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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

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      Introduction

      In 2010, the Nursing and Midwifery Board of Australia introduced its registration standard: Endorsement for scheduled medicines for midwives. A midwife holding this endorsement can apply to Medicare Australia for both a Medicare provider number under the Medicare Benefits Schedule (MBS) and a prescriber number under the Pharmaceutical Benefits Scheme (PBS). Allocation of these numbers enables midwives to provide women with Medicare-rebatable episodes of care, prescribe relevant medications and order relevant Medicare-rebatable diagnostics. Uptake for the endorsement has been slow, indicating that potential barriers affect midwives’ ability to make use of the service provisions it enables.

      Aim

      To discover the mechanisms that help and/or hinder midwives to work to their full scope of practice when they have completed a program of study leading to endorsement.

      Methods

      An observational (non-experimental) design in the form of an online web-based survey was used. Most survey questions were quantitative, using closed questions with free text options to provide any additional responses. Descriptive statistics were used to analyse the survey results and content analysis was conducted on the qualitative data collected in the free text boxes.

      Results

      Results indicated that barriers—such as the limitations of MBS and PBS provisions for endorsed midwives and a general lack of support for the role—restrict endorsed midwives’ ability to provide quality maternity services. Support for the role may act as an enabler; however, midwives stated that personal determination and confidence in their ability also promoted endorsement use. Recommendations for practice to strengthen the endorsed midwife’s role include facilitating endorsement use in the public sector, relaxing MBS and PBS restrictions, raising awareness of the role and scope and improving midwives’ pre-endorsement preparation.

      Conclusion

      This study has highlighted the need for a holistic approach to support and develop the role of the endorsed midwife.
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