Abstract
Background
In 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.
Aim
To discover the mechanisms affecting midwives’ ability to work to full scope of practice
after completing a programme of study leading to endorsement.
Methods
An 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.
Findings
Results 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.
Conclusion
This study highlights the need for an all-of-system approach to support and develop
the endorsed midwife's role.
Keywords
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Article info
Publication history
Published online: June 23, 2020
Accepted:
June 1,
2020
Received in revised form:
May 31,
2020
Received:
April 8,
2020
Identification
Copyright
© 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
