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Factors influencing the implementation of advanced midwife practitioners in healthcare settings : a qualitative study

Régine Goemaes (UGent) , Jill Shawe, Dimitri Beeckman (UGent) , Elsie Decoene (UGent) , Sofie Verhaeghe (UGent) and Ann Van Hecke (UGent)
(2018) MIDWIFERY. 66. p.88-96
Author
Organization
Abstract
Objective: To explore factors influencing the implementation of advanced midwife practitioner roles. Design: Semi-structured individual face-to-face and focus group interviews were conducted. Data analysis was performed using the Framework Method. Setting and participants: A purposive sample (n = 32) included chief nursing officers, middle managers, head midwives/nurses, primary care team leaders, midwives with and without advanced midwife practitioner roles, heads of midwifery educations, and obstetricians. Findings: Budgetary constraints on a governmental and healthcare organizational level were mentioned as main barriers for role implementation. The current fee-for-service financing model of healthcare professionals was also seen as an impediment. Obstetricians considered the implementation of advanced midwife practitioner roles as a possible financial and professional threat. Documenting the added value of advanced midwife practitioner roles was regarded a prerequisite for gaining support to implement such roles. Healthcare managers' and midwives' attitudes towards these roles were considered essential. Participants warned against automatically transferring the concept of advanced practice nursing to midwifery. Although participants seldom discussed population healthcare needs as a driver for implementation, healthcare organizations' heightened focus on quality improvement and client safety was seen as an opportunity for implementation. University hospitals were perceived as pioneers regarding advanced midwife practitioner roles. Key conclusions and implications for practice: Multiple factors influencing role implementation on a governmental, healthcare organizational, and workforce level illustrate the complexity of the implementation process, and highlight the need for a well-thought-out implementation plan involving all relevant stakeholders. Pilot projects for the implementation of advanced midwife practitioners in university hospitals might be useful.
Keywords
Advanced midwifery practice, Advanced practice nursing, Content analysis, Midwifery, Qualitative research, Role implementation, NURSE-PRACTITIONERS, FOCUS GROUPS, SPECIALIST, OUTCOMES, ROLES, PROFESSIONALS, INTERVIEWS, FRAMEWORK, IMPACT, POLICY

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Citation

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MLA
Goemaes, Régine, Jill Shawe, Dimitri Beeckman, et al. “Factors Influencing the Implementation of Advanced Midwife Practitioners in Healthcare Settings : a Qualitative Study.” MIDWIFERY 66 (2018): 88–96. Print.
APA
Goemaes, R., Shawe, J., Beeckman, D., Decoene, E., Verhaeghe, S., & Van Hecke, A. (2018). Factors influencing the implementation of advanced midwife practitioners in healthcare settings : a qualitative study. MIDWIFERY, 66, 88–96.
Chicago author-date
Goemaes, Régine, Jill Shawe, Dimitri Beeckman, Elsie Decoene, Sofie Verhaeghe, and Ann Van Hecke. 2018. “Factors Influencing the Implementation of Advanced Midwife Practitioners in Healthcare Settings : a Qualitative Study.” Midwifery 66: 88–96.
Chicago author-date (all authors)
Goemaes, Régine, Jill Shawe, Dimitri Beeckman, Elsie Decoene, Sofie Verhaeghe, and Ann Van Hecke. 2018. “Factors Influencing the Implementation of Advanced Midwife Practitioners in Healthcare Settings : a Qualitative Study.” Midwifery 66: 88–96.
Vancouver
1.
Goemaes R, Shawe J, Beeckman D, Decoene E, Verhaeghe S, Van Hecke A. Factors influencing the implementation of advanced midwife practitioners in healthcare settings : a qualitative study. MIDWIFERY. 2018;66:88–96.
IEEE
[1]
R. Goemaes, J. Shawe, D. Beeckman, E. Decoene, S. Verhaeghe, and A. Van Hecke, “Factors influencing the implementation of advanced midwife practitioners in healthcare settings : a qualitative study,” MIDWIFERY, vol. 66, pp. 88–96, 2018.
@article{8571792,
  abstract     = {Objective: To explore factors influencing the implementation of advanced midwife practitioner roles. 
Design: Semi-structured individual face-to-face and focus group interviews were conducted. Data analysis was performed using the Framework Method. 
Setting and participants: A purposive sample (n = 32) included chief nursing officers, middle managers, head midwives/nurses, primary care team leaders, midwives with and without advanced midwife practitioner roles, heads of midwifery educations, and obstetricians. 
Findings: Budgetary constraints on a governmental and healthcare organizational level were mentioned as main barriers for role implementation. The current fee-for-service financing model of healthcare professionals was also seen as an impediment. Obstetricians considered the implementation of advanced midwife practitioner roles as a possible financial and professional threat. Documenting the added value of advanced midwife practitioner roles was regarded a prerequisite for gaining support to implement such roles. Healthcare managers' and midwives' attitudes towards these roles were considered essential. Participants warned against automatically transferring the concept of advanced practice nursing to midwifery. Although participants seldom discussed population healthcare needs as a driver for implementation, healthcare organizations' heightened focus on quality improvement and client safety was seen as an opportunity for implementation. University hospitals were perceived as pioneers regarding advanced midwife practitioner roles. 
Key conclusions and implications for practice: Multiple factors influencing role implementation on a governmental, healthcare organizational, and workforce level illustrate the complexity of the implementation process, and highlight the need for a well-thought-out implementation plan involving all relevant stakeholders. Pilot projects for the implementation of advanced midwife practitioners in university hospitals might be useful.},
  author       = {Goemaes, Régine and Shawe, Jill and Beeckman, Dimitri and Decoene, Elsie and Verhaeghe, Sofie and Van Hecke, Ann},
  issn         = {0266-6138},
  journal      = {MIDWIFERY},
  keywords     = {Advanced midwifery practice,Advanced practice nursing,Content analysis,Midwifery,Qualitative research,Role implementation,NURSE-PRACTITIONERS,FOCUS GROUPS,SPECIALIST,OUTCOMES,ROLES,PROFESSIONALS,INTERVIEWS,FRAMEWORK,IMPACT,POLICY},
  language     = {eng},
  pages        = {88--96},
  title        = {Factors influencing the implementation of advanced midwife practitioners in healthcare settings : a qualitative study},
  url          = {http://dx.doi.org/10.1016/j.midw.2018.08.002},
  volume       = {66},
  year         = {2018},
}

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