Nursing Midwifery Commons^™

Development Of A Tool To Identify Barriers And Enablers To Practice Innovation In Midwifery: A Participatory Action Research Study, Sara D. Davis, Sara Bayes, Sadie Geraghty

Research outputs 2022 to 2026

Introduction: Transferring research evidence into midwifery practice is fraught with challenges and obstacles. Implementation tools can streamline the process and are most effective when they are discipline-specific; however, there are currently no midwifery specific implementation tools. The aim of this study was to develop a midwifery specific tool to identify barriers and enablers to evidence-informed practice change within the clinical setting. Methods: Participatory action research methodology was employed to ensure potential end-users contributed to content and format of the tool. Purposeful sampling ensured participants were selected from a range of midwifery practice settings in Western Australia and the United Kingdom. …

Midwives’ Experiences Of The Consequences Of Navigating Barriers To Maternity Care, Yakubu Ismaila, Sara Bayes, Sadie Geraghty

Research outputs 2022 to 2026

Midwives in Low- and middle-income countries, experience myriad barriers that have consequences for them and for maternity care. This article provides insight into the consequences of the barriers that Ghanaian midwives face in their workplaces. Glaserian Grounded Theory methodology using semi-structured interviews and non-participant observations was applied in this study. The study participants comprised of 29 midwives and a pharmacist, a social worker, a health services manager, and a National Insurance Scheme manager in Ghana. Data collection and analysis occurred concurrently while building on already analyzed data. In this study it was identified that barriers to Ghanaian midwives’ ability to …

A Scoping Review Of Nurse-Led Randomised Controlled Trials, Marion Eckert, Kate Kennedy, Kim Neylon, Claire M. Rickard, Samantha Keogh, Richard Gray, Sandy Middleton, Caroline Homer, Lisa Whitehead, Greg Sharplin

Research outputs 2022 to 2026

Background: Nurses comprise the largest portion of the healthcare workforce worldwide. However, nurse representation in the leadership of clinical research and research funding is largely unknown. The Australasian Nursing and Midwifery Clinical Trials Network was established to provide a coordinated network, focussed on building research capacity in nursing and midwifery. To support this work, this scoping review of nurse-led randomised controlled trials was conducted to summarise research activity, as well as highlight future research directions, gaps and resources. Midwife-led trials will be reported elsewhere. Aim: To quantify number, type and quality of nurse-led randomised controlled trials registered between 2000–2021. Design: …

What Is Known About Midwives' Well-Being And Resilience? An Integrative Review Of The International Literature, Lynnelle Moran, Kim Foster, Sara Bayes

Research outputs 2022 to 2026

Background: Internationally, the midwifery workforce is facing a professional crisis due to numerous organizational and individual factors that have led to midwives leaving the profession. These factors include high levels of workplace stress, systemic barriers to providing woman and person-centered care, trauma, and burnout. The COVID-19 pandemic magnified these pre-existing stressors and adversities and has further disrupted midwives' ability to practice within their professional norms. In order to understand how midwives can be better supported, there is a need to understand what contributes to and detracts from their well-being and resilience. Aim: To investigate and synthesize the extant international knowledge …

Evidence-Based Guidelines For Intrapartum Maternal Hydration Assessment And Management: A Scoping Review, Lauren Kearney, Alison Craswell, Nellie Dick, Debbie Massey, Rachael Nugent

Research outputs 2022 to 2026

Problem: Inconsistent practice relating to intrapartum hydration assessment and management is reported, and potential harm exists for laboring women and birthing persons. Background: Labor and birth are physically demanding, and adequate nutrition and hydration are essential for labor progress. A lack of clear consensus on intrapartum hydration assessment and management during labor and birth currently exists. In addition, there is an inconsistent approach to managing hydration, often including a mixture of intravenous and oral fluids that are poorly monitored. Aim: The aim of this scoping review was to identify and collate evidence-based guidelines for intrapartum hydration assessment and management of …

Midwife Led Randomised Controlled Trials In Australia And New Zealand: A Scoping Review, Caroline Homer, Kim Neylon, Kate Kennedy, Kathleen Baird, Andrea Gilkinson, Samantha Keogh, Sandy Middleton, Richard Gray, Lisa Whitehead, Judith Finn, Claire Rickard, Greg Sharplin, Stephen Neville, Marion Eckert

Research outputs 2022 to 2026

Background: Midwives are the largest workforce involved in caring for pregnant women and their babies, and are well placed to translate research into practice and ensure midwifery priorities are appropriately targeted in researched. Currently, the number and focus of randomised controlled trials led by midwives in Australia and New Zealand is unknown. The Australasian Nursing and Midwifery Clinical Trials Network was established in 2020 to build nursing and midwifery research capacity. To aid this, scoping reviews of the quality and quantity of nurse and midwife led trials were undertaken. Aim: To identify midwife led trials conducted between 2000 and 2021 …

Physiological Plateaus During Childbirth: A Constructivist Grounded Theory And Novel Definition, Marina J. Weckend

Theses: Doctorates and Masters

Background: During childbirth, one of the most common diagnoses of pathology is ‘failure to progress,’ frequently resulting in labour augmentation and intervention cascades. However, ‘failure to progress’ is poorly defined and some evidence suggests that plateauing labour (slowing, stalling and pausing of labour processes) may represent a typical and physiological occurrence during normal childbirth. Therefore, this study aimed to explore what exactly midwives define as ‘physiological plateaus’ and which significance such plateaus may have for the labour trajectory and birth outcome.

Methods: This study followed a constructivist grounded theory approach, assuming a position of ontological critical realism combined with epistemological …

Critical Thinking Development In Undergraduate Midwifery Students: An Australian Validation Study Using Rasch Analysis, Amanda G. Carter, Amanda Müller, Michelle Gray, Dianne Bloxsome, Kristen Graham, Dolores Dooley, Linda Sweet

Research outputs 2022 to 2026

Background: Well-developed critical thinking skills are required to provide midwifery care that is safe, evidence-based, and woman-centred. A valid, reliable tool to measure is required the application of critical thinking in midwifery practice. The Carter Assessment of Critical Thinking in Midwifery (CACTiM) has previously been psychometrically assessed using classical methods at a single site. This study aims to further evaluate the properties of CACTiM tools using Rasch analysis in a diverse group of midwifery students and preceptors. Methods: The CACTiM tools were completed by undergraduate midwifery students studying at three Australian universities and their preceptors. Midwifery students’ critical thinking was …

Harnessing The Nursing And Midwifery Workforce To Boost Australia's Clinical Research Impact, Marion Eckert, Claire M. Rickard, Deborah Forsythe, Kathleen Baird, Judith Finn, Andrea Gilkison, Richard Gray, Caroline S.E. Homer, Sandy Middleton, Stephen Neville, Lisa Whitehead, Greg R. Sharplin, Samantha Keogh

Research outputs 2022 to 2026

For the Medical Research Future Fund (MRFF) to achieve its full impact, it is necessary for health practitioners to be trained and reliably funded to deliver research and translation alongside their clinical work. We offer insight into current systems, concerns and suggestions as this applies to clinical research in nursing and midwifery. Nurses and midwives globally have a long record of delivering high quality clinical research that improves care and outcomes. An analysis of four landmark nursing-led studies in the United States illustrates the value-adding potential of such research: for every grant dollar, the return on investment ranged from $202 …

A Qualitative Document Analysis Of Policies Influencing Preeclampsia Management By Midwives In Ghana, Isabella Garti, Michelle Gray, Angela Bromley, Jing-Yu (Benjamin) Tan

Research outputs 2022 to 2026

Background: Preeclampsia is a global issue that causes significant morbidity and mortality in low- and middle-income countries (LMICs). The care women with preeclampsia receive in LMICs is below the standard experienced by women in westernised countries due to multiple interacting factors. A review of policy factors influencing the management of preeclampsia in Ghana is needed. Aim: This study focuses on the midwife's role and scope of practice concerning preeclampsia management. The study aimed to explore the congruence between Ghanaian preeclampsia guidelines and international best practice recommendations for midwifery practice. The study also aimed to describe how recommendations are incorporated into …

Adherence To Screening And Management Guidelines Of Maternal Group B Streptococcus Colonization In Pregnancy, Sabine Pangerl, Deborah Sundin, Sadie Geraghty

Research outputs 2022 to 2026

Aims: To investigate Group B Streptococcus (GBS) colonization in pregnancy; adherence to antenatal GBS screening and adherence to the intrapartum antibiotics protocol within two models of care (midwifery and non-midwifery led). Design: This retrospective quantitative study has employed a descriptive design using administrative health data. Methods: Data from five maternity hospitals in metropolitan and regional Western Australia that included 22,417 pregnant women who gave birth between 2015 and 2019 were examined, applying descriptive statistics using secondary data analysis. Results: The study revealed an overall GBS colonization rate of 21.7% with similar rates in the different cohorts. A lower adherence to …

Sub-Saharan African Women’S Views And Experiences Of Risk Factors For Obstetric Fistula: A Qualitative Systematic Review, Lydia Babatunde Bulndi, Deborah Ireson, Esther Adama, Sara Bayes

Research outputs 2022 to 2026

Background: Obstetric fistula used as synonymous with VVF in this study, is an abnormal communication/hole between the urinary tract and the genital tract or the gastrointestinal tract and the genital tract, resulting from prolonged obstructed labour. VVF may cause sufferers to experience chronic urinary/faecal incontinence, and the stigma of continuing foul odour. VVF is primarily caused by prolonged obstructed labour, which is brought about by a range of causes. Recently, it has been proposed that women’s groups and fistula survivors should suggest interventions to reduce or prevent the incidence of obstetric fistula. Objective: The objective of this review was to …

Challenges Experienced By Newly Qualified Nurse-Midwives Transitioning To Practice In Selected Midwifery Settings In Northern Malawi, Mathews Brave Mtegha, Elizabeth Chodzaza, Ellen Chirwa, Fatch Welcome Kalembo, Maggie Zgambo

Research outputs 2022 to 2026

Background: Literature shows that newly qualified nurse-midwives face challenges integrating into the workforce during their transition period from education to practice. However, little is known about the needs and challenges of Malawian nurse-midwives during their transition from education to practice. The aim of the study was to explore the transition experiences of newly qualified nurse-midwives working in selected midwifery units in Northern Malawi. Methodology: A qualitative descriptive approach was used. Data were collected through in-depth interviews using semi-structured interview guides from a purposive sample of 19 participants (13 newly qualified nurse-midwives and 6 key informants). The researchers developed two interview …

Saliva Cortisol Diurnal Variation And Stress Responses In Term And Preterm Infants, David Q. Stoye, James P. Boardman, Clive Osmond, Gemma Sullivan, Gillian Lamb, Gill S. Black, Natalie Z. M. Homer, Nina Nelson, Elvar Theodorsson, Evalotte Mörelius, Rebecca M. Reynolds

Research outputs 2022 to 2026

Objective:

To determine if preterm birth is associated with adaptation of the hypothalamic–pituitary–adrenal (HPA) axis and whether HPA axis programming relates to the degree of prematurity (defined as extremely preterm birth at < 28 weeks or very preterm birth at 28–32 weeks gestation).

Design:

This study reports findings from a prospective birth cohort. Saliva cortisol concentrations were measured prevaccination and postvaccination, and in the morning and evening, at 4 months chronological age.

Setting:

Infants born at a single Scottish hospital.

Participants:

45 term-born, 42 very preterm and 16 extremely preterm infants.

Outcomes:

Cortisol stress response to vaccination (postvaccination minus prevaccination cortisol concentrations), diurnal slope (log-transformed morning minus log-transformed evening cortisol values) …

Care Ethics Framework For Midwifery Practice: A Scoping Review, Kate Buchanan, Elizabeth Newnham, Deborah Ireson, Clare Davison, Sadie Geraghty

Research outputs 2022 to 2026

Background:

As a normative theory, care ethics has become widely theorized and accepted. However, there remains a lack of clarity in relation to its use in practice, and a care ethics framework for practice. Maternity care is fraught with ethical issues and care ethics may provide an avenue to enhance ethical sensitivity.

Aim:

The purpose of this scoping review is to determine how care ethics is used amongst health professions, and to collate the information in data charts to create a care ethics framework and definition for midwifery practice.

Method:

The scoping review was conducted according to the Preferred Reporting …

A Cohort Comparison Study On Women In Threatened Preterm Labor Given Nifedipine Or Nifedipine And Salbutamol Tocolysis In Air Medical Retrieval, Breeanna Spring Walsh, Fergus W. Gardiner, Dianne Bloxsome, David Ford, Brennen W. Mills, Simon M. Laws

Research outputs 2022 to 2026

Objective: Women with threatened preterm labor in remote Australia often require tocolysis in the prevention of in-flight birth during air medical retrieval. However, debate exists over the tocolytic choice. Methods: A retrospective analysis was undertaken on data containing women who required air medical retrieval for threatened preterm labor within Western Australia between the years 2013 and 2018. Results: A total number of 236 air medical retrievals were deemed suitable for inclusion; 141 received nifedipine, and 95 women received salbutamol + nifedipine. Tocolytic efficaciousness was reported in 151 cases, proportionally more (P < .05) from the women who received salbutamol + nifedipine (n = 68, 71.6%) compared with the women who received nifedipine only (n = 83, 58.9%). Those receiving salbutamol + nifedipine were more likely to suffer maternal tachycardia (n = 87 [91.6%] vs. n = 62 [44.0%]), fetal tachycardia (n = 26 [27.4%] vs. n = 13 [9.2%]), nausea (n = 17 [17.9] vs. n = 5 [3.55%]), and vomiting (n = 12 [12.6%] vs. n = 2 [1.4%]). Three women who received salbutamol + nifedipine had serious side effects including echocardiographic changes, chest pain, and metabolic and lactic acidosis. Conclusion: Salbutamol + nifedipine tocolysis was proven to be more effective than nifedipine only. Although salbutamol + nifedipine had increased temporary side effects, most were nonsevere and managed in-flight.

Parental Sleep When Their Child Is Sick: A Phased Principle-Based Concept Analysis, Stephanie Smith, Mary Tallon, James Smith, Charlotte Angelhoff, Evalotte Mörelius

Research outputs 2022 to 2026

Sleep is a common challenge for parents with sick children and can impact parents' health, wellbeing, and caregiving responsibilities. Despite the vast research around parental sleep when their child is sick, the concept is not clearly defined. A phased principle-based concept analysis that includes triangulation of methods and quality criteria assessment was used to explore how the concept is described, used, and measured in the current literature. The aim was to analyse and clarify the conceptual, operational, and theoretical basis of parental sleep when their child is sick to produce an evidence-based definition and to identify knowledge gaps. A systematic …

Moving On After Critical Incidents In Health Care: A Qualitative Study Of The Perspectives And Experiences Of Second Victims, Melanie Buhlmann, Beverley Ewens, Amineh Rashidi

Research outputs 2022 to 2026

Aims: To gain a deeper understanding of nurses and midwives' experiences following involvement in a critical incident in a non-critical care area and to explore how they have 'moved-on' from the event.

Design: An interpretive descriptive design guided inductive inquiry to interpret the meaning of moving-on.

Methods: Purposive sampling recruited 10 nurses and midwives. Data collection comprised semi-structured interviews, memos and field notes. Data were concurrently collected and analysed during 2016–2017 with NVivo 11. The thematic analysis enabled a coherent analytical framework evolving emerging themes and transformation of the data into credible interpretive description findings, adhering to the COREQ reporting …

Placental Lesions And Differential Expression Of Pro-And Anti-Angiogenic Growth Mediators And Oxidative Dna Damage Marker In Placentae Of Ghanaian Suboptimal And Optimal Health Status Pregnant Women Who Later Developed Preeclampsia, Enoch Odame Anto, David Antony Coall, Emmanuel Akomanin Asiamah, Osei Owusu Afriyie, Otchere Addai-Mensah, Yaw Amo Wiafe, W. K. B. A. Owiredu, Christian Obirikorang, Max Efui Annani-Akollor, Nicholas Akinwale Titiloye, Eric Adua, Emmanuel Acheampong, Evans Asamoah Adu, Stephen Opoku, Agartha Odame Anto, Augustine Tawiah, Youxin Wang, Wei Wang

Research outputs 2022 to 2026

Background Angiogenic growth mediators (AGMs) and oxidative stress (OS) both play essential roles in normal placental vascular development and as such, placental alterations in these factors contribute to pre-eclampsia (PE). Suboptimal health status (SHS), an intermediate between health and disease, has been associated with imbalanced AGMs and OS biomarkers. Thus, SHS pregnant women may be at increased risk of developing PE and may present abnormal placental alteration and expression of AGMs and OS compared to optimal health status (OHS) pregnant women. We examined the histopathological morphology, immunohistochemical expression of AGMs antibodies and oxidative DNA damage marker in the placentae of …

Does Midwifery-Led Care Demonstrate Care Ethics: A Template Analysis, Kate Buchanan, Elizabeth Newnham, Deborah Ireson, Clare Davison, Sara Bayes

Research outputs 2014 to 2021

Background: Ethical care in maternity is fundamental to providing care that both prevents harm and does good, and yet, there is growing acknowledgement that disrespect and abuse routinely occur in this context, which indicates that current ethical frameworks are not adequate. Care ethics offers an alternative to the traditional biomedical ethical principles.

Research aim: The aim of the study was to determine whether a correlation exists between midwifery-led care and care ethics as an important first step in an action research project.

Research design: Template analysis was chosen for this part of the action research. Template analysis is a design …

The Impact Of Three-Dimensional Visualisation On Midwifery Student Learning, Compared With Traditional Education For Teaching The Third Stage Of Labour: A Pilot Randomised Controlled Trial, Michelle Gray, Terri Downer, Donna Hartz, Patrea Andersen, Julie Hanson, Yu Gao

Research outputs 2022 to 2026

Background: Complex physiological processes are often difficult for midwifery students to comprehend when using traditional teaching and learning approaches. Face to face instructional workshops using simulation have had some impact on improving understanding. However, in the 21st century new technologies offer the opportunity to provide alternative learning approaches.

Aim: To investigate the impact of using three-dimensional (3D) visualisation in midwifery education on student's experience of learning, and retention of knowledge at three points in time.

Design: A pilot study involving a two-armed parallel Randomised Controlled Trial (RCT) comparing the retention of knowledge scores between the control and intervention groups.

Setting: …

Women's Experiences Of Breech Birth Decision Making: An Integrated Review, Sara E. Morris, Deborah Sundin, Sadie Geraghty

Research outputs 2022 to 2026

INTRODUCTION: Currently, caesarean section is the primary mode of birth for a breech presenting fetus, leading to a deskilling of clinicians and limitation of birth choices for women. The aim of this review is to present a synthesized summary of existing literature related to women's experiences of breech birth mode decision-making. METHODS: A systematic search of the literature was conducted in April 2021, utilizing five databases to identify and obtain peer-reviewed articles meeting the predetermined selection criteria. RESULTS: Four major categories were synthesized from the integrated review: 1) Women who desire a vaginal birth may experience a range of negative …

What Are The Benefits And Challenges Of Mentoring In Midwifery? An Integrative Review, Krystyl Wissemann, Dianne Bloxsome, Annemarie De Leo, Sara Bayes

Research outputs 2022 to 2026

Aim: The aim of this review was to synthesize best available evidence on mentoring programmes for midwives who have worked within the clinical setting for more than 1 year. Background: Lack of job satisfaction, stress, burnout and limited managerial support contributes to midwifery workforce attrition and the ongoing global shortage of midwives. Mentoring may be one way to improve staff retention, leading to positive clinical and organizational outcomes. Design: A five-step integrative review approach, based on a series of articles published by the Joanna Briggs Institute for conducting systematic reviews, was used to develop a search strategy, selection criteria, method …

Supporting Premature Infants’ Oral Feeding In The Nicu—A Qualitative Study Of Nurses’ Perspectives, Evalotte Mörelius, Charlotte Sahlén Helmer, Maria Hellgren, Siw Alehagen

Research outputs 2022 to 2026

One major task in the neonatal intensive care unit (NICU) involves ensuring adequate nutrition and supporting the provision of human milk. The aim of this study was to explore nurses’ experiences of the oral feeding process in the NICU when the infant is born extremely or very preterm. We used a qualitative inductive approach. Nine nurses from three family-centered NICUs were interviewed face-to-face. The interviews were transcribed verbatim and analyzed using content analysis. Five sub-categories and two generic categories formed the main category: ‘A complex and long-lasting collaboration.’ The nurses wished to contribute to the parents’ understanding of the feeding …

Development, Implementation, And Evaluation Of A Professional Practice Model: A Scoping Review, Gemma Doleman, Di Twigg

Research outputs 2022 to 2026

Aim:

The aim of this study is to synthesize available literature describing the development, implementation and evaluation of a Professional Practice Model.

Background:

A Professional Practice Model is an overarching theory-based framework that depicts nursing values and defines the structure and process of nursing care. No research has synthesized available literature on this topic in recent times. Evaluation: A review of English language papers was published from 2015 to 2022. Fourteen studies met the inclusion criteria.

Key Issues:

All studies highlighted the importance of having a Professional Practice Model that reflects nursing care activities and resonates with nurses across an …

Breech Presentation Management: A Critical Review Of Leading Clinical Practice Guidelines, Sara Morris, Sadie Geraghty, Deborah Sundin

Research outputs 2014 to 2021

Problem

Clinical practice guidelines are designed to guide clinicians and consumers of maternity services in clinical decision making, but recommendations are often consensus based and differ greatly between leading organisations.

Background

Breech birth is a divisive clinical issue, however vaginal breech births continue to occur despite a globally high caesarean section rate for breech presenting fetuses. Inconsistencies are known to exist between clinical practice guidelines relating to the management of breech presentation.

Aim

The aim of this review was to critically evaluate and compare leading obstetric clinical practice guidelines related to the management of breech presenting fetuses.

Methods

Leading obstetric …

Online Learning And Teaching Approaches Used In Midwifery Programs: A Scoping Review, Terri Downer, Michelle Gray, Tanya Capper

Research outputs 2014 to 2021

Objective: The objective of this scoping review was to map and identify existing literature that described online learning and teaching approaches used in midwifery education.

Design: An extensive search of multiple databases and gray literature was undertaken following the JBI standards, using predefined selection criteria and following the PRISMA guidelines.

Methods: This scoping review included studies published in English between 2010 and 2020 that explored the online approaches to learning and teaching for undergraduate midwifery students. The articles were reviewed by three reviewers and content analysis was undertaken.

Results: Twenty-seven articles were included in the review. Results suggest that student …

Language Abilities In Children Born To Mothers Diagnosed With Diabetes: A Systematic Review And Meta-Analysis, Diana Arabiat, Mohammad Al Jabery, Mark Jenkins, Vivien Kemp, Lisa Whitehead, Gary Adams

Research outputs 2014 to 2021

Background: This meta-analysis reviewed and synthesized the available evidence on the association between intrauterine exposure to maternal diabetes and language abilities in children. MEDLINE/PubMed, EMBASE, PsycINFO, Proquest Dissertations and Theses Global, and Google Scholar databases were searched through December 2020. Studies were systematically searched, and effect sizes were calculated using random effects models.

Results: Twelve studies were identified for inclusion in this review, however, only 10 were included in the meta-analysis. Sample size ranged from 9 to 115 participants in the diabetes group and 28 to 8192 in the control and aged around 3 years. The pooled results of the …

How Is Organisational Fit Addressed In Australian Entry Level Midwifery Job Advertisements, Dianne Bloxsome, Courtney Glass, Sara Bayes

Research outputs 2014 to 2021

Background: Midwifery job retention is an ongoing global issue. Prior research has recognised that considering an individual’s attributes in relation to their work environment may assist in improving job satisfaction among midwives, leading to improved long-term job retention in the midwifery profession. The aim of this study was to evaluate whether, and how organisational fit is addressed in current entry level midwifery job advertisements within Australia. Methods: Midwifery jobs were searched for within 12 search engines, using the search term ‘midwife’, including Seek.com, Indeed.com, government employment websites for all Australian states and territories, and private health organisation websites. Data were …

Midwives’ Strategies For Coping With Barriers To Providing Quality Maternal And Neonatal Care: A Glaserian Grounded Theory Study, Yakubu Ismaila, Sara Bayes, Sadie Geraghty

Research outputs 2014 to 2021

Background: Midwives face direct and indirect barriers in their workplaces that have negative consequences on their ability to provide quality care to women and neonates, however, they still carry on with their duties. This study aimed at investigating the coping strategies that Ghanaian midwives adopt to be able to complete their work. Methods: Glaserian Grounded theory was used in this study. Data were collected through non-participant observations and semi-structured interviews. The study participants included 29 midwives who worked in labour/birthing environments and a pharmacist, a social worker, a national Health Insurance Scheme manager and a health services manager. Findings: The …