department of Nursing, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
- Netcare Education, Netcare, Johannesburg, South Africa
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Van Haeken S, Braeken MAKA, Nuyts T, Franck E, Timmermans O, Bogaerts A. Perinatal Resilience for the First 1,000 Days of Life. Concept Analysis and Delphi Survey. Front Psychol 2020; 11:563432. [PMID: 33224056 PMCID: PMC7670043 DOI: 10.3389/fpsyg.2020.563432] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 10/09/2020] [Indexed: 02/02/2023] Open
Abstract
Background The ability to cope with challenges and stress in life is generally understood as resilience. Pregnancy and parenthood are challenging times. The concept of resilience is receiving increasing interest from researchers, clinicians, and policy staff because of its potential impact on health, well-being, and quality of life. Nevertheless, the concept is less studied during the perinatal period. Objectives The aim of this study is to understand the concept of perinatal resilience, including the underlying processes and more specifically for the first 1,000 days of life. Methods A concept analysis according to the Walker and Avant (2011) framework was used, to investigate the basic elements of the concept. Concurrently, a two-round Delphi survey involving researchers, clinicians, epidemiologists, mothers, and fathers (N = 21), was conducted to prioritize the terms associated with perinatal resilience. Data collection took place between January and April 2019. Results Through concept analysis and Delphi survey, five defining attributes for perinatal resilience were identified: social support, self-efficacy, self-esteem, sense of mastery and personality. The additional terms, rated important by the Delphi survey, were linked to the consequences of being resilient during the perinatal period for the individual and his/her family. Specifically, highlighted were the experiences of families in personal growth and achieving family balance, adaptation, or acceptance. Conclusion Based on the results of the concept analysis and Delphi survey, we describe perinatal resilience for the first 1,000 days as a circular process towards a greater well-being in the form of personal growth, family balance, adaptation or acceptance, when faced with stressors, challenges or adversity during the perinatal period. The presence of resiliency attributes such as social support, sense of mastery, self-efficacy, and self-esteem enhance the capacity to be resilient and probably prevent mental health problems.
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Affiliation(s)
- Sarah Van Haeken
- Research & Expertise, Resilient People, UC Leuven-Limburg, Diepenbeek, Belgium.,Faculty of Medicine, Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium
| | - Marijke A K A Braeken
- Research & Expertise, Resilient People, UC Leuven-Limburg, Diepenbeek, Belgium.,Faculty of Rehabilitation Sciences, REVAL-Rehabilitation Research Center, Hasselt University, Diepenbeek, Belgium
| | - Tinne Nuyts
- Faculty of Medicine, Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium
| | - Erik Franck
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium
| | - Olaf Timmermans
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium.,Professorship Healthy Region, HZ University of Applied Sciences, Vlissingen, Netherlands
| | - Annick Bogaerts
- Faculty of Medicine, Department of Development and Regeneration, Women and Child, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium
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Vermeulen J, Luyben A, Buyl R, Debonnet S, Castiaux G, Niset A, Muyldermans J, Fleming V, Fobelets M. The state of professionalisation of midwifery in Belgium: A discussion paper. Women Birth 2020; 34:7-13. [PMID: 32988768 DOI: 10.1016/j.wombi.2020.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/31/2022]
Abstract
AIM To describe the state of the professionalisation of midwifery in Belgium, and to formulate recommendations for advancing the midwifery profession. METHODS A descriptive overview of maternity care in Belgium and the professionalisation of midwifery through an analysis of relevant policy and academic texts, underpinned by Greenwood's sociological criteria for a profession: (1) own body of knowledge, (2) recognised authority, (3) broader community sanctions, (4) own code of ethics and (5) professional culture sustained by formal professional associations. From these insights, recommendations for advancing the midwifery profession in Belgium are formulated. FINDINGS Current strengths of the professionalisation of midwifery in Belgium included unified midwifery education programmes, progress in midwifery research and overarching national documents for guiding midwifery education, practice and regulation. In contrast however challenges, such as the limited recognition of midwives' roles by its clientele, limitations of midwives' competencies and autonomy, lacking development of advanced roles in maternity care practice and a lack of unity of the organisation and its members, were also identified. Based on these, recommendations are made to strengthen Belgian midwifery. CONCLUSIONS Recommendations for advancing the midwifery profession in Belgium includes in particular increasing public awareness of midwives' roles and competencies, implementing the full scope of midwifery practice and monitoring and advancing this practice. Thus, professional autonomy over both midwifery practice and working conditions should be enhanced. United midwifery organisations, together with women's groups, other maternity care professionals and policy-makers as equal partners are key to bring about changes in the Belgian maternity care landscape.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
| | - Ans Luyben
- Centre for Midwifery, Maternal and Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK; Department of Health Services Research, University of Liverpool, Liverpool, UK
| | - Ronald Buyl
- Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Serena Debonnet
- Federal Public Service, Health, Food Chain Safety and Environment, Brussels, Belgium; Clinique Saint-Jean, Brussels, Belgium
| | - Geneviève Castiaux
- Paramedical Department Sainte-Elisabeth, University College of Namur-Liège-Luxembourg, Namur, Belgium
| | - Anne Niset
- Federal Public Service, Health, Food Chain Safety and Environment, Brussels, Belgium; Centre Hospitalier du Bois de l'Abbaye, Seraing, Belgium; Belgian Midwives Association, Antwerp, Belgium
| | - Joke Muyldermans
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Midwifery Practice InTeam, Hoeilaart, Belgium; Flemish Professional Association of Midwives, Antwerp, Belgium; Care4Education, Boortmeerbeek, Belgium
| | - Valerie Fleming
- School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, UK
| | - Maaike Fobelets
- Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Brussels, Belgium; Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Goemaes R, Beeckman D, Verhaeghe S, Van Hecke A. Sustaining the quality of midwifery practice in Belgium: Challenges and opportunities for advanced midwife practitioners. Midwifery 2020; 89:102792. [PMID: 32653612 DOI: 10.1016/j.midw.2020.102792] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/10/2020] [Accepted: 07/04/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Midwifery practice is essential in achieving high-quality maternal and newborn care in all settings and countries. However, midwifery practice has become more complex over the past decades. Considerable demands are being placed on midwives to meet increasing epidemiological, socio-economic, and technological challenges. These require a well-trained midwifery workforce ready to shape the care in the near and long-term future. OBJECTIVE To discuss advanced midwife practitioner role implementation in Belgium as a possible answer to healthcare-related challenges that impact midwifery practice. Furthermore, to stimulate a debate within the profession at all levels in Belgium and in countries considering advanced midwife practitioner roles. METHOD The framework by De Geest et al. (2008) served as a basis for discussing the drivers for advanced midwife practitioner role implementation: the legal, policy and economic context, workforce issues, education, practice patterns, and healthcare needs of the population. FINDINGS A legal basis for advanced midwife practitioner role implementation is lacking in Belgium. Remuneration opportunities for the non-clinical part of these roles (e.g. leadership and innovation activities) are missing. It might be challenging for healthcare organisations to support the implementation of such roles, as immediate revenues of non-clinical activities are absent. However, sufficient potential resources are available to fill in future advanced midwife practitioner positions. Additionally, advanced midwife practitioner specific master programmes are being planned in the near future. CONCLUSIONS Although several barriers for the implementation of advanced midwife practitioner roles were identified, a discussion should be held on the opportunities of implementing these roles to facilitate the development of new models of care that meet current and future challenges in midwifery practice and healthcare. After initial discussions amongst midwives in academic, managerial, and policy positions, stakeholders such as obstetricians, general practitioners, associations representing healthcare organisations, and policy makers should be involved as a next step.
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Affiliation(s)
- Régine Goemaes
- PhD student University Centre for Nursing & Midwifery Department of Public Health and Primary Care Faculty of Medicine and Health Sciences, Ghent University. University Centre for Nursing & Midwifery Ghent University, U.Z. 5K3 Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
| | - Dimitri Beeckman
- University Centre for Nursing & Midwifery Department of Public Health and Primary Care Faculty of Medicine and Health Sciences, Ghent University Centre for Nursing & Midwifery Ghent University, U.Z. 5K3 Corneel Heymanslaan 10, B-9000, Ghent, Belgium.
| | - Sofie Verhaeghe
- University Centre for Nursing & Midwifery Department of Public Health and Primary Care Faculty of Medicine and Health Sciences, Ghent University Centre for Nursing & Midwifery, Ghent University, U.Z. 5K3 Corneel Heymanslaan 10, B-9000, Ghent, Belgium.
| | - Ann Van Hecke
- University Centre for Nursing & Midwifery Department of Public Health and Primary Care Faculty of Medicine and Health Sciences, Ghent University Centre for Nursing & Midwifery, Ghent University, U.Z. 5K3 Corneel Heymanslaan 10, B-9000, Ghent, Belgium; Nursing Department, University Hospital Ghent, Corneel Heymanslaan 10, B-9000, Ghent, Belgium..
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Van Hecke A, Goemaes R, Verhaeghe S, Beyers W, Decoene E, Beeckman D. Leadership in nursing and midwifery: Activities and associated competencies of advanced practice nurses and midwives. J Nurs Manag 2019; 27:1261-1274. [DOI: 10.1111/jonm.12808] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/01/2019] [Accepted: 05/27/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Nursing Department Ghent University Hospital Ghent Belgium
| | - Régine Goemaes
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery Ghent University Ghent Belgium
| | - Sofie Verhaeghe
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Department Health Care VIVES University College Roeselare Belgium
| | - Wim Beyers
- Department of Developmental, Personality and Social Psychology Ghent University Ghent Belgium
| | - Elsie Decoene
- Cancer Centre Ghent University Hospital Ghent Belgium
| | - Dimitri Beeckman
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- Department of Public Health and Primary Care, Skin Integrity Research Group (SKINT) University Centre for Nursing and Midwifery, Ghent University Ghent Belgium
- School of Health Sciences Örebro University Sweden
- School of Nursing and Midwifery Royal College of Surgeons in Ireland Ireland
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17
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Factors influencing the implementation of advanced midwife practitioners in healthcare settings: A qualitative study. Midwifery 2018; 66:88-96. [DOI: 10.1016/j.midw.2018.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/27/2018] [Accepted: 08/06/2018] [Indexed: 01/12/2023]
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Casey M, O'Connor L, Cashin A, Fealy G, Smith R, O'Brien D, Stokes D, McNamara M, O'Leary D, Glasgow ME. Enablers and challenges to advanced nursing and midwifery practice roles. J Nurs Manag 2018; 27:271-277. [PMID: 30252173 DOI: 10.1111/jonm.12697] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/30/2018] [Accepted: 07/13/2018] [Indexed: 11/30/2022]
Abstract
AIM To describe the enablers and challenges to the development and implementation of advanced nursing and midwifery practice roles in Ireland. BACKGROUND Leadership strategies need to be put in place to enhance the development and implementation of advanced nursing and midwifery practice roles. METHOD A descriptive qualitative approach using semi-structured interviews with key stakeholders (n = 15) was undertaken with nurses and midwives working in specialist and advanced practice roles and participants from other areas such as legislative, regulatory, policy, pharmacy, medicine and education. RESULTS Participant's perspectives on the enablers and challenges to enacting specialist and advanced practice roles resulted in the generation of three themes: organisational factors; collegial, interprofessional and interpersonal support; and role clarity, economic and regulatory contexts. CONCLUSION Addressing organisational factors, encouraging collegial and interprofessional support and establishing role clarity contribute to the effective development and implementation of the role of advanced practitioners. IMPLICATIONS FOR NURSING AND MIDWIFERY MANAGEMENT Managers of nursing services need to provide leadership in developing strategies to enhance the enablers and overcome the challenges to advanced practice role development in their own organisation.
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Affiliation(s)
- Mary Casey
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | - Laserina O'Connor
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | - Andrew Cashin
- Southern Cross University, East Lismore, New South Wales, Australia
| | - Gerard Fealy
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | - Rita Smith
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | - Denise O'Brien
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | | | - Martin McNamara
- UCD School of Nursing, Midwifery and Health Systems, Health Systems Centre, University College Dublin, Dublin 4, Ireland
| | - Denise O'Leary
- School of Hospitality Management & Tourism, Dublin Institute of Technology, Dublin 6, Ireland
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Maree C, Yazbek M, Leech R. Process of development of a contemporary curriculum in advanced midwifery. Health SA 2018; 23:1037. [PMID: 31934367 PMCID: PMC6917384 DOI: 10.4102/hsag.v23i0.1037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 04/06/2018] [Indexed: 11/05/2022] Open
Abstract
Background We identified the need for a contemporary curriculum to enhance education in advanced midwifery. Midwifery education needs to address the changing health needs, meet the requirements of the educational framework in South Africa and align with international trends. Aim The aim was to describe the development of a contemporary curriculum for advanced midwifery. Setting The curriculum development took place at a South African university. Method We used a situational analysis to create a contemporary curriculum based on the Research Development and Diffusion Model. Results We described the process followed for the situation analysis towards the development of a contemporary curriculum in advanced midwifery which is aligned with global trends. Conclusion A situation analysis of the existing curriculum, the community and country’s maternal and neonatal needs, educational framework and global trends should be used to develop the intended contemporary curriculum.
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Affiliation(s)
- Carin Maree
- Department of Nursing Science, University of Pretoria, South Africa
| | - Mariatha Yazbek
- Department of Nursing Science, University of Pretoria, South Africa
| | - Ronell Leech
- Department of Nursing Science, University of Pretoria, South Africa
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Fealy GM, Casey M, O'Leary DF, McNamara MS, O'Brien D, O'Connor L, Smith R, Stokes D. Developing and sustaining specialist and advanced practice roles in nursing and midwifery: A discourse on enablers and barriers. J Clin Nurs 2018; 27:3797-3809. [PMID: 29893441 DOI: 10.1111/jocn.14550] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2018] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To collate, synthesise and discuss published evidence and expert professional opinion on enablers and barriers to the development and sustainability of specialist and advanced practice roles in nursing and midwifery. BACKGROUND Expanded practice is a response to population health needs, healthcare costs and practitioners' willingness to expand their scope of practice through enhanced responsibility, accountability and professional autonomy. DESIGN This discursive paper is based on a rapid review of literature on enablers and barriers to the development and sustainability of specialist and advanced practice roles and is part of a wider policy analysis. METHODS We analysed and synthesised of 36 research articles, reviews and discussion papers on enablers and barriers in the development and sustainability of expanded practice roles. RESULTS Several factors enable role expansion, including: role clarity; credentialing and endorsement; availability of education for expanded roles; individual practitioners' dispositions towards role expansion; support from peers, other professionals and the work organisation; and costs. Where limited or absent, these same factors can constrain role expansion. CONCLUSIONS Enabling nurses and midwives to practice to their full scope of education and expertise is a global challenge for disciplinary leadership, a national challenge for professional regulation and a local challenge for employers and individual clinicians. These challenges need to be addressed through multistakeholder coordinated efforts at these four levels. RELEVANCE TO CLINICAL PRACTICE This discursive paper synthesises empirical evidence and expert professional opinion on the factors that enable or hinder the development and sustainability of specialist and advanced practice roles. Providing a critical appraisal of current knowledge, it provides a reference source for disciplinary debate and policy development regarding the nursing and midwifery resource and informs clinicians of the myriad issues that can impact on their capacity to expand their scope of practice.
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Affiliation(s)
- Gerard M Fealy
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Mary Casey
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Denise F O'Leary
- School of Hospitality Management and Tourism, Dublin Institute of Technology, Dublin, Ireland
| | - Martin S McNamara
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Denise O'Brien
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Laserina O'Connor
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rita Smith
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
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Mestdagh E, Timmermans O, Colin PJ, Van Rompaey B. A cross-sectional pilot study of student's proactive behavior in midwifery education: Validation of a developed questionnaire. NURSE EDUCATION TODAY 2018; 62:22-29. [PMID: 29275018 DOI: 10.1016/j.nedt.2017.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 11/02/2017] [Accepted: 12/02/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Midwifery students face major challenges in adapting quickly and effectively to different clinical settings. Proactive behavior, triggered by various individual and/or contextual antecedents, could be a significant added value to cope with these challenges. DESIGN A cross-sectional pilot study was conducted to investigate prognostic factors in proactive behavior in a group of midwifery students. SETTINGS The setting was a Belgian University College for midwifery education. PARTICIPANTS All second and third year midwifery students (n=156). METHODS Students were questioned regarding several prognostic factors: four personal characteristics, seven individual antecedents and three contextual antecedents that might trigger proactive behavior. A proportional odds logistic regression analyses was used to describe the association between prognostic factors and the probability to observe proactive behavior within the group. The strength of the newly developed questionnaire was tested. RESULTS Of all tested prognostic factors, nationality, role breadth self-efficacy, referring to the self-confidence of a midwifery-student to perform tasks that exceed expectations, and control appraisal, describing the importance attached to one's perceived control, were significantly associated with proactive behavior. The overall strength of the questionnaire was ratified. Two of the original questions were deleted, two re-formulated and for one prognostic factor the answer-options were re-formulated. CONCLUSIONS Findings from this pilot study show that midwifery students who have a high role breadth self-efficacy and low control appraisal are more likely to show proactive behavior. Additionally, Dutch students are more likely to show proactive behavior in relation to Belgian students. The questionnaire's feasibility was examined and adjustments were made for future research in a larger study to confirm these outcomes. This study can be a support in the individual guidance of midwifery students towards proactive behavior in midwifery.
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Affiliation(s)
- Eveline Mestdagh
- Department of Health and Social Work, Artesis Plantijn University Antwerp, Noorderplaats 2, 2000 Antwerp, Belgium; Centre for Research and Innovation in Care, University Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Olaf Timmermans
- Centre for Research and Innovation in Care, University Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; HZ University of Applied sciences, Edisonweg 4, 4382 NW Vlissingen, The Netherlands.
| | - Pieter J Colin
- Department of Anesthesiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
| | - Bart Van Rompaey
- Department of Health and Social Work, Artesis Plantijn University Antwerp, Noorderplaats 2, 2000 Antwerp, Belgium; Centre for Research and Innovation in Care, University Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
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