Factors Influencing Midwifery Clinical Decision-making

Sakala, Betty

doi:10.21467/ias.7.1.28-32

Cited by 3 publications

(2 citation statements)

References 25 publications

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“…It should be noted that more than half the participants (58.8%) identified insufficient time as a barrier to accurately documenting the MEWT. Insufficient time can be attributed to high workload, inappropriate skill mix, poor staffing levels, lack of education, or insufficient equipment 51 . The participants defined insufficient equipment as challenges in locating a blood pressure (BP) machine or a thermometer, which resulted in a tendency to “skip” an observation such a BP or temperature.…”

Section: Discussionmentioning

confidence: 99%

“…Insufficient time can be attributed to high workload, inappropriate skill mix, poor staffing levels, lack of education, or insufficient equipment. 51 The participants defined insufficient equipment as challenges in locating a blood pressure (BP) machine or a thermometer, which resulted in a tendency to "skip" an observation such a BP or temperature. Some participating midwives (4%) expressed that escalation of care would increase their workload, with a fifth (21%) expressing the ward could manage the situation.…”

Section: Influencing Factorsmentioning

confidence: 99%

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Midwives’ recognition and response to maternal deterioration: A national cross‐sectional study

Ebert

Massey

Flenady

et al. 2022

Birth

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Background: Early warning systems (EWS) are used across health care settings as a tool for the early identification of clinical deterioration and to determine the need to escalate care. Early detection of clinical deterioration and appropriate escalation of care in maternity settings is critical to the safety of pregnant women and infants; however, underutilization of EWS tools and reluctance to escalate care have been consistently reported. Little is known about midwives' use of EWS in the Australian context.

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Section: Discussionmentioning

confidence: 99%

Section: Influencing Factorsmentioning

confidence: 99%

Midwives’ recognition and response to maternal deterioration: A national cross‐sectional study

Ebert

Massey

Flenady

et al. 2022

Birth

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Context: a key dimension in midwifery decision making and practice for safe labour care

Chodzaza

Haycock-Stuart

Holloway

et al. 2020

African Journal of Midwifery and Women's Health

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Background/Aims Research into midwifery decision making to date is limited and, where it exists, theoretical understanding has focused on the cognitive aspects of the process. Understanding the real-life context in which midwives work and how this influences their decision making during labour is important for safer maternity care. This study aimed to explore the contextual factors that influence the decision making of midwives at secondary and tertiary level health facilities during the first stage of labour in the real context of practice. Methods Using a focused ethnographic methodology, data from nine midwives working in two hospital labour ward settings were collected from October 2013 to May 2014. A total of 27 participant observations of midwives supporting women in the first stage of labour, 26 semi-structured interviews with midwives, and a documentary analysis of maternal labour records were conducted. All data were analysed using theme and category formation. Results Four major themes that influenced midwifery decision making for the safe care of women in labour were found: dominance of the medical profession over maternity care, shortage of midwifery staff, limited material resources, and midwifery strategies for maternal and child safety. Conclusions Understanding and improving clinical decision making requires consideration of contextual factors. For safe maternal care during the first stage of labour, midwives need to be supported to manage contextual factors for favourable outcomes for the mother and neonate.

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When Student Midwives Make Clinical Mistakes: A Qualitative Study in Brunei Darussalam

Halimi,

Zolkefli

2024

Int J Care Scholars

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Background: This study aimed to understand how student midwives perceive clinical mistakes and describe how they are supported by healthcare professionals when mistakes are made. Methods: The study adopted an exploratory qualitative research design with a sample of 9 undergraduate midwifery students from a higher institution in Brunei Darussalam. Data was collected through semi-structured online interviews with five open-ended questions. Results: Three broad themes were identified, namely: (1) Clinical mistakes as lessons, (2) Toxic work environment, and (3) Value of appropriate guidance. Conclusion: The findings indicate the student midwives’ perceptions regarding mistakes encountered in the clinical setting. The student's capacity and motivation to learn were impeded by the unsupportive environment and unwelcoming attitudes demonstrated by certain midwives, including the mentors. However, they viewed clinical mistakes as opportunities to grow and learn. Furthermore, the students emphasised the significance of guidance and mentorship from clinical educators in developing proficient midwives. Thus, by recognising mistakes as learning opportunities and receiving the appropriate support from mentors, students may be better prepared to provide high-quality care for mothers and infants.

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Factors Influencing Midwifery Clinical Decision-making

Cited by 3 publications

References 25 publications

Midwives’ recognition and response to maternal deterioration: A national cross‐sectional study

Midwives’ recognition and response to maternal deterioration: A national cross‐sectional study

Context: a key dimension in midwifery decision making and practice for safe labour care

When Student Midwives Make Clinical Mistakes: A Qualitative Study in Brunei Darussalam

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