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Education and training proposals following diabetes midwife survey

By Editor
25th March 2019
Audits, Pregnancy Research

Recommendations have been put forward to address an “unmet need” for structured education and training for midwives managing diabetes in pregnancy.

The Association of British Clinical Diabetologists (ABCD) commissioned a survey to assess the education and training needs of midwives in the UK who look after pregnant women with diabetes.

The results revealed:

  • Considerable variation in the roles and responsibilities, current levels of training and education needs of midwives
  • More than 85% of midwives expressed a desire to access additional education on diabetes management in different areas
  • Training in insulin initiation and titration, management during labour and ability to contribute to the antenatal clinic was desired by at least 85% of midwives surveyed

In response, ABCD has suggested a competency framework for diabetes and a specification for a midwife training programme should be developed.

Increasingly midwives are playing a critical role in the diabetes management of women during delivery and steroid administration for prematurity. Dr Umesh Dashora, Consultant (Endocrinology and Diabetes) at East Sussex Healthcare NHS Trust

The conclusion of the report stated: “There is an unmet need for structured education and training programmes for midwives in the management of diabetes in pregnancy. We recommend further work in producing tailored and accredited training programmes at different levels to suit the differing needs of midwives and diabetes specialist midwives in the UK.”

One of the authors Dr Umesh Dashora, Consultant (Endocrinology and Diabetes) at East Sussex Healthcare NHS Trust, added: “Increasingly midwives are playing a critical role in the diabetes management of women during delivery and steroid administration for prematurity. It would be hugely helpful if there was a structured approach to diabetes education for all midwives tailored around their roles and responsibilities. An online course with the Royal College of Midwives is being developed to satisfy this unmet need.”

A freedom of information request was made to all the NHS Trusts in the UK to gather relevant information about the roles and responsibilities of midwives in the maternity units in the UK.

This was followed by a questionnaire to midwives in the UK who are members of the Royal College of Midwives to assess their education and training level, needs, desires and views preceded by a test survey on nine midwives.

Recommendations

Undertake further research arising from the results of the survey including:

  • The availability of existing diabetes in pregnancy courses. This should include university-accredited modules, both standalone modules and those that are part of a degree/masters course as well as non-accredited courses.
  • Find out more about the process for midwives to become non-medical prescribed. Ascertain the benefits for midwives being able to prescribe diabetes medications: the benefits for the midwives themselves, the mothers and babies, the wider team/s, the Trust and in terms of outcomes.
Develop a competency framework for diabetes that is specific to the midwife role in caring for women with pre-existing or gestational diabetes throughout the care pathway from pre-conception to antenatal care. Work with RCM and TREND-UK to ensure accreditation.
Develop a specification for a midwife training programme for diabetes management in pregnancy, taking into account an appraisal of the options of potential design and delivery methods, course content including refresher, cost appraisal, funding options, accreditation options, intellectual property considerations and benefits/impact appraisal.

For more information, click here.

That JBDS guidance for pregnant women with diabetes is being increasingly adopted and adapted in various trusts with the aim to reduce neonatal hypoglycaemia.

Picture credit: Carlo Navarro

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