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Toll K, Sharp T, Reynolds K, Bradfield Z. Advanced midwifery practice: A scoping review. Women Birth 2024; 37:106-117. [PMID: 37845089 DOI: 10.1016/j.wombi.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/18/2023]
Abstract
PROBLEM There is no international standard for advanced midwifery scope of practice. BACKGROUND Globally, there is variance in how scope of midwifery practice is determined and regulated, with no consensus on extended or advanced scope. This can lead to under-utilised staff potential, un-met consumer need, and loss of professional skill. AIMS The aim of this scoping review was to synthesise and map what is reported in the international literature on the advanced scope of midwifery practice. METHODS A systematic scoping review methodology was adopted utilising Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A full search was conducted of databases including MEDLINE, CINAHL, Scopus, Google. Publications from 2019 to August 2022 that met criteria were included. Reported skills were mapped to the International Confederation of Midwives (ICM) competencies of pre-conception, antenatal, labour and birth, postnatal plus globally identified areas for midwifery investment. FINDINGS 28 articles met inclusion criteria. Reported skills included abortion care (n = 6), prescribing (n = 7), ultrasound (n = 2), advanced practice skills (n = 7), midwifery-led skills, primary health, post-graduate education, HIV/AIDS testing, advocacy, and acupressure (all n = 1). DISCUSSION This review presents a synopsis of publications describing what has been defined as advanced midwifery scope of practice in international contexts. CONCLUSION Establishing evidence of midwives working to the peak of professional scope is important to continue to develop professional capacity and support contemporary practice, regulation, governance, and policy while improving consumer access to equitable care. Findings aid service development, provision, and professional planning.
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Affiliation(s)
- Kaylie Toll
- School of Population Health, Curtin University, Perth, Western Australia, Australia.
| | - Tarryn Sharp
- WA Country Health Service, Western Australia, Australia
| | - Kate Reynolds
- WA Country Health Service, Western Australia, Australia
| | - Zoe Bradfield
- School of Nursing, Curtin University, Perth, Western Australia, Australia; King Edward Memorial Hospital, Bagot Rd, Subiaco, Perth, Western Australia, Australia
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Jolles DR, Niemczyk N, Hoehn Velasco L, Wallace J, Wright J, Stapleton S, Flynn C, Pelletier-Butler P, Versace A, Marcelle E, Thornton P, Bauer K. The birth center model of care: Staffing, business characteristics, and core clinical outcomes. Birth 2023; 50:1045-1056. [PMID: 37574794 DOI: 10.1111/birt.12745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 02/28/2023] [Accepted: 06/24/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES Interest in expanding access to the birth center model is growing. The purpose of this research is to describe birth center staffing models and business characteristics and explore relationships to perinatal outcomes. METHODS This descriptive analysis includes a convenience sample of all 84 birth center sites that participated in the AABC Site Survey and AABC Perinatal Data Registry between 2012 and 2020. Selected independent variables include staffing model (CNM/CM or CPM/LM), legal entity status, birth volume/year, and hours of midwifery call/week. Perinatal outcomes include rates of induction of labor, cesarean birth, exclusive breastfeeding, birthweight in pounds, low APGAR scores, and neonatal intensive care admission. RESULTS The birth center model of care is demonstrated to be safe and effective, across a variety of staffing and business models. Outcomes for both CNM/CM and CPM/LM models of care exceed national benchmarks for perinatal quality with low induction, cesarean, NICU admission, and high rates of breastfeeding. Within the sample of medically low-risk multiparas, variations in clinical outcomes were correlated with business characteristics of the birth center, specifically annual birth volume. Increased induction of labor and cesarean birth, with decreased success breastfeeding, were present within practices characterized as high volume (>200 births/year). The research demonstrates decreased access to the birth center model of care for Black and Hispanic populations. CONCLUSIONS FOR PRACTICE Between 2012 and 2020, 84 birth centers across the United States engaged in 90,580 episodes of perinatal care. Continued policy development is necessary to provide risk-appropriate care for populations of healthy, medically low-risk consumers.
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Affiliation(s)
- Diana R Jolles
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
- Clinical Faculty, Frontier Nursing University, Hyden, Kentucky, USA
| | - Nancy Niemczyk
- Nurse-Midwife Program, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Jacqueline Wallace
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - Jennifer Wright
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - Susan Stapleton
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | - Cynthia Flynn
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
| | | | | | - Ebony Marcelle
- Community of Hope, Washington, District of Columbia, USA
| | | | - Kate Bauer
- American Association of Birth Centers, Perkiomenville, Pennsylvania, USA
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Leslie K, Bourgeault IL, Carlton AL, Balasubramanian M, Mirshahi R, Short SD, Carè J, Cometto G, Lin V. Design, delivery and effectiveness of health practitioner regulation systems: an integrative review. HUMAN RESOURCES FOR HEALTH 2023; 21:72. [PMID: 37667368 PMCID: PMC10478314 DOI: 10.1186/s12960-023-00848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/23/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability, while promoting patient safety. This review aimed to identify evidence on the design, delivery and effectiveness of HPR to inform policy decisions. METHODS We conducted an integrative analysis of literature published between 2010 and 2021. Fourteen databases were systematically searched, with data extracted and synthesized based on a modified Donabedian framework. FINDINGS This large-scale review synthesized evidence from a range of academic (n = 410) and grey literature (n = 426) relevant to HPR. We identified key themes and findings for a series of HPR topics organized according to our structures-processes-outcomes conceptual framework. Governance reforms in HPR are shifting towards multi-profession regulators, enhanced accountability, and risk-based approaches; however, comparisons between HPR models were complicated by a lack of a standardized HPR typology. HPR can support government workforce strategies, despite persisting challenges in cross-border recognition of qualifications and portability of registration. Scope of practice reform adapted to modern health systems can improve access and quality. Alternatives to statutory registration for lower-risk health occupations can improve services and protect the public, while standardized evaluation frameworks can aid regulatory strengthening. Knowledge gaps remain around the outcomes and effectiveness of HPR processes, including continuing professional development models, national licensing examinations, accreditation of health practitioner education programs, mandatory reporting obligations, remediation programs, and statutory registration of traditional and complementary medicine practitioners. CONCLUSION We identified key themes, issues, and evidence gaps valuable for governments, regulators, and health system leaders. We also identified evidence base limitations that warrant caution when interpreting and generalizing the results across jurisdictions and professions. Themes and findings reflect interests and concerns in high-income Anglophone countries where most literature originated. Most studies were descriptive, resulting in a low certainty of evidence. To inform regulatory design and reform, research funders and governments should prioritize evidence on regulatory outcomes, including innovative approaches we identified in our review. Additionally, a systematic approach is needed to track and evaluate the impact of regulatory interventions and innovations on achieving health workforce and health systems goals.
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Affiliation(s)
- Kathleen Leslie
- Athabasca University, Athabasca, Canada.
- Canadian Health Workforce Network, Ottawa, Canada.
| | - Ivy Lynn Bourgeault
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | - Anne-Louise Carlton
- Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia
| | - Madhan Balasubramanian
- College of Business, Government and Law, Flinders University, Adelaide, Australia
- Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia
| | - Raha Mirshahi
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | | | - Jenny Carè
- University of Technology Sydney, Sydney, Australia
| | | | - Vivian Lin
- University of Hong Kong, Hong Kong, China
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Addressing Barriers to APRN Practice: Policy and Regulatory Implications During COVID-19. JOURNAL OF NURSING REGULATION 2023; 14:13-20. [PMID: 37035778 PMCID: PMC10074063 DOI: 10.1016/s2155-8256(23)00064-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Abstract
Advanced practice registered nurses (APRNs) play a pivotal role in providing healthcare, including preventive care services, to the public. However, barriers to APRN practice exist that impact the provision of vital healthcare services that APRNs are authorized to provide based on their education, training, licensure, and certification. This article provides an overview of APRN barriers to practice, including in the face of the COVID-19 pandemic, and discusses key policy and regulatory implications.
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Schorn MN, Myers C, Barroso J, Hande K, Hudson T, Kim J, Kleinpell R. Results of a National Survey: Ongoing Barriers to APRN Practice in the United States. Policy Polit Nurs Pract 2022; 23:118-129. [PMID: 35119332 DOI: 10.1177/15271544221076524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Limited information is available on the barriers to practice for advanced practice registered nurses (APRNs) among states with full, restricted, and reduced practice. The purpose of this study is to identify practice barriers in relationship to United States (U.S.) state practice authority, APRN type, area of practice (rural, suburban, urban), and nature of practice (outpatient, inpatient, and both). An electronic survey of a convenience sample of APRNs was conducted to assess barriers to practice. Identified barriers were examined based on state practice environment, APRN role, practice setting, and location. Data were analyzed using thematic analysis for qualitative data and descriptive analysis for quantitative data. Over 7,000 APRNs representing all 50 states participated. Themes that were identified and reported by respondents, included licensure and administrative barriers, therapy restrictions, physician signature requirements, a lack of collegiality, prescribing barriers, uneven reimbursement, physician only procedures, and telehealth issues. Barriers were identified in all states, regardless of the type of practice authority. All four APRN role types identified practice barriers, some of which were more frequent for some roles than others. Restrictions for home health approval and the requirement for a physician signature for durable medical supply orders were identified by over 40% of respondents practicing in rural areas. Barriers to APRN practice continue to restrict aspects of patient care and patient access to care, even in states with full practice authority. Continued efforts to reduce barriers to APRN practice are needed to ensure patient access to care, especially in rural areas.
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Affiliation(s)
- Mavis N Schorn
- School of Nursing, 5718Vanderbilt University, Nashville, USA
| | - Carole Myers
- College of Nursing, 16166The University of Tennessee Knoxville, Knoxville, USA
| | - Julie Barroso
- School of Nursing, 5718Vanderbilt University, Nashville, USA
| | - Karen Hande
- School of Nursing, 5718Vanderbilt University, Nashville, USA
| | - Tamika Hudson
- School of Nursing, 5718Vanderbilt University, Nashville, USA
| | - Jennifer Kim
- School of Nursing, 5718Vanderbilt University, Nashville, USA
| | - Ruth Kleinpell
- School of Nursing, 5718Vanderbilt University, Nashville, USA
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Kleinpell R, Myers CR, Likes W, Schorn MN. Breaking Down Institutional Barriers to Advanced Practice Registered Nurse Practice. Nurs Adm Q 2022; 46:137-143. [PMID: 35239584 DOI: 10.1097/naq.0000000000000518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Advanced practice registered nurses (APRNs) significantly contribute to health promotion, disease prevention, and disease management. Yet, barriers to APRN practice exist, including regulatory, state, and institutional barriers, that hinder their ability to practice to the full extent of their education, licensure, and certification. Nurse leaders can play an important role in helping reduce unnecessary institutional barriers to APRN practice.
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Affiliation(s)
- Ruth Kleinpell
- Vanderbilt University School of Nursing, Nashville, Tennessee (Drs Kleinpell and Schorn); University of Tennessee College of Nursing, Knoxville (Dr Myers); and University of Tennessee Health Science Center College of Nursing, Memphis (Dr Likes)
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Ross L, Jolles D, Hoehn-Velasco L, Wright J, Bauer K, Stapleton S. Salary and Workload of Midwives Across Birth Center Practice Types and State Regulatory Structures. J Midwifery Womens Health 2022; 67:244-250. [PMID: 35191600 DOI: 10.1111/jmwh.13331] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/29/2021] [Accepted: 11/03/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Expansion of the midwifery-led birth center model of care is one pathway to improving maternal and newborn health. There are a variety of practice types among birth centers and a range of state regulatory structures of midwifery practice across the United States. This study investigated how those variations relate to pay and workload for midwives at birth centers. METHODS Data from the American Association of Birth Centers Practice Survey and the Bureau of Labor Statistics' report on occupational employment and wage statistics were analyzed to explore how midwife salaries and workload at birth centers compare within and beyond the birth center model. RESULTS Survey results from 161 birth centers across the United States demonstrate wide variation in nurse-midwife salaries and are inconsistent with nurse-midwife salaries across all settings as reported by the Bureau of Labor Statistics. The reported number of hours worked by midwives within the birth center model is high. Salaries of midwives who work in birth center-only practices were consistently lower than salaries of midwives who worked in blended birth center and hospital practices, independent of the midwife's level of experience, geographic region of the country, and state regulatory structure. DISCUSSION Further research is needed to understand how to bring salaries and workload for midwives at birth centers into alignment with national averages.
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Affiliation(s)
- Lisa Ross
- American Association of Birth Centers, Perkiomenville, Pennsylvania
| | - Diana Jolles
- Frontier Nursing University, Versailles, Kentucky
| | | | - Jennifer Wright
- American Association of Birth Centers, Perkiomenville, Pennsylvania
| | - Kate Bauer
- American Association of Birth Centers, Perkiomenville, Pennsylvania
| | - Susan Stapleton
- American Association of Birth Centers, Perkiomenville, Pennsylvania
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Kleinpell R, Myers CR, Schorn MN, Likes W. Impact of COVID-19 pandemic on APRN practice: Results from a national survey. Nurs Outlook 2021; 69:783-792. [PMID: 34176669 PMCID: PMC8112385 DOI: 10.1016/j.outlook.2021.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/19/2021] [Accepted: 05/01/2021] [Indexed: 11/26/2022]
Abstract
Background The impact of the COVID-19 pandemic on Advanced Practice Registered Nurse (APRN) practice is not well known. Purpose This study aimed to describe state practice barriers and explore the effects of the COVID-19 pandemic on APRN practice. Methods A descriptive study design used a 20-item web-based survey open from June 1 through September 23, 2020. Findings A total of 7,467 APRNs responded from all 50 states, including nurse practitioners (n = 6,478, 86.8%), certified registered nurse anesthetists (n = 592, 7.9%), certified nurse-midwives (n = 278, 3.7%), and clinical nurse specialists (n = 242, 3.2%). A number of barriers to practice prior to the pandemic were identified. Most respondents (n = 6334, 84.8%) identified that practice barriers limited the ability of APRNs to provide care during the pandemic. Discussion Barriers to APRN practice continue to restrict aspects of patient care and patient access to care, even in states with Full Practice Authority (FPA), during the COVID-19 pandemic and with state executive orders waiving practice restrictions. The study findings can be used to advocate for policy changes to support APRN practice authority.
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Affiliation(s)
| | - Carole R Myers
- University of Tennessee College of Nursing, Knoxville, TN
| | | | - Wendy Likes
- University of Tennessee Health Science Center College of Nursing, Memphis, TN
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De la Fuente-Solana EI, Pradas-Hernández L, González-Fernández CT, Velando-Soriano A, Martos-Cabrera MB, Gómez-Urquiza JL, Cañadas-De la Fuente GA. Burnout Syndrome in Paediatric Nurses: A Multi-Centre Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1324. [PMID: 33535707 PMCID: PMC7908244 DOI: 10.3390/ijerph18031324] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Burnout syndrome is an increasingly prevalent problem, characterised by emotional exhaustion (EE), depersonalization (D), and low personal accomplishment (PA), feelings that appear with prolonged exposure to stress-inducing situations. The syndrome alters physical well-being and endangers the quality of services provided. Among nurses working in the paediatric area, the association between burnout and the corresponding risk profile has received little research attention, despite the highly stressful nature of this work. MATERIALS AND METHODS The study population was composed of 95 nurses working in four hospitals in the province of Granada. Data were collected using the Maslach Burnout Inventory, the NEO Personality Inventory, and the Educational-Clinical Questionnaire: Anxiety and Depression. RESULTS According to the results obtained, 22.0% of the nurses working in the paediatric area present high levels of EE, 18.5% present high levels of D, and 39.6% had feelings of low PA. These burnout levels do not depend on sociodemographic or labour variables, but the three domains of the syndrome are related to the psychological factors analysed. CONCLUSIONS Among the nurses who participated in this study, 38.6% presented high levels of burnout, especially regarding feelings of low personal accomplishment. Personality factors play an important role in the development of this syndrome. This study shows the impact of burnout in paediatric nurses as well as the risk factors, providing information for the development of strategies to prevent it.
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Affiliation(s)
- Emilia I. De la Fuente-Solana
- Brain, Mind and Behavior Research Center (CIMCYC), Campus Universitario de Cartuja s/n, University of Granada, 18071 Granada, Spain;
| | - Laura Pradas-Hernández
- San Cecilio Clinical University Hospital, Andalusian Health Service, Avenida de la Investigación s/n, 18016 Granada, Spain;
| | - Carmen Tamara González-Fernández
- Virgen de las Nieves University Hospital, Andalusian Health Service, Avenida de las Fuerzas Armadas, nº6, 18014 Granada, Spain; (C.T.G.-F.); (A.V.-S.)
| | - Almudena Velando-Soriano
- Virgen de las Nieves University Hospital, Andalusian Health Service, Avenida de las Fuerzas Armadas, nº6, 18014 Granada, Spain; (C.T.G.-F.); (A.V.-S.)
| | - María Begoña Martos-Cabrera
- San Cecilio Clinical University Hospital, Andalusian Health Service, Avenida de la Investigación s/n, 18016 Granada, Spain;
| | - José L. Gómez-Urquiza
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración 60, 18016 Granada, Spain; (J.L.G.-U.); (G.A.C.-D.l.F.)
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De la Fuente-Solana EI, Suleiman-Martos N, Velando-Soriano A, Cañadas-De la Fuente GR, Herrera-Cabrerizo B, Albendín-García L. Predictors of burnout of health professionals in the departments of maternity and gynaecology, and its association with personality factors: A multicentre study. J Clin Nurs 2020; 30:207-216. [PMID: 33090612 DOI: 10.1111/jocn.15541] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/21/2020] [Accepted: 10/10/2020] [Indexed: 12/26/2022]
Abstract
AIMS AND OBJECTIVES To analyse the prevalence, levels and phases of burnout syndrome in midwives and obstetrics and gynaecology nurses, and to evaluate the relationship between burnout and sociodemographic, occupational and psychological factors. BACKGROUND Burnout syndrome is a major problem in occupational health, characterised by feelings of exhaustion, depersonalisation and a low sense of personal achievement that appears after long-term occupational stress. Recent research has found that burnout harms the physical and mental well-being of workers, and jeopardises the quality of care provided. The association between burnout and a risk profile in maternity wards has not previously been investigated but it deserves special attention since it is a highly stressful area to work in. DESIGN A cross-sectional survey design was selected. METHODS A total of 150 nurses and midwives at 18 hospitals participated in this study. The data were collected using the Maslach Burnout Inventory, NEO Personality Inventory and the Educational-Clinical Questionnaire: Anxiety and Depression. This study adhered to the STROBE guideline. RESULTS 17% of participants presented high levels of emotional exhaustion, 16.6% high depersonalisation and 55.1% a sense of low personal accomplishment. The sociodemographic and occupational variables related to burnout were gender, marital status and work shift. The three dimensions of the syndrome, emotional exhaustion, depersonalisation and personal accomplishment were predicted by depression, neuroticism, agreeableness and openness. CONCLUSIONS One third of the sample presented high levels of burnout, which was most strongly experienced as feelings of low personal accomplishment. Furthermore, personality factors play an important role in the development of burnout syndrome. RELEVANCE TO CLINICAL PRACTICE Managers and policy makers should promote strategies to reduce burnout. To prevent the syndrome, personality factors should be taken into account, for the early identification of a profile of professionals most at risk of developing burnout.
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Affiliation(s)
- Emilia I De la Fuente-Solana
- Brain, Mind and Behaviour Research Center (CIMCYC), Faculty of Psychology, University of Granada, Granada, Spain
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Krause SA, DeJoy SA, Sankey HZ. Innovations in Midwifery Education: The Academic Medical Center Model. J Midwifery Womens Health 2019; 64:649-656. [PMID: 31264777 DOI: 10.1111/jmwh.12989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/11/2019] [Accepted: 04/15/2019] [Indexed: 11/30/2022]
Abstract
Workforce analyses project a need for women's health care providers, especially in maternity care. With a stagnant number of certified nurse-midwife/certified midwife (CNM/CM) education programs, the present production of new CNMs/CMs is not robust enough to meet the growing demand. This article describes an existing but underutilized model for CNM/CM education programs, based in an academic medical center with an existing academic affiliation. Advantages include a federal funding source through the Centers for Medicare and Medicaid Services, lower tuition costs than most current programs, and expanded job satisfaction for CNMs/CMs in clinical practice.
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Affiliation(s)
- Susan A Krause
- Midwifery Education Program, Division of Midwifery and Community Health, Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts
| | - Susan A DeJoy
- Division of Midwifery and Community Health, Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts
| | - Heather Z Sankey
- Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, Massachusetts
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McDonald JA, Amatya A, Gard CC, Sigala J. In States That Border Mexico, Cesarean Rates Were Highest For Hispanic Women Living In Border Counties In 2015. Health Aff (Millwood) 2019; 38:276-286. [DOI: 10.1377/hlthaff.2018.05369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Jill A. McDonald
- Jill A. McDonald is the Stan Fulton Endowed Chair in Health Disparities Research; director of the Southwest Institute for Health Disparities Research; and a professor in the Department of Public Health Sciences, College of Health and Social Services, New Mexico State University, in Las Cruces
| | - Anup Amatya
- Anup Amatya is an associate professor in the Department of Public Health Sciences; is a member of the Biostatistics and Epidemiology Research Design Core of the Mountain West Idea Clinical and Translational Research–Infrastructure Network (CTR-IN); and is affiliated with the Southwest Institute for Health Disparities Research, College of Health and Social Services, New Mexico State University
| | - Charlotte C. Gard
- Charlotte C. Gard is an associate professor in the Department of Economics, Applied Statistics, and International Business and is affiliated with the Southwest Institute for Health Disparities Research, College of Business, New Mexico State University
| | - Jesus Sigala
- Jesus Sigala is a graduate student in the Department of Economics, Applied Statistics, and International Business and is affiliated with the Southwest Institute for Health Disparities Research, College of Business, New Mexico State University
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