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Barriers and enablers for midwives to use the Nursing and Midwifery Board of Australia's Endorsement for scheduled medicines for midwives

  • Paula Medway
    Correspondence
    Corresponding author at: College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
    Affiliations
    College of Nursing and Health Sciences, Flinders University, Australia

    Department for Health and Wellbeing, Government of South Australia, Australia
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  • Linda Sweet
    Affiliations
    School of Nursing & Midwifery, Deakin University and Western Health Partnership, Australia

    College of Nursing and Health Sciences, Flinders University, Australia
    Search for articles by this author
  • Amanda Müller
    Affiliations
    College of Nursing and Health Sciences, Flinders University, Australia
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      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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