PDF(Pubmed)
Abstract：
BACKGROUND: This study outlines the nature of Advanced Clinical Practice in Midwifery (ACPiM), reporting on a stakeholder analysis as part of a national project to develop a career framework for advanced practice in midwifery on behalf of the National Health Service (NHS) in England.
METHODS: Between June and July 2022, 31 advanced practice midwives were recruited across England within the NHS settings. Convenience sampling was used to identify midwives working as advanced practitioners, and those pursuing this career route. Focus group and one-to-one interviews were conducted, recorded, and transcribed. These stakeholder data were then analyzed using a reflexive thematic approach.
RESULTS: ACP midwives were active across many professional settings. The findings resulted in three themes: Midwifery autonomy, Desire for progression, and Avenues of support. Midwifery autonomy highlighted a midwifery desire to utilize specialist skills and expert decision-making to provide holistic care directly to women and families. Desire for progression highlighted that, regardless of career stage, midwives aspired to advance their practice requiring a range of pathways to fulfil career satisfaction and meet local population health needs. Avenues of support discussed the barriers and facilitators to progression, highlighting the need for service vision, a multi-disciplinary approach to facilitate support for individuals, and strong midwifery leadership.
CONCLUSIONS: Although the ACPiM role is desired by maternity institutions and organizations, midwives remain unclear about how to achieve this position, and employers remain unsure of how an ACPiM could transform services. If midwives are to successfully achieve ACPiM status, organizational support is needed to facilitate individuals drive for career progression, resulting in a strengthened workforce and improved patient experience.
METHODS: Between June and July 2022, 31 advanced practice midwives were recruited across England within the NHS settings. Convenience sampling was used to identify midwives working as advanced practitioners, and those pursuing this career route. Focus group and one-to-one interviews were conducted, recorded, and transcribed. These stakeholder data were then analyzed using a reflexive thematic approach.
RESULTS: ACP midwives were active across many professional settings. The findings resulted in three themes: Midwifery autonomy, Desire for progression, and Avenues of support. Midwifery autonomy highlighted a midwifery desire to utilize specialist skills and expert decision-making to provide holistic care directly to women and families. Desire for progression highlighted that, regardless of career stage, midwives aspired to advance their practice requiring a range of pathways to fulfil career satisfaction and meet local population health needs. Avenues of support discussed the barriers and facilitators to progression, highlighting the need for service vision, a multi-disciplinary approach to facilitate support for individuals, and strong midwifery leadership.
CONCLUSIONS: Although the ACPiM role is desired by maternity institutions and organizations, midwives remain unclear about how to achieve this position, and employers remain unsure of how an ACPiM could transform services. If midwives are to successfully achieve ACPiM status, organizational support is needed to facilitate individuals drive for career progression, resulting in a strengthened workforce and improved patient experience.
摘要：
背景：本研究概述了助产高级临床实践（ACPiM）的性质，作为国家项目的一部分，报告利益相关者分析，以代表英国国家卫生局（NHS）为助产士高级实践制定职业框架。
方法：在2022年6月至7月之间，英格兰在NHS环境中招募了31名高级实践助产士。便利抽样被用来识别作为高级从业者的助产士，以及那些追求这条职业路线的人。进行焦点小组及一对一访谈,记录,并转录。然后使用反身主题方法分析这些利益相关者数据。
结果：ACP助产士在许多专业环境中都很活跃。研究结果导致了三个主题：助产自主权，渴望进步，和支持的途径。助产自主强调了助产的愿望，即利用专业技能和专家决策直接为妇女和家庭提供整体护理。对进步的渴望突出表明，无论职业阶段如何，助产士渴望推进他们的实践，需要一系列途径来满足职业满意度和满足当地人口的健康需求。支持的途径讨论了进步的障碍和促进者，强调对服务愿景的需求，一种多学科的方法来促进对个人的支持，和强大的助产领导。
结论：尽管ACPiM角色是产妇机构和组织所希望的，助产士仍然不清楚如何实现这个职位，雇主仍然不确定ACPiM如何改变服务。如果助产士要成功获得ACPiM身份，需要组织支持，以促进个人推动职业发展，从而加强劳动力和改善患者体验。
方法：在2022年6月至7月之间，英格兰在NHS环境中招募了31名高级实践助产士。便利抽样被用来识别作为高级从业者的助产士，以及那些追求这条职业路线的人。进行焦点小组及一对一访谈,记录,并转录。然后使用反身主题方法分析这些利益相关者数据。
结果：ACP助产士在许多专业环境中都很活跃。研究结果导致了三个主题：助产自主权，渴望进步，和支持的途径。助产自主强调了助产的愿望，即利用专业技能和专家决策直接为妇女和家庭提供整体护理。对进步的渴望突出表明，无论职业阶段如何，助产士渴望推进他们的实践，需要一系列途径来满足职业满意度和满足当地人口的健康需求。支持的途径讨论了进步的障碍和促进者，强调对服务愿景的需求，一种多学科的方法来促进对个人的支持，和强大的助产领导。
结论：尽管ACPiM角色是产妇机构和组织所希望的，助产士仍然不清楚如何实现这个职位，雇主仍然不确定ACPiM如何改变服务。如果助产士要成功获得ACPiM身份，需要组织支持，以促进个人推动职业发展，从而加强劳动力和改善患者体验。
