Staff Midwives Research Articles

Admitting women in active labour: A randomised controlled trial about the effects of protocol use on childbirth method and interventions

AimTo determine the effects of protocol of admitting women in active labour on childbirth method and interventions during labour and childbirth. MethodsThis single-blind randomised clinical trial was conducted in a public hospital in Mazandaran province (Iran) in 2017. Two hundred nulliparous low-risk women were randomly assigned into intervention and control groups. The participant women were admitted in the intervention group using the admission protocol and to the group control by staff midwives and doctors. The admission criteria of the protocol were: the presence of regular, painful contractions, the cervix at least four cm dilated and at least one of the following cues: cervix effaced, and spontaneous rupture of membranes, or “show”. The primary outcome measure was childbirth method. Data were analyzed in SPSS-22 using Mann–Whitney and Chi–square tests. The level of statistical significance was set as p<0.05. FindingThere were significant differences between the intervention and control groups in the number of caesarian section (CS) (p<0.001). Two groups had a statistically significant difference in amniotomy (p=0.003), augmentation by oxytocin (p<0.001), number of vaginal examinations (p<0.001) and fundal pressure (p<0.001). ConclusionsUsing a protocol for admission of low risk nulliparous women in active labour contributed to reduction of the primary caesarean section rate and interventions during childbirth. A risk assessment and using evidence informed guidelines in admission can contribute to reduce unsafe and harmful practices and support normalisation of birth. This is essential for demedicalisation and a useful strategy for reducing primary CS.

Impact of work place psychological hazards upon nurse midwives quality of care at delivery rooms in Maternity Hospitals in Thi-Qar Governorate

To assess nurse-midwives exposures to psychological health hazards, and to find out the impact of work place psychological health hazards on nurse midwives care quality. A descriptive study was conducted on a “purposive” sample of 80 nurses midwives at five hospitals in Thi-Qar Governorate from the period of 3rd June until 3rd July 2016. The questionnaire consisted of three parts: socio-demographical & general information, health problems (chronic diseases and psychological hazards), and childbirth preparation environment. Reliability was determined through pilot study. A descriptive and inferential statistics were used to analyze the data. The highest percentage within the age group (17–27), good educational levels, married, and have less than five years of experience in midwifery, morning period practice time, and having hypertension. Results indicate that psychological hazards are assigned low assessment, and all main domains regarding childbirth preparation environment had a moderate and high assessment status, since two items had a high assessment 2(25%), while leftover reported moderate assessment 6(75%). Weak relationships with no significant differences at P > 0.05 between psychological health hazard, and socio-demographic characteristics, except with work practice time, highly significant at P 0.05 between childbirth preparation environment and socio-demographic characteristics, except with age groups, marital status and work practice time. Psychological hazards faced at work place upon nurse midwives reported weak impact on their quality of care. The study concludes that “Childbirth Preparation Environment” of nurses staff midwives are reported moderate quality of care.

Relationship of High Work Engagement among Staff Midwives with Their Immediate Superiors’ Burnout on Maternity and Labor Wards in Japan

Introduction: Mental conditions for work among workers are related to clinical performance and influenced by colleagues within the same workplace. The aim of study was to examine the work engagement and burnout of staff midwives working on maternity and labor wards and to determine the factors related to high work engagement of staff midwives, including their immediate superiors’ work engagement and burnout. Methods: A cross-sectional questionnaire survey was employed in Japan. Questionnaires were distributed to 452 midwives/nurses working on maternity and labor wards of 20 hospitals and responses from 96 staff midwives and 17 of their immediate superiors were analyzed. Work engagement and burnout (exhaustion, cynicism, and professional efficacy) were assessed by the Utrecht Work Engagement Scale and the Maslach Burnout Inventory-General Survey, respectively. To examine the association of work engagement among staff midwives with their ages, marital status and work engagement and burnout of their superiors, logistic regression analysis was conducted. Results: Immediate superiors showed significantly higher level of work engagement than staff midwives, while there was no difference in the burnout. High work engagement of staff midwives was significantly correlated with the professional efficacy (AOR 1.93, 95% CI 1.12 - 3.33) and cynicism (AOR 2.01, 95% CI, 1.04 - 3.90) of their immediate superiors. There was no correlation of work engagement between them. Conclusions: High work engagement of staff midwives was correlated to high professional efficacy and cynicism of their immediate superiors, suggesting that there might be crossover effects on mental conditions for work between staff midwives and their immediate superiors.

Lessons Learned Preparing Volunteer Midwives for Service in Haiti: After the Earthquake.

Midwives for Haiti is an organization that focuses on the education and training of skilled birth attendants in Haiti, a country with a high rate of maternal and infant mortality and where only 26% of births are attended by skilled health workers. Following the 2010 earthquake, Midwives for Haiti received requests to expand services and numerous professional midwives answered the call to volunteer. This author was one of those volunteers. The purpose of the study was: 1) to develop a description of the program's strengths and its deficits in order to determine if there was a need to improve the preparation of volunteers prior to service and 2) to make recommendations aimed at strengthening the volunteers' contributions to the education of Haiti and auxiliary midwives. Three distinct but closely related questionnaires were developed to survey Haitian students, staff midwives, and volunteers who served with Midwives for Haiti. Questions were designed to elicit information about how well the volunteers were prepared for their experience, the effectiveness of translation services, and suggestions for improving the preparation of volunteers and strengthening the education program. Analysis of the surveys of volunteers, staff, midwives, and the Haitian students generated several common themes. The 3 groups agreed that the volunteers made an effective contribution to the program of education and that the volunteer midwives need more preparation prior to serving in Haiti. The 3 groups also agreed on the need for better translators and recommended more structure to the education program. The results of this study are significant to international health care organizations that use volunteer health care professionals to provide services. The results support a growing body of knowledge that international health aid organizations may use to strengthen the preparation, support, and effectiveness of volunteer health providers.

Striving for excellence: Nurturing midwives' skills in Freetown, Sierra Leone

Midwives provide critical, life-saving care to women and babies. Effective midwives must be clinically competent, with the required knowledge, skills, and attitudes to provide quality care. Their success depends on an environment of supportive supervision, continuing education, enabling policies, and access to equipment and referral facilities.In Freetown, Sierra Leone, the Aberdeen Women's Centre launched a maternity unit with an emphasis on striving for excellence and providing ongoing professional development to its staff midwives. Its success was built upon fostering a sense of responsibility and teamwork, providing necessary resources, conforming to evidence-based standards, and building partnerships. An explicit philosophy of care was crucial for guiding clinical decision making.In its first two years of operation, the Aberdeen Women's Centre assisted 2076 births with two maternal deaths and 92 perinatal deaths. In-service education and supportive supervision facilitated the midwives' professional growth, leading to capable future leaders who are providing exemplary care to delivering mothers and their newborns in Freetown.

A delphi survey of midwives and midwifery students to identify non-midwifery duties

Aim of the study: to explore the skill mix requirements for the potential role of an unqualified midwifery assistant in the clinical setting. Using results from the study we report the difference between student midwives' and qualified midwives' perceptions of what constitute non-midwifery duties. Design: a two-round Delphi survey. Setting: large maternity hospital in Ireland. Participants: population of midwives ( n=194) and midwifery students ( n=79). Findings: the non-midwifery duties identified were wide ranging and could be categorised under the headings of clerical, stock, porter, domestic and other basic-care-related duties. Conclusion: although no agreed definition of non-midwifery duty exists it can be seen that, through the process undertaken in this study, a definition is created. This suggests that the values and beliefs that qualified midwives and students hold regarding their role shapes the role of the care assistant. Implications for practice: the inclusion of perceptions from student and staff midwives enabled the researchers to compare and contrast similarities and differences regarding how these different parties constitute a non-midwifery duty. The process also gave respondents a sense of ownership and involvement in the development of the midwifery assistant role. In addition, this study has demonstrated the need for further clarification of how midwives perceive and understand their role.

A Descriptive Study of Community Input into the Evolution of John Hunter Hospital Birth Centre: Results of ‘Open Entry’ Criteria

The key feature of John Hunter Hospital Birth Centre is that consumer input influences the philosophy and protocols of the unit through a management executive. The executive includes representatives from all groups who use the Birth Centre, including general practitioners, visiting midwives, obstetricians and staff midwives, as well as 50% consumer representation. This has resulted in a unique Birth Centre with open and flexible entry criteria. Since its opening in February 1991, 1,492 women have been admitted to John Hunter Hospital Birth Centre, and of these 1,221 (82%) gave birth there. This figure is greater than any other Birth Centre utilization rate in Australia (1-4). An examination of outcomes for 1992 indicates that neither the higher than usual utilization rate nor the open entry criteria has compromised safety for either women or their infants.

Nursing skill mix in neonatal care.

A large scale study of neonatal nursing was carried out with data collected from 56 sites (4 hospitals from each of the health regions of England). In the area of skill mix the key findings were: the largest segment of the neonatal nursing workforce is made up of staff nurses and staff midwives, and of these there are greater numbers of staff nurses; the E grade at 31% is the most frequently found, followed by the G (19%) and F grades (16%); vacancies were disproportionately high at staff nurse/staff midwife level; nursery nurses were employed for direct nursing care in 80% of units; nursing auxilliaries were employed in 70% of units, though in only half were they involved in the direct care of babies. Staffing policies were diverse and not clearly related to the type of unit or the numbers of designated intensive and special care costs. There was a tendency to employ more junior staff at night, the use of support staff varied widely, and in many units was at very low levels or absent. In addition to differing service demands that may affect the skill mix required, there is a clear need for the profession to address the questions that arise from changing roles and areas of responsibility in the spheres of management, teaching and clinical practice.

Sickness absence amongst nursing staff at two hospitals.

Sickness absence amongst qualified nursing staff at two major acute hospitals in Leicester was analysed for one year. Comparisons were made between full-time and part-time staff, between day staff and night staff, between grades of staff and between certificated and uncertificated sickness absence. Patterns of sickness absence throughout the year were also compared. Results showed that absence was 4 per cent per annum at the Leicester Royal Infirmary and was double this figure at the Leicester Maternity Hospital (8 per cent per annum). Part-time staff had more time off sick than full-time staff at both hospitals, but the hospitals showed different results for day and night staff. Grades of staff sickness absence showed a predictable trend at the Leicester Royal Infirmary, but not at the Leicester Maternity Hospital where staff midwives had the worst sickness absence record. Sickness absence patterns were analysed at greater depth at the maternity hospital. The results are discussed and recommendations made.