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PubMed1997

Changing childbirth--the midwifery managers' tale.

This paper concerns Maternity Services. It begins by describing the development of the current policy in Britain which culminated in the report Changing Childbirth. It proceeds to describe a qualitative investigation in which a group of Heads of Midwifery Service in one health region were interviewed concerning their views about the basic recommendations of the report and their experiences concerning the feasibility of its implementation by 1998. On the basis of its evidence, the study concludes the policy is failing to be fully realized due to both a lack of earmarked resources and confused objectives which are not fully accepted by professionals and are not understood by service users. The findings demonstrate that the Heads of Midwifery believe that what was proposed as a bold and innovative policy has become no more than lukewarm advice. The conduct of the study is described in detail to illustrate how operational managers can research the ways in which policies are influencing service delivery in their field of practice.

Attitude of Health Personnel↗

PubMed1995

The impact of the NHS internal market on the merger of colleges of midwifery and nursing. Not just a case of putting the cart before the horse.

Presents and discusses the findings from a research project into the impact of the NHS internal market on the merger of colleges of midwifery and nursing. Begins by briefly describing the major changes which have been introduced in the NHS since 1979 and sets these within the context of the charging nature of the public sector in the UK. Second, describes the background to the research and the methods employed. Continues with a brief review of the approaches to the change management process, which in particular draws attention to the importance of the environment in which the organization operates, and of the relationship between management styles and the different approaches to organizational change. Presents a case study of the merger of five colleges of nursing and midwifery. Follows with a discussion of the case study and the conclusions drawn from it for the process of change within the NHS.

Economic Competition↗

PubMed1995

Reflective midwifery practice: facilitating midwives' practice insights using a distance education reflective practitioner model.

A study was undertaken to evaluate a reflective practitioner model with midwives, who self-selected into the project when they were studying the Bachelor of Health Science (Nursing) unit NR278, Advanced Nursing Practice, Midwifery. The theoretical assumptions that influenced the research were those forwarded by Schon (1983) and Boud, Keogh and Walker (1985), who argued that practitioners are often unaware of the sophisticated knowledge they have regarding the intricacies of their practice, but that this personal knowledge can be make explicit through reflective processes. The aim of the study was to research the use of a distance education reflective practitioner process that encouraged midwives to examine their practice with a view to making changes where necessary. All the research objectives were met to some extent, although each experience of the research process was particular to the individual participant. Analysis consisted of: interpretation of the participant's insights into their individual experiences; the researcher's interpretations of participant's experiences; and collective themes arising out of the research. This paper concentrates mainly on the participant's insights into their individual experiences of practising midwifery, using a reflective practitioner model.

Education, Nursing, Baccalaureate↗

PubMed2006

Nursing and midwifery research in Scotland: from partnership to collaboration.

Nurses and midwives form the workforce that provides the greatest proportion of direct care to service users. They have the ability to make a significant impact not only on the quality and outcomes of patient care, but also on service users' and carers' perceptions of the care experience. It is therefore vital that nursing and midwifery practice has a robust knowledge and evidence base. The Scottish Executive Health Department, in partnership with other key stakeholders, launched in 2004 an 8 million pounds funding package for research and development capacity and capability initiatives for nursing, midwifery and the allied health professions. This article seeks to describe the process of engagement and partnership building that enabled this scheme to be developed. It will attempt to illustrate how the convergence of political, policy and professional agendas has provided the opportunity for nurses and midwives to set a direction of travel for research and development that will enable them to become key players within multidisciplinary research at United Kingdom and international levels.

Cooperative Behavior↗

PubMed2006

Applying to the European Research Area Network Scheme (ERA-NET): collaborative working for nursing and midwifery research.

AIM: This paper reports on work undertaken to achieve an application for monies from the European Commission's 6th Framework Programme by some key stakeholders, working with a nursing and midwifery research agenda at national policy levels. BACKGROUND: A short outline of the European Commission's European Research Area Network scheme is given in order to set the paper in context, and the vision underpinning the application is discussed. CONCLUSION: The paper describes the processes that were undertaken to bring to fruition such collaborative work, and some key lessons are outlined. Seeking opportunities to enhance nursing and midwifery research within a European context gives value to the application, which was ultimately successful.

Europe↗

PubMedDate not supplied

Quality management in a college of nursing and midwifery.

Colleges of nursing and midwifery are experiencing great change in their working environment and are now expected to offer cost-effective, high quality training and education. Mid Trent College of Nursing and Midwifery has met the challenge by introducing quality management strategies. This article explores their development.

Humans↗

PubMed1991

Nurse-midwifery services in one multi-ethnic, underserved community.

Through a nurse-midwifery service in a mixed urban and rural agricultural community, we compared maternal risk factors, prenatal care, labor and delivery, and adverse birth outcomes in low-income Mexican-American Hispanic, white (Caucasian), and Southeast Asian women--a three-way analysis rarely reported in the literature. Southeast Asian women were older and had more children. Hispanic women bore children at a younger age. Both Southeast Asians and Hispanics made fewer prenatal visits than did Caucasian women, and used less analgesia and anesthesia during delivery. The incidence of Cesarean section (7.7 percent) and low birthweight (5.9 percent) was compared to local, state, and national reference statistics. Prospective case-controlled studies and cost/benefit analyses of nurse-midwifery services could yield more definitive information. But until more precise data are collected for birth certificates, these studies will be difficult.

Adolescent↗

PubMed2002

Technical reflection for improving nursing and midwifery procedures using critical thinking in evidence based practice.

Australian nursing and midwifery education and practice have used key ideas relating to reflective practice since the 1980s. However, missing from that history has been a clear process for reflection when policies and procedures have required change, based on evidence generated from rigorous research and critical thinking processes. This article describes technical reflection as a systematic process for analysing and amending work procedures in nursing and midwifery practice, by combining key ideas in the nursing, critical thinking and reflection.

Clinical Competence↗

PubMed1998

Parenthood as talked about in Swedish ante- and postnatal midwifery consultations. A qualitative study of 58 video-recorded consultations.

In order to explore the manner in which parenthood was discussed in midwifery consultations, 58 video-recorded consultations were analysed. A content analysis revealed a variety of topics concerning conversation on parenthood--topics of an intimate nature and discussions from a societal perspective. Parenthood was not of primary importance in visits, which were mostly directed by the midwives. A phenomenological hermeneutic analysis of the meaning of being a mother revealed a complex and difficult situation of being both needed and dependent. The meaning of being a father revealed a struggle between distancing from and closeness to the child. The mate relationship was indicated as important and under strain. The metaphor of the 'spiders web', where the mother is the spider with the child mostly on her back, the father entering the web on her terms, summarizes the understanding. The results from this study could provide a basis for reflection on the status of the topic of parenthood, on the meaning of being a mother and a father disclosed in the consultations, and ultimately on the organization of ante- and postnatal midwifery care.

Adult↗

PubMed2003

Measuring progress in nursing and midwifery globally.

PURPOSE: To discuss issues and challenges encountered in the preliminary steps of identifying a core set of global indicators for measuring progress in nursing and midwifery development. ORGANIZING CONSTRUCT: Lack of a global and systematic approach for collecting evidence has undermined the ability to reliably measure progress. METHODS: Description of general principles, scientific criteria, and strategic directions. CONCLUSIONS: WHO's organizational support and global conditions are forces that indicated appropriate timing for these strategic directions. Concerted efforts are needed in all countries to implement these directions to advance nursing and midwifery services.

Data Collection↗

PubMed1995

Caseload midwifery--a cost-benefit analysis.

Two caseload teams provide midwifery care for approximately 250 mothers from booking to 28 days postpartum. The running costs of providing caseload midwifery care are comparable with those of established systems of care. Caseload practice offers midwives: Opportunity for self-development Enhanced co-operation with other health professionals The opportunity to discuss problems with colleagues and admit doubts without feeling censured or threatened.

Cost-Benefit Analysis↗

PubMedDate not supplied

Midwifery soon to be an option in B.C. for low-risk births.

Midwifery has recently been established in British Columbia as a self-regulating profession with its own regulatory body, the College of Midwives of British Columbia. Within the next few months, registered midwives will join the other members of the health care team as legitimate providers of care for childbearing women and their families. Midwifery care will be an option for low-risk women who, as long as they continue to experience a healthy pregnancy, will be able to choose to give birth attended by a midwife.

British Columbia↗

PubMed1997

All change again! Midwifery education & government initiatives.

The success of the midwifery profession in the new millennium will depend to a large extent on the appropriate preparation of future midwives and the continuing professional development of existing practitioners. Currently, pre-registration midwifery education, and some recordable continuing education for qualified staff, is regulated by the statutory body-but will this always remain so? It is sometimes difficult to comprehend where the seemingly endless changes in the NHS will lead.

Education, Nursing↗

PubMed1997

Making midwifery decisions.

In order to share practice decision making with women, midwives need to understand their own tacit knowledge and some of the heuristic processes used to arrive at clinical decisions. Arguing that midwifery decision making is intuitive and artful is insufficient defence when accounting for professional practice. Explicit reasoning, individual and shared, should be well to the fore. Contrary to received wisdom, expert practitioners can share their midwifery reasoning with junior colleagues. Role modelling decision making process involves the senior midwife in understanding her own tacit knowledge and coming to terms with practice discussion as a pursuit of understanding, rather than a blame culture activity.

Decision Making↗

PubMed1992

Criteria for the selection of experiences and content in midwifery education.

Selection of content and learning experiences for any educational endeavor is based on the aim and objectives for setting up the program, and the competencies required of graduates of the school. To exclude those experiences that will lead to skill in the management of obstetric emergencies, and at the same time expect midwives to function independently in rural communities is a negation of basic curriculum planning principles. The range of experiences available to the contemporary curriculum planner in the health field is infinite. However, due to the changing nature of societal needs in the health field, and the rapid obsolescence of previously held assumptions about health care services and the role of midwives, selection of experiences requires creativity and well defined criteria for judgment. Those suggested in this paper are validity, comprehensiveness, pattern, balance, relevance, and continuity. The six criteria are discussed to show the relevance of each to some of the current weaknesses in midwifery education in Nigeria.

Clinical Competence↗

PubMedDate not supplied

Evaluation strategies for midwifery education linked to digital media and distance delivery technology.

The goal of the teaching and learning process for health professionals is the acquisition of a fundamental core of knowledge, the demonstration of critical thinking ability, and the demonstration of competency in the performance of clinical skills. Teaching and learning in distance education programs require that the administration, teachers, and students be creative in developing evaluation strategies that can be adapted to the challenges of the cyberspace on-line educational environment. Evaluation standards for distance education programs recently have been delineated by federal agencies, private organizations, and academic accreditation associations. These standards are linked to principles of sound education practice that promote program quality, high levels of student-faculty interaction, and support effective teaching and learning in the distance education context. A growing body of evidence supports the conclusion that technology-enhanced teaching is equivalent in effectiveness compared with traditional methods when student-learning outcomes are the focus of measurement. An allied body of literature offers model approaches that can be useful to educators who must also conduct the evaluation of clinical skills, provide feedback, and promote socialization to the nurse-midwifery/midwifery role for students being educated in whole or in part through instruction delivered at a distance.

Benchmarking↗

PubMedDate not supplied

International service learning in midwifery and nursing education.

The health of women and childbearing families is a global concern that must be addressed if we are to be successful in ensuring healthy families. Numerous strategies have been suggested to increase appreciation for the global factors that influence maternal and child health and the overall health status of a community. Inclusion of cultural content in courses offered in educational programs and provision of clinical learning experiences in diverse communities have commonly been used in midwifery and nursing education. This article reviews the concept of service learning and its application in a course that provides an opportunity for students to participate in an international immersion program. Evaluation of the course found that participants increased their knowledge and skills in providing reproductive health care, developed appreciation for the knowledge and skills of traditional birth attendants, and expanded their world view of women and families in communities.

Altruism↗

PubMedDate not supplied

Genealogic origins of nurse-midwifery education programs in the United States.

This article presents a genealogy of all known basic and refresher nurse-midwifery education programs enabling every CNM and CM to track their individual lineage back to Hattie Hemschemeyer or Mary Breckinridge. Feeling connected to our founding foremothers increases our understanding of who we are and what our commitment is to the families we serve. Genealogy also gives us an opportunity to reflect on the early history and continuing historical trends of our education programs.

Education, Nursing↗