Nurses’, midwives’ and key stakeholders’ experiences and perceptions of a scope of nursing and midwifery practice framework (original) (raw)
Related papers
National review of the scope of nursing and midwifery practice framework: final report
6.3.2 Evolving roles of nurses and midwives and negotiating role boundaries 6.3.3 Impacts on care delivery 6.4 Theme 2: Scope of practice, understanding and use 6.4.1 Understanding my scope of practice 6.4.2 Use of scope of practice Framework 6.4.3 Aspects of scope 6.5 Theme 3: Expanding scope of practice 6.5.1 Expanded scope 6.5.2 Barriers to expanded scope 6.5.3 Enablers of expanded scope 6.6 Theme 4: Professional competence 6.6.1 What is competence? 6.6.2 Gaining and maintaining competence 6.6.3 Competence and the practitioner 6.7 Theme 5: Practice setting and context 6.7.1 Legislation, policies, guidelines and regulation 6.7.2 Practice concerns 6.8 Theme 6: Reflections on the current Framework 6.8.1 General thoughts on the current Framework 6.8.2 Comments on individual sections of the Framework 6.9 Summary of findings 6.10 Case examples of expanded practice 6.10.1 Case example of midwifery practice 6.10.2 Case example of advanced practice: Reflective tool 7 DISCUSSION 7.1 Introduction 7.2 Self-reported scope of practice 7.3 Expanding practice: Enablers and barriers 7.4 Scope of practice and role boundaries 7.5 Perspectives on the Framework 7.6 Strengths and limitations of the study design 8 CONCLUSIONS AND RECOMMENDATIONS
Journal of Advanced Nursing, 2015
Aims. To review, discuss and compare nursing and midwifery regulatory and professional bodies' scope of practice and associated decision-making frameworks. Background. Scope of practice in professional nursing and midwifery is an evolving process which needs to be responsive to clinical, service, societal, demographic and fiscal changes. Codes and frameworks offer a system of rules and principles by which the nursing and midwifery professions are expected to regulate members and demonstrate responsibility to society. Design. Discussion paper. Data sources. Twelve scope of practice and associated decision-making frameworks (January 2000-March 2014). Implications for nursing. Two main approaches to the regulation of the scope of practice and associated decision-making frameworks exist internationally. The first approach is policy and regulation driven and behaviour oriented. The second approach is based on notions of autonomous decision-making, professionalism and accountability. The two approaches are not mutually exclusive, but have similar elements with a different emphasis. Both approaches lack explicit recognition of the aesthetic aspects of care and patient choice, which is a fundamental principle of evidence-based practice. Conclusion. Nursing organizations, regulatory authorities and nurses should recognize that scope of practice and the associated responsibility for decisionmaking provides a very public statement about the status of nursing in a given jurisdiction.
Scope of practice decision making: findings from a national survey of Irish nurses and midwives
Journal of Clinical Nursing, 2015
Aims and objectives. The aim was to examine and describe aspects of the current scope of practice among nurses and midwives in Ireland. The objective was to describe practitioners' decision making associated with the scope of practice. Background. Regulatory frameworks on the scope of practice describe the roles and activities an individual registrant is permitted to undertake in the course of professional practice. Research into the scope of practice has examined practitioners' perspectives on particular frameworks or their experiences of practice expansion, and suggests that frameworks are helpful in guiding practitioners; however, local circumstances and practitioner competence often determine scope of practice. Design. A national postal survey of registered nurses and midwives was conducted to elicit self-reports of current scope of practice. Methods. A stratified random sample of 2354 registered nurses and midwives in Ireland were surveyed using the Scope-Q, a 64-item self-report questionnaire. Results. While over half of the respondents consulted others when making scope of practice decisions, the majority relied on their own professional judgement, acted only when they believed that they were competent to act, and recognised the limitations of their own competence. Although a small number of statistically significant associations were observed between respondents' age and self-reported scope of practice, respondents' current scope of practice was independent of either grade or gender. Conclusions. When making a decision about scope of practice, practitioners may consult other resources, including published frameworks, professional colleagues and line managers; however, most particularly, older, more experienced practitioners, rely on their own professional judgement when making scope of practice decisions.
Journal of clinical nursing, 2015
The aim was to examine current scope of practice among nurses and midwives in Ireland. The objectives were to describe practitioners' self-reported facilitators and barriers to expanding scope of practice and to develop a scope of practice barriers scale. Regulatory authorities permit practice expansion, so long as it falls within accepted parameters of scope of practice. Enduring difficulties in relation to scope of practice include the difficulty of balancing practice restriction with practice expansion. A postal survey design was used to examine registered nurses' and midwives' current scope of practice, including their experiences of facilitators and barriers to expanding practice. A stratified random sample of registered nurses and midwives in Ireland was surveyed using the Scope-QB, a 19-item self-report scope of practice barriers scale. Based on a sample of 1010 respondents, the self-reported perceived barriers to practice expansion included fear of legal conseque...
Scope of Midwifery Practice: Concept Analysis
IOSR Journal of Nursing and Health Science
The objective of the paper was to describe the concept Scope of Midwifery practice (SOMP). Scope of midwifery practice remains dynamic and varies in many countries. It takes several forms ranging from listing of services, interventions given to women during pregnancy, labour and delivery to competencies expected of individual to practice. International confederation of Midwives (ICM) does not prescribe a fixed definition of the concept SOMP but emphasized that it should be built upon its international definition of the midwife. This position allows individual countries to come up with own variation. Existence of variations have compounded negatively on midwifery practice leading to skill loss in some cases and lack of confidence to practice to full capacity hence the need to describe the scope of midwifery practice by assigning measurable attributes for standardisation in midwifery practise. A literature search was conducted using PubMed, journal of midwifery and Medline which yielded 29 articles from 2006 to 2016. Filtering to consider only those describing the concept in relation to Midwifery yielded 6. The identified attributes defining the scope of midwifery practice were autonomy, leadership, competencies and practice setting (policy and regulations).
2017
Developing countries account for 99% of the 830preventable pregnancy related deaths. The deaths occur mostly in rural and poor communities not affording skilled attendance Zimbabwe significantly contributes to these global rates with a Maternal Mortality Ratio of 651/100 000 live births of which 47% are avoidable deaths, despite increasing institutional delivery and skilled attendance. Competent midwives working in a clear scope of practice can make the deference. The purpose of this study is to explore the perception of the nurses/midwives regarding their scope of practice, clinical competences and their association with maternal outcomes.in Mashonaland east province of Zimbabwe. The exploratory mixed method will be utilised. Focus group discussions with practising midwives and in-depth interviews with Key nursing/ midwifery leaders from Nurses/ midwifery associations, Ministry of Health and Nurses Council of Zimbabwe will be conducted. Clinical competence will be assessed using a ...
Journal of advanced nursing, 2017
To explore the perceptions of key stakeholders of the roles of specialist and advanced nursing and midwifery practitioners. There is evidence that the contribution of these roles to patient care is poorly understood. This research took place over 2 months in 2015 and is part of a larger study involving a rapid review to inform policy development on the specialist and advanced nursing and midwifery practice in Ireland. As an added value, a qualitative element involving thematic analysis was undertaken with key stakeholders. A phenomenological qualitative study was conducted incorporating semi-structured interviews with key stakeholders (n = 15). Purposive sampling with maximum diversity was used to recruit a wide range of perspectives. Participant's perspectives led to seven themes: Impact of these roles; role preparation, experience and organizational support; specialist and advanced practice roles in an interdisciplinary context; different folks but not such different roles; im...
Understanding nursing scope of practice: a qualitative study
International journal of nursing studies, 2011
The past decade has seen increased patient acuity and shortened lengths of stays in acute care hospitals resulting in an intensification of the work undertaken by nursing staff in hospitals. This has ultimately led to a reconsideration of how nursing staff manage their work. The aim of this study was to understand how medical and surgical nurses from two Australian hospitals conceive their scope of practice in response to the available grade and skill mix of nurses and availability of unlicensed health care workers and other health care professionals. By exploring these meanings, this study aimed to build an understanding of how nursing work patterns were shifting in the face of changing patient acuity, patient profiles and nursing skill mix. A constructivist methodology, using critical incident technique (CIT) was used to explore nurses' role and scope of practice. Twenty nurses, 16 registered nurses (RNs) and four enrolled nurses (ENs), discussed significant events during whic...
Collegian
Background: Enrolled Nurses constitute an important part of the Australian health care system. Recently, improvements to education and medication endorsement have initiated expansion to EN scope of practice. Aim: This paper reports on a study conducted to inform development of revised Nursing and Midwifery Board (NMBA) of Australia Enrolled Nurse practice standards that explored with ENs their scope of practice. Design: A qualitative design using focus groups and individual interviews with ENs across Australia. Data were analysed using thematic analysis. Findings: ENs work in diverse practice contexts with differing scope of practice. Confusion existed regarding EN scope of practice as a result of many different types of ENs in practice. Care of unstable patients was seen to be outside the EN scope of practice. They were also often required to supervise the work of nursing assistants and new registered nurses. Lack of career pathway was seen as a limitation to ENs. Conclusions: EN education and scope of practice has evolved significantly, particularly in many practice settings, since the existing standards were developed. Further work is needed to address issues related to EN supervision of new RNs and AINs (Assistants in Nursing), and clarity of EN supervision in specialist clinical areas.
PLOS ONE, 2023
Background There is a global shortage of midwives, whose services are essential to meet the healthcare needs of pregnant women and newborns. Evidence suggests that if enough midwives, trained and regulated to global standards, were deployed worldwide, maternal, and perinatal mortality would decline significantly. Health workforce planning estimates the number of midwives needed to achieve population coverage of midwifery interventions. However, to provide a valid measure of midwifery care coverage, an indicator must consider not only the raw number of midwives, but also their scope and competency. The tasks midwives are authorized to deliver and their competency to perform essential skills and behaviors provide crucial information for understanding the availability of safe, high-quality midwifery services. Without reliable estimates for an adequate midwifery workforce, progress toward ending preventable maternal and perinatal mortality will continue to be uneven. The International Labor Organization (ILO) and the International Confederation of Midwives (ICM) suggest standards for midwifery scope of practice and competencies. This paper compares national midwifery regulations, scope, and competencies in three countries to the ILO and ICM standards to validate measures of midwife density. We also assess midwives' self-reported skills/behaviors from the ICM competencies and their acquisition.