Midwife-Led Community Transformation (Milcot) Nursing Now Challenge in Uganda

Summary This paper describes the journey of a young African midwife utilising the Nursing Now Nightingale Challenge framework to undertake a gap analysis and a mapping exercise to provide high-quality continuous professional development education for midwives working in isolation in a deprived suburb in Uganda. The project was completed in three stages: Stage one mapped out the services available within Nansana, Uganda Stage two identified the gaps in education for midwives and nurses within the area Stage three developed and offered educational study days for nurses, midwives and adolescents based on the gap analysis

Characteristics of strong midwifery leaders and enablers of strong midwifery leadership:An international appreciative inquiry

Objectives: This research aimed to identify the characteristics of strong midwifery leaders and explore how strong midwifery leadership may be enabled from the perspective of midwives and nurse-midwives globally. Design: In this appreciative inquiry, we collected qualitative and demographic data using a cross-sectional online survey between February and July 2022.Setting: Responses were received from many countries (n = 76), predominantly the United Kingdom (UK), Australia, the United States of America (USA), Canada, Uganda, Saudi Arabia, Tanzania, Rwanda, India, and Kenya. Participants: An international population (n = 429) of English-speaking, and ethnically diverse midwives (n = 211) and nurse-midwives (n = 218).Measurements: Reflexive thematic analysis was used to make sense of the qualitative data collected. Identified characteristics of strong midwifery leadership were subsequently deductively mapped to established leadership styles and leadership theories. Demographic data were analysed using descriptive statistics. Findings: Participants identified strong midwifery leaders as being mediators, dedicated to the profession, evidence-based practitioners, effective decision makers, role models, advocates, visionaries, resilient, empathetic, and compassionate. These characteristics mapped to compassionate, transformational, servant, authentic, and situational leadership styles. To enable strong midwifery leadership, participants identified a need for investment in midwives’ clear professional identity, increased societal value placed upon the midwifery profession, ongoing research, professional development in leadership, interprofessional collaborations, succession planning and increased self-efficacy. Key conclusions and implications for practice: This study contributes to understandings of trait, behavioural, situational, transformational and servant leadership theory in the context of midwifery. Investing in the development of strong midwifery leadership is essential as it has the potential to elevate the profession and improve perinatal outcomes worldwide. Findings may inform the development of both existing and new leadership models, frameworks, and validated measurement tools

Characteristics of Strong Midwifery Leaders and Enablers of Strong Midwifery Leadership: An International Appreciative Inquiry

Objectives This research aimed to identify the characteristics of strong midwifery leaders and explore how strong midwifery leadership may be enabled from the perspective of midwives and nurse-midwives globally. Design In this appreciative inquiry, we collected qualitative and demographic data using a cross-sectional online survey between February and July 2022. Setting Responses were received from many countries (n=76), predominantly the United Kingdom (UK), Australia, the United States of America (USA), Canada, Uganda, Saudi Arabia, Tanzania, Rwanda, India, and Kenya. Participants An international population (n=429) of English-speaking, and ethnically diverse midwives (n=211) and nurse-midwives (n=218). Measurements Reflexive thematic analysis was used to make sense of the qualitative data collected. Identified characteristics of strong midwifery leadership were subsequently deductively mapped to established leadership styles and leadership theories. Demographic data were analysed using descriptive statistics. Findings Participants identified strong midwifery leaders as being mediators, dedicated to the profession, evidence-based practitioners, effective decision makers, role models, advocates, visionaries, resilient, empathetic, and compassionate. These characteristics mapped to compassionate, transformational, servant, authentic, and situational leadership styles. To enable strong midwifery leadership, participants identified a need for investment in midwives’ clear professional identity, increased societal value placed upon the midwifery profession, ongoing research, professional development in leadership, interprofessional collaborations, succession planning and increased self-efficacy. Key conclusions and implications for practice This study contributes to understandings of trait, behavioural, situational, transformational and servant leadership theory in the context of midwifery. Investing in the development of strong midwifery leadership is essential as it has the potential to elevate the profession and improve perinatal outcomes worldwide. Findings may inform the development of both existing and new leadership models, frameworks, and validated measurement tools

Implementing and enacting placement learning precepts in UK pre-registration nurse education: a caste study experience

This study focuses on the practice component of United Kingdom (UK) pre-registration nurse education. In particular, the research has concentrated on one school of health - part of a larger higher education institution, in the UK and has explored how the institution ensures the quality of the practice component of two of its pre-registration nurse education programmes, the Adult and Mental Health branch programmes. A ‘Major Review’ inspection of these programmes was undertaken in 2005 as part of the requirement of the Quality Assurance Agency (QAA) (2001). The research analysed whether the precepts that relate to the practice component of the school’s pre-registration programmes were being implemented, enacted and experienced by those engaged in them. To achieve this Yin’s (2003) qualitative case study approach was adopted, involving interviewing senior lecturers (n=9), mentors (n=7) and student nurses (n=8) and undertaking in depth analysis of relevant documentation.The findings identified that the precepts themselves did not directly influence what the link tutors and mentors did. As a result, the student nurses experienced different levels of support from link tutors and mentors. This prevented students from experiencing a standardised approach to the practice component of the programmes studied. From this it has been concluded that the ethos of the Major Review process has had no long term impact with regards to standardising and quality assuring the practice component of the programmes studied, a finding that has not been formally reported elsewhere. Instead individual values, beliefs and practices dominated the way in which the players studied operated. The study also highlights how broad and non-descript the precepts themselves are in guiding the school towards a standardised approach to the practice component of the programmes in question. All but one of the precepts ‘Staff Development’ were evidenced as being implemented and/or experienced. Having researched the placement learning precepts (QAA 2001) in their entirety, which has never been done before, it became evident that whilst the content of all of the precepts had been included in the documentary data studied (Clinical Assessment of Practice Documents, School Plan and Pathway Guide), this did not guarantee that all of the precepts were fully implemented and enacted by relevant players. This was because the instruction and guidance within the documents studied were often broad and non specific, to which the design of the precepts allowed. The outcome of this enabled a) link tutors to interpret their roles and responsibilities in different ways; b) theory practice gaps to emerge, which ranged from weak partnership relationships between link tutors and practice placement mangers; c) mentors and link tutors interpreting the CAPD differently and d) mentors mentoring and assessing students in different ways. This resulted in students nursing experiencing different types of learning opportunities and assessment practices that did not always match the learning and development that may be needed in order to practice as a competent and confident registered nurse, at the point of registration. Additionally, there was a lack of understanding by all players about local quality assurance systems and processes. This ranged from none of the participants being familiar with the complaints procedures, or being clear about how placement learning experiences were monitored and evaluated. As a result of these findings the competence of the personnel (link tutors and mentors) studied has been questioned. A phenomenon that highlighted that precept 6 ‘Staff Development’ (which required institutions to ensure that staff who are involved in placement learning are competent to fulfil their role), was not being demonstrably implemented or enacted. A series of recommendations have been designed to meet both the needs of the school studied and others similar. Some of the recommendations relating to the school studied have already been implemented with positive effect. This was evidenced when the researched school was confirmed as having an ‘Outstanding Level of Achievement’ for practice learning following a more recent quality assurance inspection by HLSP on behalf of the Nursing and Midwifery Council

The Nightngale Challenge, leadership and change in Uganda

Despite great strides made by Uganda, the Maternal Mortality Rate still stands at 336 deaths per 100,000 live births and is among the highest on the continent and in the world.1 As a result, the Minister of Health, Dr Jane Ruth Aceng called on stakeholders to devise strategies to bring the rates down.2 One of the challenges is the limited access to family planning services. With limited adolescent-friendly service providers, 42% of all preg- nancies among adolescents are unintended.