Supporting breastfeeding mothers on children’s wards: an overview

Just under half of all six-week-old babies in the UK are breastfed, and just under a quarter are still being breastfed at six months old so it is likely that children’s nurses will frequently encounter breastfed babies on children’s wards. Support for breastfeeding has traditionally been left to midwives but Department of Health guidance requires that all relevant staff have training in this practice. Children’s nurses need to understand the principles and practice of breastfeeding support including correct positioning and attachment, prevention and management of breastfeeding problems, mothers’ needs and safe use of breast pumps. Breastfeeding should be part of the curriculum for children’s nursing courses, including practical sessions to observe breastfeeding support in the clinical setting. Children’s nurses should be aware that literature and learning resources written for midwives might be appropriate for them to access to increase their understanding in this important area of practice.

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.

Birth technology competence: a concept analysis

Aim. To identify birth technology competencies used by midwives to support women during the birthing process and to explore the concept of birth technology competence in midwifery practice in order to inform both education and practice. Objective. To define attributes of birth technology competence. Method. The Chinn and Kramer framework for concept analysis was used to examine sources including popular and professional literature, government reports and statutory regulation. The model allows for the exploration of three areas of experience, which interact to form the meaning of an idea or concept – feelings, values and attitudes associated with the concept, the symbolic label for the concept and the concept itself. Results. Exploration of the literature led to the development of exemplar cases that illuminate tentative attributes of the concept, contained within three domains – interpersonal skills, professional knowledge and clinical proficiency. Implications. Following testing in midwifery practice to ensure its transferability into the clinical context, the theoretical perspective developed here will provide a basis to inform education and practice in relation to the use of technology.

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.

El uso de la musicoterapia para la mejora de la comunicación de niños con Trastorno del Espectro Autista en Aulas Abiertas Especializadas

Los beneficios que aporta la musicoterapia en alumnos con Trastorno del Espectro Autista, han sido demostrados profusamente por los distintos autores, si bien carecemos de literatura suficiente sobre su utilización en las Aulas Abiertas Especializadas en colegios ordinarios (Aulas TEA). En este sentido, el objetivo del trabajo, ha consistido en analizar qué mejoras aporta la musicoterapia al desarrollo de la comunicación en los alumnos con Trastorno del Espectro Autista dentro de las Aulas Abiertas de los CEIPs de Castilla-La Mancha y la Comunidad Autónoma de Madrid. Para ello, se ha realizado una amplia revisión documental de fuentes de referencia y se ha entrevistado a los docentes responsables de las Aulas Abiertas Especializadas que utilizan actividades de musicoterapia como recurso en el aula. Se concluye el artículo manifestando, en primer lugar, la escasa integración de la musicoterapia en las aulas TEA (menos del 20% de los centros). En aquellas aulas que sí se programa con actividades de musicoterapia, los beneficios que ésta aporta se ven reflejados en un incremento claro de la intención comunicativa en los alumnos. Además, a la hora de planificar las actividades se tiene muy en cuenta conocer las preferencias y la historia musical del niño. No obstante, existen factores que impiden el aprovechamiento total de las posibilidades terapéuticas de la musicoterapia debido, especialmente a: a) una escasa formación del profesorado y b) un espacio inadecuado para poner en práctica una sesión de musicoterapia.

Peer-mentoring for first-time mothers from areas of socio-economic disadvantage: a qualitative study within a randomised controlled trial

Objective: To explore the difficulties experienced by lay-workers, women and health professionals involved in a peer-mentoring programme for first-time mothers living in socially disadvantaged areas. Design: Qualitative study; semi-structured interviews with lay-worker peer-mentoring programme participants at two separate stages of the programme (antenatal and postnatal). Setting: Community based. Participants: 11 women receiving peer-mentoring support (from first hospital antenatal visit to one year postnatal); 11 lay-workers; 2 research midwives. Results: Lay-workers had difficulty initiating contact with women and failure to establish contact affected their morale adversely. They felt that women understood their intended role poorly and attempted to develop relationships with them by sharing personal experiences and offering friendship; women who participated in the programme appreciated this. Developing a peer-mentor relationship was difficult if women lacked interest in the programme or in continuing contact. External influences on peer-mentoring uptake and delivery included family and friends who could prevent or encourage women’s participation and cause difficulties for the lay-worker both in delivering support and arranging follow-up. Lay-workers providing support to women from a different ethnic background experienced difficulties relating to both language and culture: these were perceived to affect peer-mentor relationships adversely. Major personal difficulties for lay-workers related to time constraints in reconciling mentoring requirements with demands of family and other work. Informing midwives of these difficulties helped identify solutions through training and ongoing professional support for the lay-workers. Conclusions: Lay-worker peer support is appreciated by first time mothers but difficulties in initiating contact, developing peer-mentor relationships and external influences such as family, ethnicity and time constraints are relevant to poor uptake and high staff turnover. In developing peer support programmes, awareness of potential difficulties and of how professional support can help resolve these should improve uptake and thus optimise the evaluations of their effectiveness.