Consultation to review clinical placement processes: A quality assurance project.

AIM: Working in partnership is a key goal for nursing and community health practice. This case study reports the quality assurance process employed to enhance the process of allocating clinical places for postgraduate Maternal and Child Health nurses in Victoria, Australia. BACKGROUND: The review of the clinical placement process occurred because councils (placement providers) reported being overwhelmed with inquiries and applications for places, time-line issues and some confusion about processes. This situation was further compounded as these clinical placements were provided by Councils at no cost to universities or students. DESIGN: The Quality Assurance consultation process was guided by an action research approach and systematically explored the experience of municipalities hosting students. METHOD: This involved five discrete phases: Online survey 1, Focus group, Draft consultation report, Online survey 2 and Distribution of Maternal and Child Health clinical placement process packages. Feedback was reported regarding what was working well, challenges with existing student placements and suggested strategies to improve the student placement process. RESULTS: Collaboration led to improvements in the clinical placement process and produced key resources for stakeholders. An unexpected outcome of the process was the development of a List of Expectations and Responsibilities for all stakeholders. CONCLUSION: The councils providing MCH clinical experience are highly valued by the universities and their students as clinical placement is provided voluntarily as a contribution to the MCH profession. All parties indicated it was very beneficial to collaborate to optimise this process.

Enablers and Barriers to Identifying Children at Risk of Developmental Delay: A Pilot Study of Australian Maternal and Child Health Services.

BACKGROUND: Twenty per cent of Australian children enter primary school with at least one area of developmental vulnerability (Commonwealth of Australia. (2018). Australian early development census [AEDC]. Retrieved from https://www.aedc.gov.au/.). This statistic is in the context of Maternal and Child Health (MCH) services offering regular developmental screening up to 8 times between 2 weeks and 3.5 years of age. OBJECTIVES: This study investigated: (1) enablers and barriers influencing MCH nurses in identifying children from birth to school age at risk of developmental delay. This focused on their experience, knowledge, attitudes and skills regarding the use of developmental screening tools. And (2) strategies to support MCH nurses and parents to identify children at risk of delay. METHOD: This mixed-methods study combined an online questionnaire and three focus groups and participants were MCH Nurses (N = 19) from one Australian municipality. RESULTS: MCH nurses surveyed (N = 19) reported more confidence in screening older children compared to children younger than 12 months. 15 of 19 nurses did not have accurate knowledge and skill in using PEDS and Brigance screens. In the focus group interviews (N = 16), time restraints, language used in developmental screening tools, and excessive waiting time for referral were raised as key barriers to identifying children at risk. LIMITATIONS: While the study provides rich insight, caution needs to be exercised when making generalisations from the findings given the small number of participants from one municipality. CONCLUSION: Recommendations for practice, service management, and further research are provided to improve the process of early detection.

Women's experiences of learning to breastfeed.

AIM: This research explores women's experiences of learning to breastfeed. DESIGN: A purposive cohort of healthy mothers participated in individual audio recorded interviews late pregnancy and then 2 and 8 weeks after birth. All interviews were transcribed verbatim and analysed using van Manen's approach. SETTING AND PARTICIPANTS: Participants were 13 first time mothers based in a rural municipality in Victoria, Australia. KEY FINDINGS: Women's voices gave rich descriptions of their experience of learning to breastfeed. Women shared the physicality of having 'great big engorged breasts' or 'sore nipples', and 'learning to latch' while 'having so very many things happening'. CONCLUSION: Many participants felt overwhelmed with learning to breastfeed at the same time as coping with caesarean wounds, perineal trauma, uterine bleeding and extreme fatigue. FUTURE IMPLICATIONS: Parenting education needs to be offered early in pregnancy so couples can explore birthing and its potential outcomes and to introduce infant cues and behaviours as a base for understanding how these impact on breastfeeding and problem solving.