Nursing Midwifery Commons^™

Delegation Practices Between The Registered Nurse And The Assistant In Nursing In The Acute Care Setting In Western Australia, Carol Crevacore

Theses: Doctorates and Masters

Background:

Delegation is an essential skill that allows the Registered Nurse (RN) to allocate aspects of patient care to other team members including the unregulated Assistant in Nursing (AIN). Concerns have been raised about the activities delegated to AINs in the acute care environment.

Aim:

The aim of this research was to explore the practice of delegation between the RN and the AIN in the acute care environment. This delegation practice was examined through the lens of both the RN and the AIN.

Methodology:

This study used a mixed method explanatory sequential design. The participants were RNs and AINs working …

Breeching The System: An Exploration Of Women’S Experiences In Western Australia And Breech Birth Recommendations, Sara Elizabeth Morris

Theses: Doctorates and Masters

Breech presentation creates division in the consumer and healthcare communities. A number of studies report the use of scare tactics and bullying from clinicians, when women express a preference for vaginal birth after the diagnosis of a breech presenting fetus. Despite evidence showing that vaginal birth of a breech presenting fetus is safe in the presence of an appropriately skilled and experienced clinician, Caesarean Section is the primary mode of birth for breech presenting fetuses, which has resulted in a global lack of accessibility to breech birth experienced practitioners and birth mode options for women. Women planning a vaginal breech …

Development Of A Breech-Specific Integrated Care Pathway For Pregnant Women: Protocol For A Mixed Methods Study, Sara Morris, Sadie Geraghty, Deborah Sundin

Research outputs 2014 to 2021

Background: The development of an integrated care pathway with multidisciplinary input to standardize and streamline care for pregnant women experiencing breech presentation at 36 or more weeks of gestation poses several challenges because of the divisive and contentious nature of the phenomenon. Although many clinicians are interested in obtaining the skills required to safely support women desiring a vaginal breech birth, the primary trend in most health care facilities is to recommend a cesarean section. Objective: This paper aims to discuss the mixed methods approach used in a doctoral study conducted to generate new knowledge regarding women’s experiences of breech …

Understanding The Barriers To Ghanaian Midwives’ Ability To Provide Quality Care: Using Classic Grounded Theory Methodology In A New Context, Yakubu Ismaila, Sara Bayes, Sadie Geraghty

Research outputs 2014 to 2021

Background:

Interpretive-naturalist methodologies, including Grounded Theory are increasingly being used in health research in Ghana however, none of the studies that have used Grounded Theory in the setting has used the methodology in full.

Aim:

The main aim of this article is to describe the experiences, the strengths and limitations of using Glaserian Grounded Theory methodology to understand the barriers to Ghanaian midwives’ ability to provide quality maternal and neonatal care.

Design:

Glaserian Grounded Theory methodological principles were adhered to in this study in relation to the use of literature, participant recruitment, data collection and analysis, and theory development. Data …

The Knowledge, Attitudes And Beliefs Of Midwives On The Vaccination Coverage Rates In Perth’S Aboriginal Children, Rebecca Carman, Lesley Andrew, Amanda Devine

Research outputs 2014 to 2021

Background:

Midwives are well placed to promote vaccination awareness throughout a women’s pregnancy and strengthen childhood vaccination demand following hospital discharge. In Perth, Western Australia, Aboriginal children experience some of the lowest vaccination coverage rates across the nation. To identify factors preventing greater vaccination uptake amongst the target population, a theory-based study was conducted with midwives across two Perth maternity hospitals to explore behavioural attributes, knowledge, attitudes and beliefs surrounding vaccination provision and the vaccines administered to Aboriginal children.

Methods:

A purpose-designed questionnaire was distributed to midwives working in two Perth public maternity hospitals. The proximal constructs of The Theory …

Breeching The System: An Exploration Of Women’S Experiences And Breech Care Recommendations, Sara Morris

Research outputs 2014 to 2021

Aim:

This presentation reports the findings of a mixed methods study exploring women’s experiences of breech birth in Western Australia (WA) and professional recommendations for breech care.

Methods:

This pragmatic study consisted of a clinical guideline review, semi-structured interviews with women who had experienced a breech birth in WA and a multi-national e-Delphi study involving professionals with knowledge and/or experience of caring for women with a breech presenting fetus. These methods were deemed the optimal way of incorporating current clinical practice guidelines, with multi-disciplinary recommendations and consumer feedback.

Findings:

The clinical guideline review revealed similarities in antenatal care structure and …

Into The Breech: A Multi-National E-Delphi Study Exploring Breech Presentation And Birth Care, Sara Morris

Research outputs 2014 to 2021

Aim: To establish consensus regarding care of women with a breech presenting fetus through the exploration of participants’ knowledge, experiences and opinions regarding breech presentation and care.

Design: Three round Delphi e-survey

Setting: Multi-national

Participants: A panel of fifteen midwives, four obstetricians and one academic with an interest in breech care and birth.

Methods: The initial survey comprised of open-ended questions. Answers were coded and integrated to form statements presented to participants over 3 sections in the second round due to the abundance of information collected from first round responses. Consensus was deemed reached if 70% or more of participants …

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 …

Exploring The Usability Of The Com-B Model And Theoretical Domains Framework (Tdf) To Define The Helpers Of And Hindrances To Evidence-Based Practice In Midwifery, Annemarie De Leo, Sara J. Bayes, Dianne Bloxsome, Janice Butt

Research outputs 2014 to 2021

Background Despite the advancement of scientific research in the field of maternity care, midwives face challenges translating latest evidence into evidence-based practice (EBP) and express reticence towards leading practice change in clinical areas. This study aimed to explore midwifery leaders’ views on what factors help or hinder midwives’ efforts to translate latest evidence into everyday practice and consider them in relation to both the Capability, Opportunity, Motivation and Behaviour (COM-B) model and Theoretical Domains Framework (TDF). Methods This qualitative study formed part of a larger action research (AR) project that was designed to improve midwives’ EBP implementation capability. Data were …

An Early Collaborative Intervention Focusing On Parent-Infant Interaction In The Neonatal Period. A Descriptive Study Of The Developmental Framework, Charlotte Sahlén Helmer, Ulrika Birberg Thornberg, Evalotte Mörelius

Research outputs 2014 to 2021

Moderate to late preterm infants are at risk of developing problems later in life. To support attachment and infants’ development, high quality parent-infant interaction is important. Parent-infant interaction is known to improve through intervention programs but since no such intervention program is addressed directly to moderate to late preterm infants, a tailor-made intervention was developed. The aim was to describe the rationale, development, framework and practical provision of a new early collaborative intervention program. This study has a descriptive design and the intervention is described using the Template for Intervention Description and Replication. During an intervention-session, the preterm infant’s cues …

Barriers To Ghanaian Midwives’ Ability To Provide Quality Care: A Glaserian Grounded Theory Study, Yakubu Ismaila

Theses: Doctorates and Masters

The midwifery model of care that promotes the employment of trained and regulated midwives for the provision of maternal and neonatal care has been found to be beneficial, especially in Low and Middle-Income Countries that have high maternal and neonatal mortalities. Midwives in those setting are however, facing a myriad of barriers which negatively affect their ability to provide optimal care. Although Ghana is implementing the midwifery model of care, maternal and neonatal mortality remains high in the country. Little is known from the point of view of midwives, who are the primary providers of maternal and neonatal care, about …

Improving Processes For Implementing Evidence-Based Practice In Midwifery: Development Of An Etool(Kit) For Midwives, Annemarie June De Leo

Theses: Doctorates and Masters

Evidence-based practice (EBP) is well-established as the gold standard for service delivery of quality healthcare around the world, yet there remains a significant gap between best available evidence and its everyday use in maternity services. The numerous benefits of EBP are therefore never realised and although a considerable body of knowledge has evolved on how to promote the uptake of new EBPs, little is known about midwives’ experience of implementing EBP or leading practice change projects in clinical areas.

The aim of this study was to work collaboratively with midwives towards the co-development of an evidence implementation resource, designed to …

Do Midwifery International Clinical Placements Influence Students' Practice And Employment Decisions?, Sadie Geraghty, Carol Davidson, Annemarie Deleo, Dianne Bloxsome

Research outputs 2014 to 2021

AIM: The aim of this study was to investigate whether an International two-week clinical maternity placement enhances, and is beneficial, to midwifery students' future practice and employment decisions during the final year of an undergraduate degree.

BACKGROUND: International placements are common in undergraduate pre-registration nursing midwifery university curricula, with the emphasis on preparing students to work with diverse women in multicultural environments whilst incorporating cultural competence. However, little is known as to whether an International placement influences future graduate's work place choice.

METHODS: Using a qualitative approach, focus groups were undertaken with 16 final year midwifery students from a University …

Factors Associated With Midwives' Job Satisfaction And Intention To Stay In The Profession: An Integrative Review, Dianne Bloxsome, Deborah Ireson, Gemma Doleman, Sara Bayes

Research outputs 2014 to 2021

AIMS AND OBJECTIVES: To conduct an integrative review of the factors associated with why midwives stay in midwifery.

BACKGROUND: Midwifery retention and attrition are globally acknowledged as an issue. However, little is known as to why midwives stay in midwifery as the focus has previously focussed on why they leave.

DESIGN: A structured six-step integrative review approach was used, and this involved the development of a search strategy, study selection and critical appraisal, data abstraction and synthesis, interpretation of findings and recommendations for future practice.

METHODS: The review was conducted using the databases MEDLINE, CINAHL and PsychInfo. Included studies were …

Home Childbirth Among Young Mothers Aged 15-24 Years In Nigeria: A National Population-Based Cross-Sectional Study, Emmanuel O. Adewuyi, Vishnu Khanal, Yun Zhao, Lungcit David, Olasunkanmi D. Bamidele, Asa Auta

Research outputs 2014 to 2021

Objective To estimate the prevalence and identify factors associated with home childbirth (delivery) among young mothers aged 15–24 years in Nigeria. Design A secondary analysis of cross-sectional data from the 2013 Nigeria Demographic and Health Survey (NDHS). Setting Nigeria. Participants A total of 7543 young mothers aged 15–24 years. Outcome measure Place of delivery. Results The prevalence of home delivery among young mothers aged 15–24 years was 69.5% (95% CI 67.1% to 71.8%) in Nigeria—78.9% (95%CI 76.3% to 81.2%) in rural and 43.9% (95%CI 38.5% to 49.5%, p < 0.001) in urban Nigeria. Using the Andersen’s behavioural model, increased odds of home delivery were associated with the two environmental factors: rural residence (adjusted OR, AOR: 1.39, 95% CI 1.06 to 1.85) and regions of residence (North-East: AOR: 1.97, 95% CI 1.14 to 3.34; North-West: AOR: 2.94, 95% CI 1.80 to 4.83; and South-South: AOR: 3.81, 95% CI 2.38 to 6.06). Three of the enabling factors (lack of health insurance: AOR: 2.34, 95% CI 1.16 to 4.71; difficulty with distance to healthcare facilities: AOR: 1.48, 95% CI 1.15 to 1.88; and < 4 times antenatal attendance: AOR: 3.80, 95% CI 3.00 to 4.85) similarly increased the odds of home delivery. Lastly, six predisposing factors—lack of maternal and husband’s education, poor wealth index, Islamic religion, high parity and low frequency of listening to radio—were associated with increased odds of home delivery. Conclusions Young mothers aged 15–24 years had a higher prevalence of home delivery than the national average for all women of reproductive age in Nigeria. Priority attention is required for young mothers in poor households, rural areas, North-East, North-West and South-South regions. Faith-based interventions, a youth-oriented antenatal care package, education of girls and access to health insurance coverage are recommended to speed up the reduction of home delivery among young mothers in Nigeria.

Cesarean Delivery In Nigeria: Prevalence And Associated Factors -A Population-Based Cross-Sectional Study, Emmanuel O. Adewuyi, Asa Auta, Vishnu Khanal, Samson J. Tapshak, Yun Zhao

Research outputs 2014 to 2021

Objective To investigate the prevalence and factors associated with caesarean delivery in Nigeria. Design This is a secondary analysis of the nationally representative 2013 Nigeria Demographic and Health Survey (NDHS) data. We carried out frequency tabulation, χ2 test, simple logistic regression and multivariable binary logistic regression analyses to achieve the study objective. Setting Nigeria. Participants A total of 31 171 most recent live deliveries for women aged 15–49 years (mother–child pair) in the 5 years preceding the 2013 NDHS was included in this study. Outcome measure Caesarean mode of delivery. Results The prevalence of caesarean section (CS) was 2.1% (95% …

Reversing The Spiral Of Fear, Sara Morris

ECU Posters

Introduction: The proposed poster aims to bring about discourse regarding current breech birth practices. Outlined within are factors which have contributed to the current state of breech birth, not only in Australia but on a global scale and highlights steps which have been taken by others and may be used in Western Australia (WA) to reverse the spiral of fear currently surrounding breech birth. There is currently no literature pertaining to the state of breech birth in WA.

The publication of the Term Breech Trial (TBT) in 2000, the lack of trust and the need to control the birthing environment, …

Are Midwifery Students Adequately Prepared For Vaginal Breech Birth In Clinical Practice?, Steffne Nel, Sadie Geraghty

Research outputs 2014 to 2021

While the value of the clinical skills and expertise required to enable safe vaginal breech birth remains high, midwives who possess these skills are becoming scarce. Additionally, for many midwifery students, vaginal breech birth is becoming somewhat of an elusive event, rarely experienced in clinical practice when completing their training. Not so long ago, this was a standard competency taught to and held by obstetricians and midwives alike, but for those in developed nations working within robust healthcare systems, the frequency of planned vaginal breech birth is on a downward trend, and this is reflected in midwifery educational curriculums.

Prevalence And Factors Associated With Underutilization Of Antenatal Care Services In Nigeria: A Comparative Study Of Rural And Urban Residences Based On The 2013 Nigeria Demographic And Health Survey, Emmanuel O. Adewuyi, Asa Auta, Vishnu Khanal, Olasunkanmi D. Bamidele, Cynthia P. Akuoko, Kazeem Adefemi, Samson J. Tapshak, Yun Zhao

Research outputs 2014 to 2021

Introduction Antenatal care (ANC) is a major public health intervention aimed at ensuring safe pregnancy outcomes. In Nigeria, the recommended minimum of four times ANC attendance is underutilized. This study investigates the prevalence and factors associated with underutilization of ANC services with a focus on the differences between rural and urban residences in Nigeria. Methods We analyzed the 2013 Nigeria Demographic and Health Survey dataset with adjustment for the sampling weight and the cluster design of the survey. The prevalence of underutilization of ANC was assessed using frequency tabulation while associated factors were examined using Chi-Square test and multivariable logistic …

‘Fighting A Losing Battle’: A Glaserian Grounded Theory Of Midwives’ Workplace Stress, Sadie Margaret Geraghty

Theses: Doctorates and Masters

The development of the midwifery profession and the culture of childbirth are inevitably entwined from an historical perspective through to current day practice. Early written accounts describe the fifteenth century midwife as dealing with high maternal and child mortality rates, the invention of forceps, the rise of male obstetric practitioners, and the complex social and cultural changes of that era. The twenty-first century midwife faces challenges in Australia and worldwide, which are not dissimilar to our midwifery predecessors.

Midwifery clinical practice has become more complex due to the medicalisation of childbirth and 21st century lifestyles, which have contributed to a …

Australian Midwifery Students' Views About Profession-Specific Peer Mentoring, Sara J. Bayes, Doreen Collyer, Kirsten Dobbs, Laura Walsh

eCULTURE

Midwifery is one of the most demanding professions there is, and midwifery students can find coping with the practice aspect of their course difficult. Mentoring is one way of supporting health clinicians’ emotional wellbeing; to date however, there is little research on mentoring for midwifery students. In this study, the aim of which was to discover midwifery students’ views of profession-related peer mentoring, qualitative and quantitative data were collected from 21 midwifery students at one Australian university. Analysis of the data revealed that most participants felt they would benefit from and would like to know more about mentoring. The qualitative …

“Keeping It Together, Keeping Their Heads Above Water”: Western Australian Child Health Nurses’ Understanding Of Resilience In Postpartum Mothers, Rachael O. Collins, Julie Ann Pooley, Myra F. Taylor

Research outputs 2014 to 2021

Assessing the well-being of postpartum mothers is an important aspect of postnatal nursing care. For this reason, Child Health Nurses (CHNs) are charged with the responsibility of identifying postpartum mothers who do/not manifest resilient behavioral qualities. However, little is known about CHNs’ conceptualization of resilience or how they assess resilience in postpartum mothers. This exemplar study addressed this knowledge shortfall by conducting semi-structured interviews with eight practicing CHNs. The study’s findings reveal that although CHNs’ conceptual understanding of resilience is congruent with current theoretical thinking, some variance does exist in the ways in which CHNs assess postpartum resilience, particularly, in …

Promoting Abstinence From Alcohol During Pregnancy: Implications From Formative Research, Kathryn France, Robert Donovan, Nadine Henley, Carol Bower, Elizabeth Elliott, Janet Payne, Heather D'Antoine, Anne Bartu

Research outputs 2013

This research developed messages to promote abstinence from alcohol during pregnancy and identified elements that enhance message persuasiveness. An exploratory phase was conducted in 2009 that comprised four focus groups with 23 women inWestern Australia and elicited beliefs and attitudes on alcohol use during pregnancy and motivations for behavior change. Four television concepts were subsequently developed and appraised in five focus groups with 31 participants using standard advertising pretesting questions. The implications for campaigns addressing prenatal alcohol exposure and further research are noted and limitations discussed. Funding was received from Healthway and the National Health and Medical Research Council.

Papanicoloau Smear Uptake Among Substance-Using Mothers In Western Australia, Sadie Geraghty, Sara J. Bayes, Renate Mclaurin, Angela O'Connor

Research outputs 2013

Background: Papanicoloau (Pap) smear screening has helped to reduce cervical cancer rates significantly through the detection of premalignant cells (Bray et al, 2005). Uptake among women who use alcohol and other drugs (AOD) is known to be low (Chau et al, 2002) so they are at increased risk of being under-represented in the adequately screened population. AOD-using women experience disproportionately increased morbidity and mortality from cervical dysplasia and cancer (Nogara et al, 2013). Pregnancy may provide the midwife an opportunity to offer this vital screening test.

Objective: The audit investigated Pap smear uptake and results among AOD-using pregnant women.

Setting: …

The Use Of Naltrexone In Pregnancy In Opiate-Dependent Mothers, Sadie Geraghty, Carly Dixon

Research outputs 2012

There is an absence of sufficient evidence regarding naltrexone use in pregnancy due to the limited range of human studies. Naltrexone implants are being used in Western Australia as a treatment for opioid dependency, and although contraindicated for insertion during pregnancy, there are a number of women who conceive while undergoing treatment. A review of the available data revealed that naltrexone is associated with improved maternal and fetal outcomes. Extensive research into this area in the form of large, multicentre trials is required to confirm the results of the current research.

The Development Of An Interdisciplinary Research Agenda At Ngala: An Innovative Case Study, E Bennett, Y Hauck, S Bindahneem, Vicki Banham, M Owens, L E Priddis, G Wells, W Sinclair, L Shields

Research outputs 2012

Background Ngala is an early parenting, not-for-profit organisation in Western Australia (WA). Research academics from three universities in Perth had been involved in separate research activities over recent years at Ngala. During 2007, a strategic decision was made to forge formal links and articulate an interdisciplinary research framework to promote a research culture amongst Ngala practitioners. Aim To describe an organisational case study of the development of an interdisciplinary research agenda within Ngala. Methods Collaborative methods were used. An action learning project was undertaken over a two-year period with the involvement of researchers, managers and practitioners across the five disciplines …

The Development And Evaluation Of A Childbirth Education Program For Malawian Women, Address M. Malata

Theses: Doctorates and Masters

Childbirth education provided to women is an Integral aspect of the childbirth experience. In Malawi, midwives face a major challenge because one of their major roles is to provide childbirth information to women. However, there are no existing Childbirth Education Programs to facilitate this process. The purpose of this study was, therefore, threefold. First, it explored childbirth Information needs of Malawian mothers from the perspectives of both mothers and midwives, as well as strategies that would be appropriate to disseminate this childbirth information to Malawian women. Second, it developed a Childbirth Educational Program (CEP) to meet the specific needs of …

Bottle-Feeding Mothers' Experiences Of Coping In A Pro-Breastfeeding Context : The Case For A Caring-Options-Responsive Model Of Midwifery Services, Elizabeth P. Duffy

Theses: Doctorates and Masters

The original contribution of this qualitative study is that it sketches the front-line of the contested domain of infant feeding choices by exploring the under-researched experiences and perceptions of mothers who actively choose to bottle-feed their babies. Twelve bottle-feeding mothers in Western Australia participated in open-ended, in-depth interviews. The interview findings were further explored using participant observations of relevant hospital practices and critical, hermeneutic re-readings of midwifery's professional and policy documents. The thesis argues that bottle-feeding is marginalised by the midwifery profession that currently defines its practices in accordance with policies such as the Baby Friendly Hospital Initiative. Bottle-feeding mothers …

Early Discharge Planning : Primiparous Women's Perceptions Of Their Readiness For Going Home, Graeme N. Boardley

Theses: Doctorates and Masters

Early discharge for women after childbirth was introduced in Australia approximately ten years ago. Early discharge involves going home from hospital within three days of giving birth. Since its introduction, early discharge has been the subject of much debate. Previous research has argued the cost effectiveness and safety of early discharge, but little has been done to examine this phenomenon from the human aspect. An exploratory study of first time mothers, in an early discharge programme was undertaken to address how these women felt in relation to their readiness for going home. A purposive sample of twenty Caucasian, English speaking …

Women's Perceptions Of Birth Centre Care: A Qualitative Approach, Karen Coyle

Theses: Doctorates and Masters

The purpose of this exploratory study was to describe women's perceptions of the care they received in a birth centre, compared to their previous experiences in a hospital. Australian statistics indicate that five percent of childbearing women now choose to receive care in a birth centre setting. Clinical outcomes of birth centre care are now well documented, but there is limited empirical data about women's experiences of this model of care. Seventeen women, who had recently given birth in a birth centre, and had previously experienced care in a hospital setting, were interviewed about their care experiences. Using content analysis, …