Implementing an intervention to promote normal labour and birth : A study of clinicians' perceptions
- Authors: Shee, Anna , Nagle, Cate , Corboy, Denise , Versace, Vincent , Robertson, Carolyn , Frawley, Natasha , McKenzie, AnneMarie , Lodge, Julie
- Date: 2019
- Type: Text , Journal article
- Relation: Midwifery Vol. 70, no. (2019), p. 46-53
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- Description: Objective: Prior to implementation of a Normal Labour and Birth Bundle (NLBB) at a regional maternity service in Victoria, Australia, this study aimed to understand clinician factors that may influence the uptake, acceptance and use of the NLBB. Design: This was a mixed methods study in which The Theory of Planned Behaviour (TPB) provided the framework for the conduct and analysis of the staff survey and focus groups. Descriptive and multiple regression were used to analyse the survey data and thematic analysis was used for the focus group data. Participants: Participants for the survey and focus groups included clinicians providing publicly funded care and management of labour for women birthing at the health service. Maternity care clinicians were invited to participate in both the survey and the focus groups. Findings: Seventy-six clinicians (88.8%) responded to the survey. Mean scores for TPB constructs were well above the mid-scale score of 4, indicating strong positive attitudes, high levels of self-efficacy and positive social pressure to use the NLBB and strong intentions to use it in the future. Self-efficacy was the strongest independent predictor (beta=0.45, p < 0.001) of intention to use the NLBB (overall model R2 = 0.38). A valued consequence of implementing standardised and objective guidelines, highlighted in the focus groups, was the positive impact on clinicians' confidence in their decision-making. Key conclusions: This study found that midwives and obstetricians were in favour of using a normal labour and birth care bundle and perceived the bundle to align with the expectations of work colleagues and the women they care for. The findings of this study show that clinicians at the health service had strong intentions to use the normal labour and birth care bundle in the future. Implications for practice: Implementation science is important in embedding and sustaining practice change. Understanding staff perceptions is an essential first step of this process. (c) 2018 Elsevier Ltd. All rights reserved.
Defining and classifying aggression and violence in health care work
- Authors: Hills, Danny
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 607-612
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- Description: Background: There is considerable contention in defining workplace aggression, especially in health care. This can lead to challenges in effectively researching workplace aggression, and ensuring a sound basis for developing strategies to prevent and minimise its likelihood and consequences. Aim: The aim of this discussion paper is to provide a pragmatic definition of workplace aggression, based on a contemporary conceptualisation of human aggression, followed by a discussion on key classifications of workplace aggression. Methods: The argument presented draws on theoretical and applied literature to develop a case for adopting a pragmatic definition of aggression, with key classification components. Findings and Discussion: A highly practical conceptualisation of workplace aggression differentiates two main forms – verbal or written and physical aggression – and two main source groups – internal (co-workers) and external (patients, their relatives or carers and others external to the workplace). Conclusion: Clarity and consensus on defining and classifying workplace aggression, should provide a sound and coherent basis for researchers, policy makers, clinicians and health care organisations to successfully prevent and minimise this challenging and serious work health and safety concern. © 2018 Australian College of Nursing Ltd
Workplace aggression experiences and responses of Victorian nurses, midwives and care personnel
- Authors: Hills, Danny , Lam, Louisa , Hills, Sharon
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 6 (2018), p. 575-582
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- Description: Background: Workplace aggression is a major work health and safety, and public health concern. To date, there has been limited investigation of population level exposure and responses to workplace aggression from all sources, and little evidence on the experiences, reporting and support-seeking behaviour of nurses, midwives and care personnel in Australian settings. Aim: To determine the 12-month prevalence of aggression experienced by nurses, midwives and care personnel from sources external and internal to the organisation, and the reporting behaviours and support sought from employers, health services, Trade Unions, work health and safety agencies, police and legal services. Methods: An online survey of the membership of the Australian Nursing and Midwifery Federation – Victorian Branch was conducted between 1 st May and 30th June 2017. Findings: In the previous 12 months, 96.5% of respondents experienced workplace aggression, with 90.9% experiencing aggression from external sources and 72.3% from internal sources. A majority indicated they just accepted incidents of aggression, and most rarely or never took time off work, sought medical or psychological treatment, or sought organisational or other institutional support, advice or action. Levels of satisfaction with institutional services were mostly neutral to poor. Discussion: Victorian nurses, midwives and care personnel work in aggressive and violent workplaces. The incivility endemic in health care likely sets the climate for the generation of and exposure to so much explicit aggression and violence. It appears that any systems or processes instituted to protect health care personnel from harm are failing. Conclusion: More targeted and effectively operationalised legislation, incentives and penalties are likely required. Further research may elaborate the extent of the impact of exposure to workplace aggression over time.
The perspectives of Australian midwifery academics on barriers and enablers for simulation in midwifery education in Australia: a focus group study
- Authors: Fox-Young, Stephanie , Brady, Susannah , Brealy, W , Cooper, Simon J. , McKenna, Lisa , Hall, Helen , Bogossian, Fiona
- Date: 2012
- Type: Text , Journal article
- Relation: Midwifery Vol. 28, no. 4 (2012), p. 435-441
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- Description: Objective: To describe Australian midwifery academics' perceptions of the current barriers and enablers for simulation in midwifery education in Australia and the potential and resources required for simulation to be increased. Design: A series of 11 focus groups/interviews were held in all states and territories of Australia with 46 participating academics nominated by their heads of discipline from universities across the country. Findings: Three themes were identified relating to barriers to the extension of the use of simulated learning environments (SLEs) ('there are things that you can't simulate'; 'not having the appropriate resources'; and professional accreditation requirements) and three themes were identified to facilitate SLE use ('for the bits that you're not likely to see very often in clinical'; ['for students] to figure something out before [they] get to go out there and do it on the real person'; and good resources and support). Key conclusion: Although barriers exist to the adoption and spread of simulated learning in midwifery, there is a long history of simulation and a great willingness to enhance its use among midwifery academics in Australia. Implications for practice: While some aspects of midwifery practice may be impossible to simulate, more collaboration and sharing in the development and use of simulation scenarios, equipment, space and other physical and personnel resources would make the uptake of simulation in midwifery education more widespread. Students would therefore be exposed to the best available preparation for clinical practice contributing to the safety and quality of midwifery care.
Is simulation a substitute for real life clinical experiences in Midwifery? A qualitative examination of the perceptions of educational leaders
- Authors: McKenna, Lisa , Bogossian, Fiona , Hall, Helen , Bady, S , Fox-Young, Stephanie , Cooper, Simon J.
- Date: 2011
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 31, no. 7 (2011), p. 682-686
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- Description: This paper describes the perceptions of midwifery educational leaders concerning the potential for simulation to provide a realistic experience in midwifery education. A qualitative design was employed using focus groups which were audio-taped and transcribed verbatim. Data were analysed using thematic analysis. Eleven focus groups were conducted with 46 key midwifery academics across Australia. Three main themes emerged relating to realism and simulation in midwifery practice: 'we already use a lot of simulation', 'level of realism of manikins', and 'some things cannot be simulated'. Simulation is currently widely used in midwifery education, but this is limited due to realism of available models and equipment. Despite this, within a woman-centred, holistic approach to care there are many aspects of midwifery practice that cannot be easily simulated. There is a need for research and development of realistic simulation approaches to support the enhanced use of simulation. Furthermore, strategies for developing approaches that reflect midwifery care provision need to be developed.
Swaziland rural maternal care : Ethnography of the interface of custom and biomedicine
- Authors: Thwala, Siphiwe , Jones, Linda , Holroyd, Eleanor
- Date: 2011
- Type: Text , Journal article
- Relation: International Journal of Nursing Practice Vol. 17, no. 1 (2011), p. 93-101
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- Description: Thwala SBP, Jones LK, Holroyd E. International Journal of Nursing Practice 2011; 17: 93-101 Swaziland rural maternal care: Ethnography of the interface of custom and biomedicine A retrospective ethnographic enquiry was used to examine the values and beliefs that underpin Swazi women's birth practices during pregnancy, labour, birth and the postnatal period. An unstructured interview guide was used to conduct 15 one-to-one audio-taped interviews in the field. Results revealed that although Swazi women embraced modern biomedical practices, they also largely adhered to customary practices, including use of traditional model of causation of illness, and the use of traditional medicines during childbirth. Recommendations include parallel antenatal education, which gives credence to the customs within the context of scientific modernity. In addition, changes are needed to public health policy that allows parallel systems of care to be delivered within the context of community midwifery practice. © 2011 Blackwell Publishing Asia Pty Ltd.
Challenges for midwives : pregnant women and illicit drug use
- Authors: Miles, Maureen , Francis, Karen , Chapman, Ysanne
- Date: 2010
- Type: Text , Journal article
- Relation: The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation Vol. 28, no. 1 (2010 2010), p. 83-89
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- Description: Objective The purpose of the paper is to introduce illicit drug use as a societal problem and describes the response of the Australian Government. Specifically the paper examines the use of illicit drugs by pregnant women and the role of midwives in supporting these women throughout pregnancy and birth. Setting Maternity services, specifically antenatal care clinics. Conclusion In Australia the rate of pregnant women who use illicit drugs is escalating. These pregnancies are high obstetric risk with potential for harm to both the mother and the baby. Pregnancy however is seen as 'window of opportunity'; a time to provide education, choices and support. The literature describes that for health professionals working with pregnant women who are illicit drug users is challenging and for some health professionals their interaction can be negative. Australia advocates harm minimisation and encourages harm reduction strategies. Midwives are in a position to implement these strategies within the maternity setting. Further research is recommended as well as professional development programs for midwives to upgrade knowledge and cultivate engagement skills to enable appropriate and positive interaction with pregnant women who use illicit drugs.
Developing an interactive electronic maternity record
- Authors: Homer, Caroline , Catling-Paull, Christine , Sinclair, Dee , Faizah, Nor , Balasubramanian, Venki , Foureur, Maralyn , Hoang, Doan , Lawrence, Elaine
- Date: 2010
- Type: Text , Journal article
- Relation: British Journal of Midwifery Vol. 18, no. 6 (2010), p. 384-389
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- Description: Women have a strong need to be involved in their own maternity care. Pregnancy hand-held records encourage women's participation in their maternity care; gives them an increased sense of control and improves communication among care providers. They have been successfully used in the UK and New Zealand for almost 20 years. Despite evidence that supports the use of hand-held records, widespread introduction has not occurred in Australia. The need for an electronic version of pregnancy hand-held records has become apparent, especially after the introduction of the Electronic Medical Record in Australia. A personal digital assistant (PDA) was developed as an interactive antenatal electronic maternity record that health-care providers could use in any setting and women could access using the internet. This article will describe the testing of the antenatal electronic maternity record.
Postnatal unhappiness : Who should direct support?
- Authors: Peart, Kerry
- Date: 2002
- Type: Text , Journal article
- Relation: Australian journal of midwifery : professional journal of the Australian College of Midwives Incorporated Vol. 15, no. 4 (2002), p. 18-20
- Full Text: false
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- Description: Depression following childbirth is a common, distressing but frequently underreported disorder. It involves a spectrum of symptoms, some of which may be self-limiting, while others can have major mental health implications in the post partum period. A range of health professionals, including midwives and mental health nurses, come into contact with women who suffer from postnatal depression; however, there is often little attempt made to integrate maternity and mental health care approaches. More collaborative frameworks of care are vital if health professionals are to adequately meet the needs of 'unhappy' women in the postnatal period.
- Description: 2003000060