Barriers and enablers for midwives to use the Nursing and Midwifery Board of Australia's Endorsement for scheduled medicines for midwives |
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| Affiliation: | 1. College of Nursing and Health Sciences, Flinders University, Australia;2. Department for Health and Wellbeing, Government of South Australia, Australia;3. School of Nursing & Midwifery, Deakin University and Western Health Partnership, Australia;1. UNFPA, Sexual and Reproductive Health Branch, New York, United States;2. UNFPA, Asia and Pacific Regional Office, Bangkok, Thailand;3. UNFPA, Office of Geneva, Geneva, Switzerland;4. UNFPA, Arab States Regional Office, Cairo, Egypt;5. UNFPA, East and Southern Africa Regional Office, Johannesburg, South Africa;1. Research Centre for Midwifery Science, Zuyd University, Universiteitssingel 60, 6229 ER Maastricht, The Netherlands;2. Department of Primary and Community Care, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands;3. Center for Bioethics and Social Sciences in Medicine University of Michigan Medical School, North Campus Research Complex, 2800 Plymouth Road, Building 16, 419W, Ann Arbor, MI 48109-2800, USA;1. School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia;2. Trans-Tasman Midwifery Education Consortium, New Zealand, Australia;3. School of Nursing and Midwifery, University of South Australia, North Terrace, Adelaide South 5000, Australia;4. School of Clinical Sciences, Auckland University of Technology, 640 Great South Road, Manukau 2025, New Zealand;5. University of Canberra and ACT Government Health Directorate, Canberra 2617, Australia;1. Department of Anesthesiology and Critical Care Medicine, Paris-Seine-Saint-Denis Hospital Group, APHP, Paris, France & Paris 13 University, Sorbonne-Paris-Cité, Paris, France;2. Immunology Department, Bichat Hospital, APHP, Paris, France;3. UMR-996 INSERM, Paris-Sud University, Châtenay-Malabry, France;4. Department of Dermatology and Allergo-Anesthesia Unit, University Hospital Center, Vandœuvre-lès-Nancy, France;1. The University of Queensland, School of Nursing, Midwifery and Social Work Level 3, Chamberlain Building (35), St Lucia, Qld 4072, Australia;2. University of the Sunshine Coast, Sippy Downs, Qld 4558, Australia;1. Maternal, Childand Adolescent Program, Burnet Institute, Victoria, Australia;2. The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia;3. Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia;4. School of Nursing and Midwifery, University of Western Sydney, New South Wales, Australia;5. Centre for Midwifery, Child and Family Health, School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, New South Wales, Australia |
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| Abstract: | BackgroundIn 2010, the Nursing and Midwifery Board of Australia introduced a new registration standard: Endorsement for scheduled medicines for midwives. The endorsement enables midwives to provide women with Medicare-rebatable care, prescribe relevant medications, and order relevant Medicare-rebatable diagnostics. Translating endorsement education into clinical midwifery practice has been slow, indicating the presence of barriers affecting midwives’ ability to use this standard, despite it increasing their scope for service provision.AimTo discover the mechanisms affecting midwives’ ability to work to full scope of practice after completing a programme of study leading to endorsement.MethodsAn observational (non-experimental) design was used. Midwives who had completed an education programme leading to endorsement were invited to complete a survey. Descriptive statistics were used to analyse the quantitative questions and content analysis was conducted on the qualitative data.FindingsResults indicated that barriers – such as the limitations of Medicare provisions for endorsed midwives and a general lack of support for the role – restrict endorsed midwives’ ability to provide quality maternity services. Having some form of support for the role may act as an enabler, in addition to midwives having personal determination and confidence in their ability to use the endorsement. Recommendations to strengthen the endorsed midwife's role include facilitating endorsement use in the public sector, relaxing Medicare Benefit Schedule and Pharmaceutical Benefit Scheme restrictions, raising awareness of the role and scope, and improving midwives’ pre-endorsement preparation.ConclusionThis study highlights the need for an all-of-system approach to support and develop the endorsed midwife's role. |
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| Keywords: | Midwifery Endorsement Medicare-rebatable Prescribing Diagnostic test ordering |
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