Advanced midwifery practice: An evolutionary concept analysis |
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| Affiliation: | 1. University Centre for Nursing & Midwifery, Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, U.Z. 5K3, De Pintelaan 185, B-9000 Ghent, Belgium;2. School of Health Sciences, Faculty of Health & Medical Sciences, University of Surrey, Duke of Kent Building, University of Surrey, Guildford, Surrey GU2 7XH, United Kingdom;3. University Hospital Ghent, De Pintelaan 185, B-9000 Ghent, Belgium;1. Erasmus University College Brussels, Department Health Care, Knowledge Centre Brussels Integrated Care, Midwifery Section, Belgium;2. Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Rehabilitation Research, Belgium;3. Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Department of Biostatistics and Medical Informatics, Belgium;4. Vrije Universiteit Brussel (VUB), Faculty of Medicine and Pharmacy, Department Medical Sociology, Belgium;5. University Hospital Brussels, Nursing and Midwifery Research Unit, Belgium;1. James Paget University Hospitals NHS Foundation Trust, Lowestoft Road, Gorleston, Gt Yarmouth, Norfolk NR31 6LA, UK;2. School of Nursing Sciences, Edith Cavell Building, University of East Anglia, Norwich NR4 7TJ, UK;1. Department of Health Services Research, University of Liverpool, Waterhouse Blds, Block B, 1-5 Brownlow Street, Liverpool L69 3GL, England, UK;2. Centre for Midwifery, Maternal and Perinatal Health, Faculty of Health & Social Sciences, Bournemouth University, Bournemouth House, 19, Christchurch Road, Bournemouth, BU1 3LH, England, UK;3. School of Nursing, University of San Diego, San Diego, CA, USA;4. School of Nursing, University of Minnesota, Minneapolis, MN, USA;5. School of Healthcare, Faculty of Medicine and Health, University of Leeds, Leeds, England, UK;6. School of Nursing and Midwifery, University College Cork, Cork, Ireland;7. Institute of Midwifery, School of Health Professions, Zürich University of Applied Sciences ZHAW, Zürich, Switzerland;8. Independent Consultant, Michigan, USA;9. Independent Consultant, Bristol, England, UK;1. Department of Health Administration and Policy, George Mason University, Fairfax, VA;2. Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN |
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| Abstract: | Aimthe concept of ‘advanced midwifery practice’ is explored to a limited extent in the international literature. However, a clear conception of advanced midwifery practice is vital to advance the discipline and to achieve both internal and external legitimacy. This concept analysis aims to clarify advanced midwifery practice and identify its components.Methodsa review of the literature was executed using Rodgers’ evolutionary method of concept analysis to analyze the attributes, references, related terms, antecedents and consequences of advanced midwifery practice.Resultsan international consensus definition of advanced midwifery practice is currently lacking. Four major attributes of advanced midwife practitioners (AMPs) are identified: autonomy in practice, leadership, expertise, and research skills. A consensus was found on the need of preparation at master’s level for AMPs. Such midwives have a broad and internationally varied scope of practice, fulfilling different roles such as clinicians, clinical and professional leaders, educators, consultants, managers, change agents, researchers, and auditors. Evidence illustrating the important part AMPs play on a clinical and strategic level is mounting.Key conclusionsthe findings of this concept analysis support a wide variety in the emergence, titles, roles, and scope of practice of AMPs. Research on clinical and strategic outcomes of care provided by AMPs supports further implementation of these roles. As the indistinctness of AMPs’ titles and roles is one of the barriers for implementation, a clear conceptualization of advanced midwifery practice seems essential for successful implementation.Implications for practicean international debate and consensus on the defining elements of advanced midwifery practice could enhance the further development of midwifery as a profession and is a prerequisite for its successful implementation. Due to rising numbers of AMPs, extension of practice and elevated quality requirements in healthcare, more outcomes research exclusively evaluating the contribution of AMPs to healthcare becomes possible and desirable. |
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| Keywords: | Advanced practice nursing midwifery certified nurse midwife advanced midwife practitioner concept analysis |
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