Boost to number of midwives as extra training places announced

Secretary of Health and Social Care Jeremy Hunt, will announce plans today  (27 March) for an extra 3000 midwives to be trained over the next four years, increasing the number of training places by a quarter.  It will start with an additional 650 midwives and maternity support staff in training next year, then a further 1000 places for the next three years. The plan will also include a new maternity support worker (MSW) role,  as well as opening new training pathways into midwifery.  As part of the same announcement Mr Hunt is expected to outline plans that ensure mothers will be seen by the same midwife throughout labour, pregnancy and birth by 2021 (via RCM).

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The Royal College of Midwives (RCM) chief executive Gill Walton said: ‘while we welcome the commitment to continuity of care, it is ambitious. The additional midwives who start training next year won’t be qualified midwives working in our maternity services until 2022. That will make a difference and it will begin to have an impact on the workload of midwives, but it will not transform maternity services right now.”

It will take seven or eight years before all of the new midwives announced today will be actually working in our maternity services. This will be offset to some extent by the extra MSWs promised. This will help make the staffing overall feel better, though we need to see details about how many more MSWs there will be.’

The full RCM response to the plan can be read here Government promises more midwives

In the media:

BBC News  NHS: Over 3,000 more midwifery training places offered

The Guardian Hunt to unveil plan for women to have same midwives through pregnancy

Early pregnancy care

Clinical nurse specialist in early pregnancy care | The Royal College of Nursing

This document outlines the key skills and knowledge required to develop the role of the clinical nurse specialist in early pregnancy care.  It is intended to provide direction for commissioners and managers when creating roles to support best practice in local service provision for women and their families.

Full document: Clinical Nurse Specialist in Early Pregnancy Care

National maternity and perinatal audit

The Healthcare Quality Improvement Partnership (HQIP) has published National Maternity and Perinatal Audit: Clinical report 2017.

This report identifies areas of good practice and opportunities for improvement in the care of women and babies in maternity services across Britain. The report recommends further improvements in the quality of maternity data so that more outcomes, such as proportion of births without intervention, can be measured accurately. This data will enable women, clinicians, commissioners and policy makers to evaluate care given locally and nationally and use it to drive further improvements in the quality of maternity services.

Additional links: HQIP press release  | Royal College of Midwives press release

Protection of Nurses Working with Children and Young People

Guidance to raise awareness among nurses and their managers of the complex issues surrounding safeguarding in the context of relationships between nurses and children and young people | RCN

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Image source: RCN

For the vast majority of nurses, harming those in their care, or even the possibility that another professional/colleague could, is the farthest thing from their minds. However, the RCN recognises that there are child abusers who target young people when they are at their most vulnerable. Abusers of children sometimes actively seek access to children by joining professions such as nursing, medicine, social work and teaching.

While in most identified cases, sexual abuse against children is carried out by men, it is important to recognise that women do it too. It is also important to keep things in perspective – the vast majority of nurses provide high standards in all aspects of caring for children and young people and protecting them from harm.

 

The role of nurses’ clinical impression in the first assessment of children at the emergency department

This study explores the diagnostic value and determinants of nurses’ clinical impression for the recognition of children with a serious illness on presentation to the emergency department (ED) | Archives of Disease in Childhood

Main outcome measures: Diagnostic accuracy of nurses’ clinical impression for the prediction of serious illness, defined by intensive care unit (ICU) and hospital admission. Determinants of nurses’ impression that a child appeared ill.

Results: Nurses considered a total of 1279 (20.0%) children appearing ill. Sensitivity of nurses’ clinical impression for the recognition of patients requiring ICU admission was 0.70 (95% CI 0.62 to 0.76) and specificity was 0.81 (95% CI 0.80 to 0.82). Sensitivity for hospital admission was 0.48 (95% CI 0.45 to 0.51) and specificity was 0.88 (95% CI 0.87 to 0.88). When adjusted for age, gender, triage urgency and abnormal vital signs, nurses’ impression remained significantly associated with ICU (OR 4.54; 95% CI 3.09 to 6.66) and hospital admission (OR 4.00; 95% CI 3.40 to 4.69). Ill appearance was positively associated with triage urgency, fever and abnormal vital signs and negatively with self-referral and presentation outside of office hours.

Conclusion: The overall clinical impression of experienced nurses at the ED is on its own, not an accurate predictor of serious illness in children, but provides additional information above some well-established and objective predictors of illness severity.

Full reference: Zachariasse, J.M. et al. (2017)  The role of nurses’ clinical impression in the first assessment of children at the emergency department. Archives of Disease in Childhood. Published Online First: 10 June 2017

Protection of Nurses Working with Children and Young People

This guidance aims to raise awareness among nurses and their managers of the complex issues surrounding safeguarding in the context of relationships between nurses and children and young people.

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Image source: http://www.rcn.org.uk

In the publication, the Royal College of Nursing  include the age range of 0-18 (up to 25 years in line SEND reforms) in this definition and also advocate the need for special consideration in view of children and young people who may have a disability, or other need that affects their mental capacity to make decisions. This guidance concentrates on allegations of abuse made against staff such as smacking a child and inappropriate physical contact.

Click here to view this guidance.

Facilitators & barriers of palliative care in the neonatal unit

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Kilcullen, M. & Ireland, S. Palliative care in the neonatal unit: neonatal nursing staff perceptions of facilitators and barriers in a regional tertiary nursery. BMC Palliative Care | Published online: 11 May 2017

Background: Neonatology has made significant advances in the last 30 years. Despite the advances in treatments, not all neonates survive and a palliative care model is required within the neonatal context. Previous research has focused on the barriers of palliative care provision. A holistic approach to enhancing palliative care provision should include identifying both facilitators and barriers. A strengths-based approach would allow barriers to be addressed while also enhancing facilitators. The current study qualitatively explored perceptions of neonatal nurses about facilitators and barriers to delivery of palliative care and also the impact of the regional location of the unit.

Conclusions: This study identified and explored facilitators and barriers in the delivery of quality palliative care for neonates in a regional tertiary setting. Themes identified suggested that a strengths-approach, which engages and amplifies facilitating factors while identified barriers are addressed or minimized, would be successful in supporting quality palliative care provision in the neonatal care setting. Study findings will be used to inform clinical education and practice.

Read the full article here