Factors influencing the implementation of advanced midwife practitioners in healthcare settings: A qualitative study

Goemaes, Régine; Shawe, Jill; Beeckman, Dimitri; Decoene, Elsie; Verhaeghe, Sofie; Hecke, Ann Van

doi:10.1016/j.midw.2018.08.002

Cited by 17 publications

(14 citation statements)

References 28 publications

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“…Further, where such studies do exist, the reporting conflates the meso and micro levels. 16,17,18 This paper also adds new knowledge in that it addresses the introduction of ACPs from across professional backgrounds, rather than a single profession. This qualitative study reports relatively few ACP posts in the NHS, against a national policy promoting such roles and supported by training funds.…”

Section: Discussionmentioning

confidence: 99%

“…Further, where such studies do exist, the reporting conflates the meso and micro levels. [21][22][23] This paper also adds new knowledge in that it addresses the introduction of ACPs from across professional backgrounds, rather than a single profession.…”

Section: Discussionmentioning

confidence: 99%

“…20 Where studies have included consideration of the hospital and community health services organization level perspective, the reporting of findings has not distinguished the meso from the micro level. [21][22][23] In this study we investigate the factors influencing the development and continuance, or otherwise, of ACP posts at the meso level of the health system, in English NHS organizations, in the context of significant macro level policy support for the workforce innovation of advanced clinical practice roles.…”

Section: Introductionmentioning

confidence: 99%

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Are advanced clinical practice roles in England’s National Health Service a remedy for workforce problems? A qualitative study of senior staff perspectives

Drennan

Collins

Allan

et al. 2021

J Health Serv Res Policy

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Objective A major issue facing all health systems is improving population health while at the same time responding to both growing patient numbers and needs and developing and retaining the health care workforce. One policy response to workforce shortages has been the development of advanced clinical practice roles. In the context of an English national policy promoting such roles in the health service, we explored senior managers’ and senior clinicians’ perceptions of factors at the organization level that support or inhibit the introduction of advanced clinical practice roles. The investigation was framed by theories of the diffusion of innovation and the system of professions. Methods We conducted a qualitative interview study of 39 senior manager and clinicians in 19 National Health Service acute, community, mental health and ambulance organizations across a metropolitan area in 2019. Results Small numbers of advanced clinical practice roles were reported, often in single services. Four main influences were identified in the development of advanced clinical practice roles: staff shortages (particularly of doctors in training grades) combined with rising patient demand, the desire to retain individual experienced staff, external commissioners or purchasers of services looking to shape services in line with national policy, and commissioner-funded new roles in new ambulatory care services and primary care. Three factors were reported as enabling the roles: finance for substantive posts, evidence of value of the posts, and structural support within the organization. Three factors were perceived as inhibiting developing the roles: confusion and lack of knowledge amongst clinicians and managers, the availability of finance for the roles, and a nervousness (sometimes resistance) to introducing the new roles. Conclusions While the national policy was to promote advanced clinical practice roles, the evidence suggested there was and would continue to be limited implementation at the operational level. Development scenarios that introduced new monies for such roles reduced some of the inhibiting factors. However, where the introduction of roles required funding to move from one part of a service to another, and potentially from one staff group to another, the growth of these roles was and is likely to be contested. In such scenarios, research and business evidence of relative advantage will be important, as too will be supporters in powerful positions. The paucity of publicly available evidence on the effectiveness of advanced clinical practice roles across the specialties and professions in different contexts requires urgent attention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Are advanced clinical practice roles in England’s National Health Service a remedy for workforce problems? A qualitative study of senior staff perspectives

Drennan

Collins

Allan

et al. 2021

J Health Serv Res Policy

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“…Midwife practitioners are autonomous, independent practitioners who provide evidence-based care and use their clinical and professional leadership, research and education skills to advance midwifery practice (Goemaes et al, 2018;Health Education England, 2022a).…”

Section: Backg Rou N Dmentioning

confidence: 99%

“…The Republic of Ireland is one of a limited number of countries to introduce midwife practitioner roles (Goemaes et al, 2018). In Ireland, the terms registered advanced nurse practitioner (RANP) and registered advanced midwife practitioner (RAMP) are used to delineate healthcare professionals practising at an advanced level (Nursing andMidwifery Board of Ireland, 2017, 2018).…”

Section: Backg Rou N Dmentioning

confidence: 99%

Advanced nurse and midwife practitioners' experience of interprofessional collaboration when implementing evidence‐based practice into routine care: An interpretative phenomenological analysis

Clarke,

Lehane,

Cotter

et al. 2023

Journal of Advanced Nursing

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AimTo understand advanced nurse and midwife practitioners' experience of interprofessional collaboration in implementing evidence‐based practice into routine care.DesignA qualitative interpretative phenomenological analysis.MethodsA purposeful sample of 10 Registered Advanced Nurse and Midwife Practitioners from a range of practice settings in the Republic of Ireland participated in semi‐structured interviews over a 10‐month timeframe. Interviews were transcribed verbatim and data were analysed using a multi‐stage approach in line with guidance for interpretative phenomenological analysis.ResultsSix superordinate themes emerged: Understanding of advanced practice; ‘Treated as an equal and as a “nurse”’; Nursing management support; ‘A voice to implement anything new’; Confidence and Emotional intelligence. These factors impacted interprofessional relationships and the extent to which advanced practitioners could implement evidence‐based practice.ConclusionThere is scope to improve advanced practitioners' ability to collaborate with the interprofessional team in implementing evidence‐based practice into routine care.Impact and ImplicationsThe study findings demonstrate that enhancing understanding of the advanced practice role; increasing organizational support for advanced practitioners and augmenting specific practitioner skills and attributes will increase their ability to collaborate effectively and implement evidence‐based practice. Supporting advanced practitioners in this important aspect of their role will positively influence health outcomes for patients.Contribution to the Wider Global Clinical CommunityAs numbers of both nurse and midwife practitioners increase globally, this study provides timely evidence from a range of practice settings to guide the design of education programmes and policies governing advanced practice.Study recommendations have broad applicability to all healthcare professionals who are engaged in implementing evidence‐based practice into routine care.Reporting MethodConsolidated criteria for reporting qualitative research (COREQ).Patient or Public ContributionNo patient or public contribution.

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The future of midwife-led continuity of care: Call for a dialogue

Kuipers

2024

Dialogues in Health

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Factors influencing the implementation of advanced midwife practitioners in healthcare settings: A qualitative study

Cited by 17 publications

References 28 publications

Are advanced clinical practice roles in England’s National Health Service a remedy for workforce problems? A qualitative study of senior staff perspectives

Are advanced clinical practice roles in England’s National Health Service a remedy for workforce problems? A qualitative study of senior staff perspectives

Advanced nurse and midwife practitioners' experience of interprofessional collaboration when implementing evidence‐based practice into routine care: An interpretative phenomenological analysis

The future of midwife-led continuity of care: Call for a dialogue

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