Master Resource Outline

 

Course Title: NRSG 648 Advanced Midwifery Clinical IV

Credits: 6 (clinical)
Semesters Offered: Spring
Prerequisites: NRSG 647
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 fourth of four nurse midwifery clinical courses where students independently apply knowledge, skills, and abilities acquired in the required prerequisite nurse midwifery courses when providing safe, accountable, evidence-based midwifery care in the clinical setting. Students use sound rationale as they proficiently assess and intervene to provide culturally competent, holistic care to people throughout the lifespan including the childbearing cycle and neonates in the first 28 days of life. Students are now about to provide care independently and across settings and to recognize and intervene in complicated and emergency situations referring to other members of the interprofessional health care team as indicated.

Catalog Description:

This is the fourth of four nurse midwifery clinical courses where students independently apply knowledge, skills, and judgment acquired in the required prerequisite midwifery courses when providing culturally competent 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 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. Demonstrate advanced level of clinical judgment when independently identifying and managing complications and emergencies across settings including home, birth center, hospital, or any other maternity care service and referring to members of the interprofessional health care team as needed.
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 advanced levels of clinical judgment, systems thinking, and accountability when independently providing primary care and promoting continuity of 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 advanced levels of clinical judgment, systems thinking, and accountability when independently 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 advanced levels of clinical judgment, systems thinking, and accountability when independently providing evidence-based care during the antepartum period to promote normal pregnancy and fetal health using strategies such as pregnancy dating, management of unplanned pregnancies, management of spontaneous abortion, anticipatory guidance, and education on the minor discomforts.
8. Demonstrate advanced levels of clinical judgment, systems thinking, and accountability when independently providing evidence-based care during the intrapartum period including assessment of labor, pharmacologic and non-pharmacologic 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 advanced levels of clinical judgment, systems thinking, and accountability when independently 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 advanced levels of clinical judgment, systems thinking, and accountability when independently 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. Apply ethical and legal standards when caring for people including those from underserved communities and those identifying as transgender and gender nonconforming (TGNC).
12. Discuss the significance and impact of social determinants of health when identifying unique evidence-based care approaches across settings.
13. Evaluate nursing interventions and repeat the midwifery management process as needed.
14. Discuss the process of one’s individual transition to the role of nurse midwife.

Exemplars of Course Learning Outcomes: The student will:

1. Document clinical experiences in Typhon. [CLO1-3]
2. Perform and repair an episiotomy during the second stage of labor if indicated. [CLO1-4, 8-10]
3. Repair first or second degree lacerations if indicated. [CLO1-4, 8-10]
4. Apply the midwifery management process when caring for a person experiencing a complicated labor. [CLO1-4, 8-10]
5. Participate in a clinical conference that focuses on role transition, licensure, and certification processes specific to state of intended practice. [CLO14]

 

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
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
Q. Ability to provide safe and effective care across settings including home, birth center, hospital, or any other maternity care service

III. Components of Midwifery Care: Midwifery Management Process – Components of Midwifery Care: Midwifery Management Process:

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 throughout 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 life span 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