Including the newborn physical examination in the pre-registration midwifery curriculum: National survey

Carole Yearley,Cathy Rogers,Annabel Jay

doi:10.12968/bjom.2017.25.1.26

Abstract

Aims This study aimed to assess the scope of newborn infant physical examination (NIPE) education in programmes of pre-registration midwifery education. Methods An online questionnaire was sent to all lead midwives for education in the UK. Findings are reported in two parts: part A (the current paper) examines the education provision for the inclusion of NIPE in the midwifery curriculum. Part B (a subsequent paper) explores NIPE education as a post-registration module. Findings Of 58 education institutions, 40 (68.9%) completed the questionnaire. A quarter (25.0%) stated that NIPE training is included in their pre-registration midwifery programmes; 37.5% reported plans to implement it within the next 2–5 years and 30.0% had no plans to do so. Benefits for practice partners, commissioners, students and service users were identified. Challenges were noted, particularly in relation to resources and student support in practice. Conclusion Although barriers doubtless exist, the success of the few institutions that have incorporated NIPE into their curricula is evidence that this is not only possible, but has proven benefits.

Highlights

Introduction and backgroundMidwives are responsible for undertaking a preliminary examination of the newborn at birth, to ascertain any obvious signs of abnormally and thereafter to undertake a daily examination in accordance with article 40 of the EU Directives for midwives 2005/36/EU (Nursing and Midwifery Council, 2009)
Newborn Infant Physical Examination (NIPE) training was reported as being included in 10 pre-registration midwifery programmes, one Approved Education Intuitions (AEIs) offered the NIPE as part of an optional module for third year student midwives
One of the 40 AEIs included NIPE as part of the shortened midwifery programme, the others included it as part of the three year programme

Summary

Introduction

Introduction and backgroundMidwives are responsible for undertaking a preliminary examination of the newborn at birth, to ascertain any obvious signs of abnormally and thereafter to undertake a daily examination in accordance with article 40 of the EU Directives for midwives 2005/36/EU (Nursing and Midwifery Council, 2009). The NMC sets the standards for midwifery education which specify that on entry to the register, midwives must be able to evaluate neonatal wellbeing, which includes performing a physical examination. The more detailed Newborn Infant Physical Examination (NIPE), colloquially known as the ‘discharge examination’ was traditionally performed only by junior doctors or GPs. It has long been argued that the inclusion of the NIPE within the midwives’ sphere of practice is a logical step for midwives as experts in the care of normal childbirth and provides continuity of care and a more holistic service as well as improved standards in the quality of care due to midwives’ enhanced knowledge and understanding of neonatal wellbeing (MacKeith, 1995; Michaelides, 1997; Rose, 1994). Whilst midwives in this study were concerned about increased workloads and pressure to adopt new roles, the NIPE was generally believed to be incorporated without jeopardising overall standards of care (Rogers, Bloomsfield, & Townsend, 2003; Townsend et al, 2004)

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Conclusion