Week 13-14 Flashcards
What Midwifery competency standard relates to culturally competent care
Competency Standard 10 midwife requires that midwives ensure their care is culturally safe
Element 10.1 Plans, implements and evaluates strategies for providing culturally safe practice for women, their families and colleagues
Cultural Safety is initially defined as….
The effective nursing or midwifery practice of a person or family from another culture, and is determined by that person or family. Culture includes, but is not restricted to, age or generation; gender; sexual orientation; occupation and socio-economic status; ethnic origin or migrant experience; religious or spiritual belief; and disability.
What is culturally unsafe practice?
‘Culturally unsafe practice’ includes anything that ‘diminishes, demeans, or disempowers the cultural identity and well being of the individual’
What are the 4 principles of Cultural Safety
- seeks to improve the health status of all people.
- seeks to enhance the delivery of healthcare and disability services through a culturally safe workforce.
- is broad based and broad in its application.
- focuses closely on ‘understanding of self, the rights of others and the legitimacy of difference’
How do you develop an understanding of cultural safety
Step 1- Cultural Awareness: beginning to understand there is a difference
Step 2- Cultural Sensitivity: alerts students to the legitimacy of differences and begins a process of self-exploration
Step 3- Cultural Safety: is an outcome of nursing and midwifery education
What are the essential features of cultural safety in a midwifery partnership
- Understanding of ones own culture
- Acknowledgement of difference
- Informed by knowledge of power relations
- Is about the person receiving the care
- Is not defined by the caregiver
What is cultural competence in Midwifery
A culturally competence midwife recognises that many different elements of culture exist side by side and that at any time one aspect may be more important than the other….When women experience midwifery care that acknowledges and supports their individual needs they will achieve better childbirth outcomes, as will their babies”
Describe: NMBA Compentency standard 7
The NMBA Competency standard seven states that the midwife should complete ‘the midwifery relationship in a timely and appropriate manner
Explain: A partnership model
Within the partnership model, the woman is assumed to be self determining and therefore makes choices around how the relationship with the midwife evolves.
- Over‑involvement in a woman’s care must be considered within the context of the partnership model.
- Level of involvement is considered in the context of single or limited contact between a woman and a midwife or whether the partnership occurs for the duration of pregnancy and over a number of pregnancies.
List some behavioural indicators for potential boundary violations
- Excessive self‑disclosure
- ‘Super midwife’ behaviour
- Singled‑out treatment or woman paying attention to the midwife
- Selective communication
- Flirtations
- Failure to protect the woman in their care
- Sexual misconduct/assault
What is involved in concluding the professional relationship with the woman
Current physical health assessment
- 6 week physical health assessment
- Follow up is there is backache, perineal pain (regardless of a healing wound), ongoing bleeding etc
- Sexual and reproductive health needs
- Discussion about cervical screening
Emotional health assessment - EPDS
Social needs
- transport needs, budget services, legal services, low-cost counselling options and new mothers’ groups etc
Spiritual needs as appropriate
Return to work or study plans
- Maintaining breastfeeding
Child and Family Health
What is involved in concluding the professional relationship with the Infant
- Head to toe physical assessment
- Social interaction - by 6 weeks smiling
- Maternal – infant relationship
- Infant feeding
- Community support
- Child and Family health service interactions
- Discuss vaccinations that are due
- Well child referral
Drugs and Breastfeeding
Explain: Natural barriers to drugs
Natural barriers in the cells that create breastmilk make it difficult for most medications to pass into breastmilk. Even for those medications that do enter breastmilk, most do so in amounts so low that there is no effect on the baby
Drugs and Breastfeeding
Explain: MotherSafe
MotherSafe provides a comprehensive counselling service for women and their healthcare providers concerned about exposures during pregnancy and breastfeeding.
Such exposures may include: - Prescription drugs Over-the-counter medications - Street drugs - Infections - Radiation - Occupational exposures
Explain: the categorisation’s of medication
Category A
Drugs which have been taken by a large number of pregnant women and women of childbearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus having been observed.
Category B1
Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have not shown evidence of an increased occurrence of fetal damage
Category B2
Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals are inadequate or may be lacking, but available data show no evidence of an increased occurrence of fetal damage.
Category B3
Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have shown evidence of an increased occurrence of fetal damage, the significance of which is considered uncertain in humans.
Category C
Drugs which, owing to their pharmacological effects, have caused or may be suspected of causing, harmful effects on the human fetus or neonate without causing malformations. These effects may be reversible. Accompanying texts within product monographs appearing in MIMS Annual should be consulted for further details.
Category D
Drugs which have caused, are suspected to have caused or may be expected to cause, an increased incidence of human fetal malformations or irreversible damage. These drugs may also have adverse pharmacological effects. Accompanying texts within product monographs appearing in MIMS Annual should be consulted for further details.
Category X
Drugs which have such a high risk of causing permanent damage to the fetus that they should not be used in pregnancy or when there is a possibility of pregnancy.
