Healthcare practitioners' experiences and perspectives of music in perinatal care in Ireland: An exploratory survey.

INTRODUCTION: Evidence shows that music can promote the wellbeing of women and infants in the perinatal period. Ireland's National Maternity Strategy (2016-2026) suggests a holistic approach to woman's healthcare needs and music interventions are ideally placed as a non-pharmacological and cost-effective intervention to improve the quality of care offered to women and infants. This cross-sectional survey aimed to explore the healthcare practitioners' personal and professional experiences of using music therapeutically and its impact and barriers in practice. The survey also investigated practitioners' knowledge and attitudes towards the use of music as a therapeutic tool in perinatal care. METHODS: A novel online survey was developed and distributed through healthcare practitioners' electronic mailing lists, social media, Perinatal Mental Health staff App, and posters at the regional maternity hospital during 26th June and 26th October 2020. Survey items included demographics, personal and professional use of music, and perspectives on music intervention in perinatal care. RESULTS: Forty-six healthcare practitioners from across 11 professions were recruited and 42 were included in this study. 98 % of perinatal practitioners used music intentionally to support their wellbeing and 75 % referred to using music in their work. While 90 % found music beneficial in their practice, 15 % reported some negative effect. Around two-thirds of the respondents were familiar with the evidence on music and perinatal wellbeing and 95 % thought there was not enough guidance. 40 % considered music therapy an evidence-based practice and 81 % saw a role for music therapy in standard maternity service in Ireland. The qualitative feedback on how music was used personally and professionally, its' reported benefits, negative effects, and barriers are discussed. DISCUSSION: This study offers insights into how healthcare practitioners viewed and applied music in perinatal practice. The findings indicate high interest and positive experiences in using music as a therapeutic tool in perinatal care which highlights the need for more evidence and guidance.

Midwifery students' experiences of their clinical internship placement during the COVID-19 pandemic in Ireland: A qualitative descriptive study.

OBJECTIVE: To explore the impact of the COVID-19 global pandemic on midwifery students' experiences of clinical internship placement in the final year of their midwifery programme. DESIGN: A qualitative descriptive study was conducted following ethical approval. Four online focus groups were facilitated. SETTING AND PARTICIPANTS: To prepare for autonomous practice, BSc Midwifery students in the Republic of Ireland (RoI) undertake a 36-week internship in the final year of their programme. Midwifery students (n = 15), from one Higher Education Institute (HEI), who were undertaking internship across two clinical practice sites volunteered to participate in the study. FINDINGS: Four overarching themes were identified: Fear and uncertainty of internship in the context of a pandemic, Consequences of COVID-19 within the clinical environment, Student supports, Opportunities and challenges during internship. Working within a health care environment dominated by the presence of COVID-19 had significant consequences for the students and their provision of care for women and families. Students were challenged with managing increased responsibility within the context of COVID-19 practice requirements and restrictions. Students balanced their need to progress to autonomous practice, whilst acknowledging their needs as learners. COVID-19 also brought unexpected benefits, which included enhancing students' ability to develop relationships with women in their care, and students described a sense of belonging within the midwifery team. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Midwifery students identified internship, during the COVID-19 pandemic as challenging and stressful. However, students also portrayed a sense of pride in their achievements. Support structures assisted students to cope during this period which included peer support, protective reflective time (PRT) in the HEI and support from clinical placement coordinators in midwifery (CPC-Midwifery) within clinical placements sites. It is essential that these support structures continue within midwifery educational programmes. Promoting peer support in a more formal support structure may need consideration. These support structures need to be protected and enhanced during unprecedented times, such as the COVID-19 pandemic.

A qualitative evidence synthesis (QES) exploring the barriers and facilitators to screening in emergency departments using the theoretical domains framework.

BACKGROUND: Validated screening tools can be utilised to detect early disease processes and risk factors for disease and adverse outcomes. Consequently, identifying individuals in need of early intervention and targeted assessment can be achieved through the implementation of screening in the ED. Successful implementation can be impacted by a lack of resources and ineffective integration of screening into the clinical workflow. Tailored implementation processes and staff training, which are contextually specific to the ED setting, are facilitators to effective implementation. This review will assist in the identification of barriers and facilitators to screening in the ED using a QES to underpin implementation processes. Healthcare workers engage in screening in the ED routinely. Consequently, this review focused on synthesizing the experience of healthcare workers (HCWs) who are involved in this process. This synthesis is informed by a QES protocol published by the lead author in 2021 (Barry et al., HRB Open Res 3:50, 2021). METHODOLOGY: A comprehensive literature search, inclusive of grey literature sources, was undertaken. Initially, an a priori framework of themes was formed to facilitate the interpretation and organisation of search results. A context specific conceptual model was then formulated using "Best fit" framework synthesis which further assisted in the interpretation of data that was extracted from relevant studies. Dual blind screening of search results was undertaken using RAYYAN as a platform. Thirty studies were identified that met the inclusion criteria. Dual appraisal of full text articles was undertaken using CASP, GRADE CERQual assessed confidence of findings and data extraction was performed by two reviewers collaboratively. FINDINGS: This is the first known synthesis of qualitative research on HCW's experiences of screening in the ED. Predominantly, the findings illustrate that staff experience screening in the ED as a complex challenging process. The barriers and facilitators identified can be broadly categorised under preconditions to screen, motivations to screen and knowledge and skills to screen. Competing interests in the ED, environmental stressors such as overcrowding and an organisational culture that resists screening were clear barriers. Adequate resources and tailored education to underpin the screening process were clear facilitators. TRIAL REGISTRATION: PROSPERO: CRD42020188712 05/07/20.

Music as a health resource in pregnancy: A cross-sectional survey study of women and partners in Ireland.

BACKGROUND: Wellbeing in pregnancy can have long term effects for women, infants, and families. Research has shown that music can promote maternal health, infant development, and parent-infant bonding. This study aimed to explore women's and their partners' experiences of using music during pregnancy while also considering their perspectives on the potential role of music in maternity care. METHODS: A cross-sectional online survey was conducted from June to October 2020 in Ireland. 265 respondents including 254 women and 11 partners who were pregnant or had given birth in the past 12 months participated. Descriptive statistics and content analysis were used to analyse the results. RESULTS: Findings indicated that, during pregnancy, 75% of respondents sang to their unborn baby, 47% created playlists for childbirth, 46% intentionally used music to support their wellbeing, over one-third were not aware of supporting evidence on music for perinatal wellbeing, 88% thought there was not enough guidance, and 70% supported the idea of establishing music therapy in maternity care. Qualitative analysis revealed three themes: 'Positive impacts of music', 'Facilitators and barriers to the use of music during pregnancy', and 'Future visions on implementing music in maternity care'. CONCLUSION: This study is the first to explore the experience and perspectives of women and partners in Ireland on using music during pregnancy. The findings highlight the need for more music-based resources and education on this topic and suggests an openness amongst women and partners towards the implementation of music therapy in maternity care to promote perinatal health and wellbeing.

Interventions to reduce work-related musculoskeletal disorders among healthcare staff in nursing homes; An integrative literature review.

Background: : The incidence of work-related musculoskeletal disorders have been consistently high in nursing sectors and are a significant cost to the health service due to absenteeism. Work-related musculoskeletal disorders are more common among healthcare workers in nursing homes due to the high dependency needs of older persons which often include need for help with self-care and mobility. Therefore, staff are exposed to potential injury associated with moving and handling patients. Work-related musculoskeletal disorders significantly impact on the quality of life of affected individuals, can cause economic hardship and affect service provision. Aim: : To identify, review, and discuss interventions that may be effective in reducing the prevalence and consequences of work-related musculoskeletal disorders in nursing homes. Design: : An integrative literature review. Method: : A systematic search of Embase, Science direct, Web of science and EBSCO Host was conducted and an ancestry search of the references of the reviewed articles were also reviewed. Peer reviewed primary research published between 2000 and 2020 were selected. The quality of these studies was appraised with Crowe Quality Appraisal Tool and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The components of the interventions were categorised using Burnard (2011) framework for content analysis. Results: : Fifteen studies met the criteria for inclusion in the review. Interventions reported in the literature were in four categories; (i) Specialised equipment (ii) Staff training (iii) Policies and procedures to reduce work-related musculoskeletal disorders and (iv) Support and follow up. A ceiling lift is the intervention of choice to reduce work-related musculoskeletal disorders, as it reduces the stress associated with pushing and pulling. Risk assessment is vital to determine the individual needs of clients for safe handling. Train-the-trainer roles could be used to implement training interventions where resources limit the employment of a designated lead to facilitate injury prevention. A multifaceted approach to prevent and reduce work-related musculoskeletal disorders is recommended. Further research is required to ascertain the effectiveness of Cognitive Behavioural Therapy on injury reduction in nursing homes. Conclusion: : These findings have the potential to inform the development and adherence to injury prevention policies and regulations by healthcare managers and staff which could reduce injuries. Identifying the appropriate interventions to prevent and reduce work-related musculoskeletal disorders is significant for staff wellbeing, has economic implications in terms of reduced work-related musculoskeletal disorder absenteeism and ultimately will positively impact on the care of mobility impaired clients.

Preparing midwifery students for practice: The value of elective placements in enhancing midwifery practice.

An elective placement where students are facilitated to access different models of midwifery care was included in the 18 month Higher Diploma Midwifery programme in 2008 in a university in Ireland. All students since then have had the opportunity to experience this placement which is advocated by the regulatory board for Nursing and Midwifery in Ireland (NMBI). This paper details the integration of an elective placement referred to as an 'observation week' into the 18 month midwifery programme. It includes a description of the organisation of the observation week, a summary of services accessed by midwifery students, student evaluation of their experience and mechanisms for feedback of these experiences to our partners in clinical practice. The benefits and the challenges of the observation week are considered with reference to the published literature.

Concealed pregnancy and newborn abandonment: a contemporary 21st century issue Part 2.

This second of a two-part article explores the consequences of concealed pregnancy and the association with newborn abandonment, with reference to recent cases of public interest. Concealed pregnancy is a complex process which involves hiding a pregnancy, and can lead to tragic consequences, such as maternal or neonatal morbidity or mortality (Murphy Tighe and Lalor 2016; Chen et al 2007).The psychosocial issues involved will also be explored and points for midwifery practice are presented and considered (Murphy Tighe and Lalor 2016).

Concealed pregnancy and newborn abandonment: a contemporary 21st century issue. Part 1.

This two-part series explores the phenomenon of concealed pregnancy and the association with newborn abandonment, with reference to recent cases of public interest. In Part 1 we focus on defining concealed pregnancy as a complex process which involves hiding a pregnancy, that can lead to tragic consequences such as maternal or neonatal morbidity or mortality (Murphy Tighe and Lalor 2016; Chen et al 2007).The psychosocial issues involved will also be presented (Murphy Tighe and Lalor 2016).