Post Basic Midwifery Education Certificate Programme

Programme Overview

Aim of the Programme

The aim of the Post Basic Midwifery Programme is to prepare a professional nurse midwife with the requisite knowledge, skills and behaviours to deliver safe and effective, evidenced-based care and to assume responsibility and accountability for his/her practice as a midwife.

Overview of the Post Basic Midwifery Programme

The fifteen Months Post Basic Midwifery Education Programme is a course of study in the theory and practice of the art and science of Midwifery. It is designed specifically for qualified post-registered nurses, enabling them on successful completion of the programme to be entered on the midwifery part of the register maintained by the St. Christopher and Nevis Nurses and Midwives Council and to earn the title registered nurse-midwife. It also provides for equitable and appropriate placement of midwives in varied health care roles.

The programme is also designed to prepare a workforce of professionals with the requisite knowledge, skills and behaviors necessary to care for and improve the lives of parents and child and the family as a whole. The main focus of the programme therefore is meeting the needs of child-bearing families in the promotion of normal, healthy pregnancy and child-birth and care of the new-born. The programme further equips students to address deviations from the norm, as well as challenges and issues associated with midwifery care and management.

Organization and Structure of the Programme

The fifteen months Post Basic Midwifery programme is comprised of eleven (11) modules which are organized and delivered in blocks of theory and clinical practice, and run concurrently. The programme is so arranged to facilitate the congruence between and or/support the application of theory and practice. The programme utilizes sound pedagogical approaches to teaching and learning, is competency based and grounded in current specific evidence. It integrates the nursing process and critical thinking skills for clinical decision making and problem solving as the basis to provide quality maternal health care. The core content of the programme is the pregnancy continuum and women’s and family health.

The programme commences with a four (4) week introductory block and culminates with a four (4) week clinical internship and a one (1) week review block, prior to final examination. Opportunities are provided during clinical blocks for students to acquire necessary learning experiences and practical skills in both hospital and community-based settings.

Students are required to adapt and build on transferable skills from prior nursing experiences.

Programme Certification

The Certificate to be awarded will be the Post Basic Certificate in Midwifery.

EQUIVALENCE AND ARTICULATION

The Certificate may be used for entry into higher education or for advanced specialty clinical placement.

MODULE I – INTRODUCTION TO MIDWIFERY

Unit 1          Historical trends in Midwifery

Unit 2          Contemporary Maternity-Newborn Care

Unit 3          Roles, Responsibilities and Scope of practice of the Midwife in the Changing Context of Maternity Care

Unit 4          Perspectives and Challenges of Midwifery in St. Kitts and Nevis

Unit 5          Culture and the Child-bearing Family

Unit 6          Special Ethical issues and Legal Considerations in Maternity Care

Unit 7          Concepts, Principles and Perspectives of the International Confederation of Midwives (ICM)

Unit 8          Evidenced-based Practice in Maternal and New-born Nursing

MODULE II – PRE-CONCEPTUAL COUNSELLING AND EDUCATION IN THE PROMOTION OF REPRODUCTIVE HEALTH

 Unit 1- Social, Cultural and Biopsychosocial Influences affecting women’s Health   Globally

Unit 2- Unit 2- Preparation for Pregnancy and Parenthood

Unit 3- Education for Families with Special Reproductive Concerns and

Gynecologic problems

Unit 4- Review of Family Planning Methods and Practices

Unit 5- Health Promotion relative to Women’

MODULE III – REPRODUTIVE ANATOMY AND PHYSIOLOGY

Unit 1- Sexual Differentiation

Unit 2- Structure and Function of the Male Reproductive System

Unit 3- Hormonal Control of the Male Reproductive System

Unit 4- Structure and Function of the Female Reproductive System

Unit 5- Hormonal Control of the Female Reproductive Cycle

Module IV- FOETAL DEVELOPMENT

Unit 1- Fertilization and Early Development

Unit 2- The Placenta

Unit 3- Pre-embryonic, Embryonic and Fetal Stages of Development

Unit 4- Congenital Malformations

Module V- CHANGES AND ADAPTATION IN PREGNANCY

Unit 1- Diagnosis of Pregnancy

Unit 2- Physiological Changes of Pregnancy

Unit 3- Individual and Family Adaptation to Pregnancy

Unit 4- Antenatal Care and Management

Module VI- PROBLEMS ASSOCIATED WITH PREGNANCY

Unit 1- Abnormalities of Early Pregnancy

Unit 2- Specific Conditions related to Pregnancy

Unit 3- Common Medical Disorders of Pregnancy

Unit 4- Multiple Pregnancies

Unit 5- Specialized Antenatal and Fetal Investigations

Module VII – NORMAL LABOUR AND DELIVERY

Unit 1- Physiology of the 1^st Stage of Labour

Unit 2- Management of the 1^st Stage of Labour

Unit 3- Fetal Monitoring during Labour

Unit 4- Pharmacotherapeutics in Obstetrics

Unit 5- Transition and Physiology of the Second Stage of Labour

Unit 6- Management of the Second Stage of labour

Unit 7- Physiology and Management of the Third Stage of Labour

Module VIII – CHALLENGES OF PREGNANCY, LABOUR AND DELIVERY

Unit 1- Prolonged Pregnancy

Unit 2- Disorders of Uterine Action

Unit 3- Malpositions of the Occiput and Malpresentations

Unit 4- Obstetric Anesthesia and Operative Deliveries

Unit 5- Midwifery and Obstetric Emergencies

Unit 6- Needs and Management of the Woman with Obstetrical Emergencies

Unit 7- Complications of the Third Stage Labour

Module IX – THE PUERPERIUM

Unit 1- Physiology and Care of the Woman in the Puerperium

Unit 2- The Postnatal Emotional and Psychological response to Pregnancy and Childbirth

Unit 3- Complications and Management of the Puerperium

Unit 4- Loss and Bereavement in Maternity Practice

Module X – THE NEWBORN BABY

Unit 1- The Baby at Birth

Unit 2- The Normal Baby

Unit 3- Nutrition and Feeding of the Newborn

Unit 4- Promotion of the Baby Friendly Initiative

Unit 5- The Healthy Low Birth Weight Baby

Module XI – PROBLEMS ASSOCIATED WITH THE NEWBORN

Unit 1- Recognizing and Managing the Ill/High Risk Baby

Unit 2- Respiratory Deficits/Problems

Unit 3- Neonatal Infections

Unit 4- Haemorrhage and Convulsions

Unit 5- Congenital Abnormalities

Unit 6- Jaundice and the Newborn

Unit 7- Metabolic Problem and Endocrine Disorders

Unit8- Drug Withdrawal in the Newborn

Programme Hours

Delivery Strategies

• Lecture
• Discussion
• Individual and Group Projects/Presentations
• Self-Directed and Peer Learning
• Case Study
• Clinical Simulation Laboratory Activities
• Demonstration and Return Demonstration
• Role Play
• Observational/participatory activities in varied community and hospital based maternal and child-health settings 

EVALUATION OF THE PROGRAMME

FORMATIVE

• In-class end of module assessments (Written/Practical)
• Case Study
• Portfolio of Clinical Experiences
• Practical Assessments

Course Work will contribute 40% of the final grade/score.

SUMMATIVE

The final examination would consist of a written paper and a practical exam.

Written paper – 100 objective type questions (20%) of final grade/score

Practical Exam – OSCE format (40% of final grade/score

Final Examination accounts for 60% of the final grade/score.

The passing grade is 50%. Pupil midwives who are unsuccessful in the first sitting of the examination are allowed two re-sits at six (6) weeks intervals.

CRITERIA FOR WRITING FINAL EXAMINATION

• All Assessments, Projects and Assignments must be completed prior to writing final examination
• Record must indicate a minimum of 85% classroom and 95% clinical attendance.
• Students falling below the required clinical attendance will be expected to make up the deficit before writing final exams.
• Portfolio must be completed to include signing of all entries by relevant personnel and submitted by due date.
• The stipulated number of deliveries, a programme completion requirement must be met, before final exams are written.

CLINICAL ASSESSMENTS

• Clinical skills and procedures are assessed on a continuous basis throughout the programme.
• Clinical skills will be assessed in the simulation laboratory and clinical practice settings.
• It is the responsibility of students to have their continuous assessment form checked and signed off by the relevant personnel.
• Students will not be assessed on a particular procedure/skill unless they have acquired the required number of check-offs prior to being assessed on the particular procedure/skill.

CRITERIA FOR COMMENCING DELIVERIES

• Pupil Midwife must observe ten (10) deliveries which should be recorded on the form provided and signed by the Obstetrician and or/ attendant Nurse-Midwife.
• Pupil Midwife must successfully defend witness cases before a panel comprising of College Faculty and Clinical Staff
• Pupil Midwife must demonstrate correct method of mechanism of labour by passing the doll through the pelvis.
• Patient’s docket number must be recorded when writing up witness cases and deliveries, for verification purposes.

SICKNESS AND ABSENCE POLICY

• All absences during the Programme must be reported promptly to the Programme Coordinator (whether in clinical or classroom) no later than 9:00 am on the day of absence, if possible. This applies to week-end and public holidays.
• The Nurse in Charge must also be informed of absence, when on clinical placement, preferably before the start of the Shift.
• Absence of less than five days should be made up during that particular placement for which student was absent and must be arranged with the Programme Coordinator and Nurse-in Charge. Only one day per week can be used for ‘make-up’ of absence.
• When reporting absence, the pupil midwife must make a note of the person whom they spoke with.
• A request for authorized absence (compassionate or otherwise) must be made through the Programme Coordinator.
• All absences exceeding 5% must be made up before writing final examination.
• A ‘make-up’ clinical attendance record form will be issued to the pupil midwife to ensure accuracy and for documentation purposes.
• All absences will be recorded in the pupil midwife’s file.
• Pupil Midwives in excess of 20% absence will be required to meet with the Programme Coordinator, and further action taken as deemed necessary.

SUBMISSION OF COURSE WORK

• All course work/projects/ and or assignments must be submitted on the date and time specified.
• Work submitted after the specified deadline, will result in 5% of the total mark been deducted for each day that the work is not submitted.
• Course work will not be accepted after the due date unless in attenuating circumstances, to be decided by the Programme Coordinator or in cases where special permission has been granted.
• Please refer to and be guided by the College’s Plagiarism Policy at all times.
• All twenty deliveries must be written up in your log book.
• Evidence must be provided e.g. signature of doctor/nurse, patient’s docket number, etc for verification of work posted in your log book.
• Please note that names of patients/clients, under no circumstance, are to be recorded in your log book, projects, case study, note book or any document in your possession

ON-CALL SYSTEM

During the Programme an “on-call” system will be implemented, designed specifically to assist the pupil-midwife to attain the required number of deliveries, a necessary criterion for graduation from the programme. Please note the following:

• A rotation schedule for “on-calls’ will be constructed by the Clinical Facilitator of the Institution of practice and the College Staff. Any related concerns regarding schedules must be directed to the personnel aforementioned.
• On-call schedules will include week-ends, public holidays and after 4:00 PM during community and theoretical blocks
• It is advisable to take a snack/drink when on call as you can be at the clinical site for long, extended hours.
• It is your responsibility to put measures in place for child-care and also for transportation as you may have to arrive at the clinical site with little advance notice.
• It is not the responsibility of the Maternity Unit to keep you informed of pending deliveries, admissions and/ or women in labour and therefore will not necessarily be expected to alert you of such activities.
• It is your responsibility to take full advantage of this opportunity and be punctual and present at clinical site as per “on-call” schedule.

PROFESSIONAL EXPECTATIONS

 The Pupil Midwife is expected to demonstrate professionalism in manner, appearance, attire, deportment and conduct at all times whether in the classroom, community or in the clinical environment. The following are some of the required professional behaviour expected of the Pupil Midwife:

• Practices in accordance with ethical and legal standards of the profession e.g. respect for patients/clients privacy and confidentiality of their information.
• Exhibits culturally appropriate behaviour and respect when dealing with individuals of different cultural background
• Respects all individual differences (i.e. ethnicity, religion, gender, age, sexual orientation).
• Demonstrates a spirit of team-work and helping behavior for colleagues
• Displays honesty, integrity and accountability in your line of duty, as well as appropriate verbal and non-verbal behaviour and open and assertive communication.
• Demonstrate an attitude of caring and empathy
• Maintains personal and professional ethics
• Shows respect for patients/clients and their families, peers, faculty members and members of the Health Care Team.
• Respects the personal space and quiet time of others.
• Demonstrates limited or in the event appropriate use of cell phones and pagers, particularly in clinical environments.
• Maintains anxiety to a functional level in the clinical setting
• Takes responsibility for own learning by asking questions, incorporating constructive feed-back on your performance into the management of patients/clients and reading current literature and other sources of information e.g. on-line books.