NRSG 645 Advanced Midwifery Clinical I
Course Title: NRSG 645 Advanced Midwifery Clinical I
Credits: 3 (clinical)
Semesters Offered: Spring
Prerequisites: NRSG 639, NRSG 642, NRSG 643
Degree: DNP
AACN Core Competencies for Advanced-level Nursing Education: 1, 2, 4, 5, 6, 9
MRJCON DNP Program Learning Outcome: 1, 2, 4, 5, 6, 9
MRJCON NM Option Learning Outcomes: 1, 2, 3, 4, 6, 7, 8
Course Description:
This is the initial nurse midwifery clinical courses where students begin to apply knowledge, skills, and abilities acquired in the required prerequisite nurse midwifery courses in the clinical setting. Students use the midwifery management process when providing culturally competent, holistic care to people throughout the lifespan including the childbearing cycle and neonates in the first 28 days of life.
Catalog Description:
This is the first of four nurse midwifery clinical courses where students begin to apply knowledge, skills, and abilities acquired in required prerequisite courses. Students use the midwifery management process when providing holistic care.
Course Learning Outcomes: Upon completing this course the student will be able to:
1. Exemplify the therapeutic value of human presence when providing care to people
experiencing the childbearing cycle and neonates.
2. Recognize the lifecycle events including childbearing as normal, advocate for nonintervention
in the absence of complications and for shared decision-making, right to self-determination,
and informed choice when communicating with, counseling, and guiding those individuals
experiencing childbearing.
3. (With direct preceptor or faculty supervision) Use critical thinking skills when
identifying and managing complications and emergencies.
Depending on the setting of clinical experiences, upon completing this course the
student will be able to:
4. Integrate relevant evidence-based knowledge and research into the midwifery management
process to improve health outcomes of people across the life span, including the childbearing
cycle, and neonates in accordance with the ACNM Philosophy, Standards, and Code of
Ethics.
5. Demonstrate beginning clinical judgment skills when providing primary care based
on a comprehensive evidence-based plan to people experiencing common health problems
and gynecological/reproductive/sexual health concerns and deviations emphasizing health
promotion and education, disease prevention, and informed decision-making.
6. Demonstrate beginning clinical judgment skills when providing preconception care
including: assessing for risk factors and readiness for pregnancy; performing indicated
health screenings; counseling regarding fertility awareness, pregnancy spacing, and
discontinuance of contraceptive use; and addressing infertility issues using consultation,
collaboration, and referral as indicated.
7. Demonstrate beginning clinical judgment skills when providing evidence-based care
during the antepartum period to promote normal pregnancy and fetal health including
confirmation of pregnancy and pregnancy dating, management of unplanned pregnancies,
management of spontaneous abortion, anticipatory guidance related to birth, infant
feeding, emotional changes, and education on the minor discomforts of pregnancy.
8. Demonstrate beginning clinical judgment skills when providing evidence-based care
during the intrapartum period including: assessment of labor; pharmacologic and nonpharmacologic
support; emotional, psychological, spiritual, and social support; administration of
local anesthesia; fetal assessment; management of spontaneous vaginal birth; management
of the third stage of labor; episiotomy if indicated and repair of lacerations; and
family/household support.
9. Demonstrate beginning clinical judgment skills when providing evidence-based care
during the postpartum period including: management of involution and common discomforts;
anticipatory guidance and counseling regarding mental health, self-care, resumption
of sexual activity, contraception, and pregnancy spacing; and lactation or safe formula
feeding.
10. Demonstrate beginning clinical judgment skills when providing evidence-based care
to the neonate immediately after birth and up to 28 days of life by: supporting physiologic
transition to extrauterine life including infant resuscitation if needed; assessing
for gestational age and deviations from normal development; developing a plan of care
for feeding, preventive care, and interaction during the neonatal period; and promoting
safe
integration into the family/household.
11. Evaluate nursing interventions and repeat the midwifery management process as
needed.
Exemplars of Course Learning Outcomes
1. Document clinical experiences in Typhon. [CLO1-11]
2. Perform a pelvic exam on a patient demonstrating sensitivity to patient values
and experiences.[CLO 1, 5-8, 11]
3. Apply the midwifery management process when caring for a person receiving preconception
care. [CLO2,4-6, 11]
4. Perform a prenatal assessment on a pregnant person that includes pregnancy dating,
Leopold’s maneuvers, fundal height assessment, and assessment of fetal well-being.[CLO
7, 11]
American College of Nursing Midwives Core Competencies for Basic Midwifery Practice
Includes the fundamental knowledge, skills, and abilities expected of new midwives
certified by
the American Midwifery Certification Board (AMCB).
I. Hallmarks of Midwifery – The art and science of midwifery are characterized by
the following hallmarks:
A. Recognition, promotion, and advocacy of menarche, pregnancy, birth, and menopause
as normal physiologic and developmental process
B. Advocacy for non-intervention in physiologic processes in the absence of complications
H. Utilizing an understanding of social determinants of health to provide highquality
care to all persons including those from underserved communities
K. Advocating for informed choices, shared decision making, and the right for self-determination
P. Ability to collaborate with and refer to other members of the interprofessional
health care team
III. Components of Midwifery Care: Midwifery Management Process – The
midwifery management process guides all areas of clinical care. When engaging in
the management process the midwife:
E. Develops a comprehensive evidence-based plan of care in partnership with the client
that is supported by a valid rationale, is based on the preceding steps (assessment,
problem identification, evaluation), and includes therapeutics as indicated
F. Assumes responsibility for the safe an efficient implementation of an evidenced-based
plan of care including the provisions of treatments and interventions as indicated
V. Components of Midwifery Care - While each person’s life is a continuum, midwifery care can be divided into primary, preconception, gynecologic/reproductive/sexual health, antepartum intrapartum and postpregnancy care:
A. A midwife demonstrates the knowledge, skills, and abilities to provide primary
care of the individuals they serve
B. A midwife demonstrates the knowledge, skills, and abilities to provide preconception
care
C. A midwife demonstrates the knowledges, skills, and abilities to provide comprehensive
gynecologic/reproductive/sexual health care
D. A midwife demonstrates the knowledge, skills, and abilities to provide care in
the antepartum period
E. A midwife demonstrates the knowledge, skills, and abilities to provide care in
the intrapartum period
F. A midwife demonstrates the knowledge, skills, and abilities to provide care in
the period following pregnancy
G. A midwife demonstrates the knowledge, skills, and abilities to independently manage
the care of the well neonate (newborn immediately after birth and up to 28 days of
life)
American College of Nurse Midwives Competencies for Practice Doctorate in Midwifery
1. Translate expert clinical knowledge and research relevant to midwifery into best
practice models
3. Interpret and apply research related to the national and international distribution
and determinants of health and disease in women and newborns
5. Use effective communication and leadership skills to enhance team function and
promote positive change in health care of women and newborns
American College of Nurse Midwives Core Values
• Excellence
• Evidence based care
• Inclusiveness
• Woman-centered care
• Primary care
• Partnership
• Advocacy
Recommended Content:
- Midwifery management process when caring for people experiencing the childbearing cycle
- Midwifery management process when caring for the well neonate immediately after birth and up to 28 days of life
- Midwifery management process when providing primary care to people throughout the lifespan with chronic health deviations, preconception health needs and gynecological/reproductive/sexual health needs
Approved by GAAC: 9/9/2022
Approved by Faculty: 9/12/2022