SEMINAR

ON
Independent practice
issues in nursing and independent nurse midwifery practitioner

Outlines
Independent
practice issues
Introduction
Definition of
independent
practitioners
Key issues
Areas of independent
nursing practice
Responsibility of
independent nursing
practitioner

Independent nurse
midwifery
practitioner
Introduction
Definition of
midwife
Independent
midwifery practice
packages.
Standards for
midwifery practices.
Challenges for
Indian midwives.

Introduction

Definition
NURSE PRACTIONERS
Nurse practitioners (NPs) are
registered nurses who have graduate
level nursing preparation as a nurse
practitioner at the masters or
doctoral level and perform
comprehensive assessments and
promote health and the prevention of
illness and injury.

KEY ISSUES TO CONSIDER PROFESSIONAL ISSUES

1.
2.
3.
4.
5.

Conflict of interest
Endorsement
Advertising
Fees
Informed consent

Contiiii
1. Documentation
2. Confidentiality
3. Other issues
.Liability protection
.Networking
.Business or legal council

AREAS OF INDEPENDENT
NURSING PRACTICE

CONSULTANCY
GERIATRIC NURSING
MEDICAL SURGICAL NURSING PRACTICE
PAEDIATRIC NURSING
PSYCHIATRIC NURSING
Women Health Nursing
School Health Nursing

RESPONSIBILITY OF A
INDEPENDENT NURSE PRACTIONER
UNIVERSAL
PRECAUTION

UNACCEPTABLE
PRACTICES

 VERIFYING
RECIPIENT
ELIGIBILITY

PRIVATE DUTY
NURSING
REQUIREMENTS

 EMERGENCY AND
BACK-UP
PROCEDURES

WRITTEN
STATEMENT OF
RECIPIENT RIGHTS

 CONTRACTS WITH
RECIPIENT AND/OR
FAMILY
REQUIRED
INFORMATION FOR
MEDICAL RECORD
TERMINATING
SERVICE TO A
RECIPIENT

Independent nurse
midwifery
practitioner

Independent midwifery practice

package

Access to a midwife 24 hours a day, 7

days a week.

Provide women centered care

antenatal, intrapartum and postnatal
midwifery care.
Antenatal care in privacy.

Continuity of care through the

labour.

Postnatal care up to 6 weeks.

Knowledgeable breastfeeding
support.

Standards for midwifery

practice
STANDARD I
Midwifery care is provided by
qualified practitioners

STANDARD II
Midwifery care occurs in a safe
environment within the context
of the family, community, and a
system of health care.

STANDARD III
Midwifery care supports
individual rights and selfdetermination within boundaries
of safety

STANDARD IV
Midwifery care is comprised of
knowledge, skills, and judgments
that foster the delivery of safe,
satisfying, and culturally
competent care.

STANDARD V
Midwifery care is based upon
knowledge, skills, and judgments
which are reflected in written
practice guidelines and are used
to guide the scope of midwifery
care and services provided to
clients.

STANDARD VI
Midwifery care is documented in
a format that is accessible and
complete.

STANDARD VII
Midwifery care is evaluated
according to an established
program for quality management
that includes a plan to identify
and resolve problems.

STANDARD VIII
Midwifery practice may be
expanded beyond the ACNM core
competencies to incorporate new
procedures that improve care for
women and their families.

Challenges for Indian midwives

Practice challenges
Midwives should be recognized as independent
practitioners with the rights and
responsibilities regarding scope of practice.
Authority and accountability that all
independent by share.
Health organization should use to allow quality
and standard based midwifery care.
Midwife should ensure case consultation,
collaboration and referral provided to a woman
without interruption and for overall benefits.

Challenges for law regulation

State regulators should enact laws which are
based on entry to practice standards on
successful completion of midwifery
educational programme.
Health care system should develop privileging
and credentializing mechanisms for midwives
that are consistent with professional
standards, recognize established process that
permits midwives to build upon competencies
within their statutory scope of practice.

Educational challenge
Direct entry midwife programme to
create a new category of professional
midwife.
The midwifery profession should
identify, develop and implement
mechanism to recruit midwives who
reflect Indian population with their
competencies.
It is needed to develop categories of
midwives as per their expertise in
their midwifery.

Challenges for research activities

It is required to continually grow and
evolve in order to provide evidence
based midwifery practice which will
help to practice independently.
Analysis of midwifery practice in view
of consumers or women who receive
care.

Challenges for policy makers

Some of the most pressing issue regarding
midwifery go beyond the current scope of
regulatory bodies, professional
associations, educators and practitioners.
Policy makers are to be convinced for the
importance of independent practice.
Research efforts have found the midwifery
makes a positive contribution to the
health of the women and babies.

References

Basher P. Shabeer, Khan Yasheen S. A concise text book of advanced nursing

practice, EMMESS Medical Publishers, first edition 2012, page no. 694-698.
Kozier B, Erb G, Barman A, Synder AJ. Fundaments of Nursing, concepts, process
and practice, edition 7 2001.
Potter Perry;S, fundaments of nursing by Jackie crisp, patricia ann potter, 2 nd
edition, Annegriffin perry page no. 143-155.
World Health Organization (2001) Health and human rights publication series, WHO
press, geneva available: www.who.int accessed 19 march 2008.
A.A.C. Title 9, Chapter 10, Article 8: Hospices; Inpatient Hospice Services. (2003).
Arizona
AAFP. (2008). Guidelines on the Supervision of Certified Nurse Midwives, Nurse
Practitioners and Physician Assistants. Retrieved March 5, 2009, from American
Academy of Family
PhysiciansPolicyandAdvocacy:http://www.aafp.org/online/en/home/policy/policies/n/
nonphysicianproviders.html American Association of Colleges of Nursing. (2004).
AACN Position Statement on the Practice
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currentnursing.com
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