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
- Full Text: false
- Reviewed:
- 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.
Informing the development midwifery standards for practice : A literature review for policy development
- Authors: Nagle, Cate , McDonald, Susan , Morrow, Jane , Kruger, Gina , Cramer, Rhian , Couch, Sara , Hartney, Nicole , Bryce, Julianne , Birks, Melanie , Heartfield, Marie
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Midwifery Vol. 76, no. (2019), p. 8-20
- Full Text: false
- Reviewed:
- Description: Aim: To critically appraise and synthesise the literature regarding the role and scope of midwifery practice, specifically to inform the evidence based development of standards for practice for all midwives in Australia. Design: A structured scoping review of the literature Data sources: CINAHL Complete, MEDLINE Complete and Cochrane Libraries databases, online and grey literature databases Review methods: Comprehensive searches of databases used key words and controlled vocabulary for each database to search for publications 2006-2016. Studies were not restricted by research method. Findings: There is no substantive body of literature on midwifery competency standards or standards for practice. From 1648 papers screened, twenty-eight papers were identified to inform this review. Eight studies including systematic reviews were annotated with three research papers further assessed as having direct application to this review. To inform the development of Midwife standards for practice, the comprehensive role of the midwife across multiple settings was seen to include: woman centred and primary health care; safe supportive and collaborative practice; clinical knowledge and skills with interpersonal and cultural competence. Key conclusions: Midwifery practice is not restricted to the provision of direct clinical care and extends to any role where the midwife uses midwifery skills and knowledge. This practice includes working in clinical and non-clinical relationships with the woman and other clients as well as working in management, administration, education, research, advisory, regulatory, and policy development roles. Implications for practice: This review articulates the definition, role and scope of midwifery practice to inform the development of contemporary standards for practice for the Australian midwife. (C) 2019 Elsevier Ltd. All rights reserved.