NMBA Development of Midwife standards for practice: phase one (a) report
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The Nursing and Midwifery Board of Australia (NMBA) Development of Midwife standards for practice project will review the National competency standards for the midwife (Nursing and Midwifery Board Australia, 2006) to inform the development of Midwife standards for practice (Standards). This first report brings together the findings from the phase one literature review and consultation interviews. The literature review spans the available publications for peer-reviewed evidence for the role and scope of midwifery practice. While few publications provide evidence of the comprehensive role of the midwife to directly inform the development of Standards, there is evidence for the contribution of midwifery to many positive maternal outcomes. Globally the definitions of midwife scope of practice are primarily influenced by the International Confederation of Midwives (ICM) publications, though this full scope of practice is not always evident in some midwifery standards and competencies. The literature highlights woman-centred care, safe and quality care, collaborative practice, interpersonal and cultural competence, information, education and primary health care as concepts for further consideration in the development of Standards for all midwives in Australia. Australian Chief Nursing and Midwifery Officers (CNMOs) in the Commonwealth and state and territory offices have been consulted on the midwife role, scope of practice and the National competency standards for the midwife. Consistent with the project plan, an additional interview was conducted with a principal of the team responsible for development of the National competency standards for the midwife (Nursing and Midwifery Board Australia, 2006). While not all interview participants were midwives, at least one midwife contributed to each interview. These interviews and one written submission identified many relevant issues, with the overriding responsibility for safety and quality common to all responses. Many of the comments were operational, and there was consensus that the National competency standards for the midwife could be updated to better reflect the current scope of practice of the midwife in Australia. There were recommendations that the scope of midwifery practice in the Standards is explicit in referring to the practice of all midwives, not only those at entry to practice or those who practice in labour and birth. Most participants acknowledged that not all midwives would work across the full scope of practice as defined in the current document. References to safety and quality, collaboration, interprofessional team practice, primary health care and culturally appropriate care were valued, with requests made to strengthen and clarify these practices in the Standards. The Australian National Safety and Quality Health Service Standards (NSQHSS) 2 and 9 (consumer participation and clinical deterioration) (Australian Commission on Safety and Quality in Health Care, 2012), underpinned concerns about the capacity of some midwives to respond to the needs of women with risks that include social disadvantage, unsafe health practices, age and/or chronic conditions.
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70
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Nursing & Midwifery Board of Australia
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