A model for developing, implementing and evaluating a strategy to improve nursing and midwifery care

Background: Health care organizations world wide are faced with the need to develop and implement strategic organizational plans to meet the challenges of modern health care. There is a need for models for developing, implementing and evaluating strategic plans that engage practitioners, and make a measurable difference to the patients that they serve. This article describes the development of such a model to underpin a strategy for nursing and midwifery in an acute hospital trust. An integrated model: The processes for strategy development (values clarification, critical companionship and focus groups) are discussed, together with the development of processes for implementation, based upon a modification of the PARIHS (Promoting Action on Research Implementation in Health Services) conceptual framework. Finally, the methods for evaluating the strategy (a pre-test/post-test approach measuring the quality of nursing care, the degree to which the organization supports professional nursing care, the leadership styles of ward managers, and patient satisfaction with care) are described. Conclusion: The model is offered as one that may be of use to others who wish to develop an integrated approach to strategic change; an approach in which the development, implementation and evaluation of strategic plans are informed by the core values of nurses and midwives.

Ethnography of technological competence in clinical midwifery practice

Background. Concept analysis has identified three domains in the competent use of birth technology â?? interpersonal skills, professional knowledge and clinical proficiency â?? and tentative criteria for birth technology competence. Aim. Fieldwork was undertaken to observe, confirm and explore pre-defined attributes of birth technology competence. Method. The Swartz-Barcott and Kim (2000) hybrid model of concept development was expanded to include an ethnographic observation of theory in action. Findings. Key attributes of birth technology competence found in â??real-worldâ?? midwifery practice were skills in using the machines, decision-making and traditional midwifery skills. Conclusions. The confusion surrounding the use of technology in midwifery practice needs to be addressed by both professionals and educationalists. Midwives should be taught to value traditional midwifery skills alongside those of machine skills. The identification of a model of appropriate technology use is needed in midwifery.

An exploration of the importanceof emotional intelligence in midwifery

Background, Recognition of the importance of Emotional intelligence dates back as far as Aristotle (350BC). More recently the notion of emotional intelligence features in social psychology literature; it has also been embraced within personnel management and is now beginning to appear in nursing, medical and midwifery journals. Emotional intelligence involves possessing the capacity for motivation, creativity, the ability to operate at peak performance and the ability to persist in the face of setbacks and failures. Emotional intelligence refers to the ability to recognise our own feelings and those of others and it enables us to manage emotions effectively in ourselves and in our relationships. Midwives are constantly responding to change and challenges within maternity services. This paper examines how emotional intelligence can assist midwives in dealing with pressures which involve delivering the Government reforms, providing choice to women and facing current issues within the midwifery workforce. Midwives need emotional intelligence in order to express their feelings and recognize the feelings of others. Enhancing our relationships with colleagues and clients will ultimately impact on the quality of care delivered to women. Overall the aims of the paper are to create an awareness of the importance of emotional intelligence in practice and define emotional intelligence.

Midwifery research by midwifery researchers: challenges and considerations

This paper will discuss some of the challenges which may be encountered by midwifery researchers when conducting research where the research setting is familiar or study participants are known to the researchers. The paper identifies some of the key challenges which should be considered such as researching in a familiar culture, perception of participants, sample selection, finding space in the setting and interview dynamics. Examples are provided from three previous qualitative research projects conducted by the authors in educational and clinical settings with both pre registration and post registration midwives (pre and post registration). Each of the key issues will be discussed highlighting specific issues relevant to each with further consideration of how these issues may impact on progress of the project, data collected and subsequent findings. Finally, these will be drawn together with recommendations for future research conducted by midwives or where the setting or participants are known to the researchers. Although the paper is focused on midwifery research the issues raised may bear relevance in other areas where the setting or participants are known to researchers.