Advanced Nursing Practice Diploma in Midwifery

2018

Advanced Nursing Practice Diploma in Midwifery

ADVANCED NURSING MIDWIFERY PROGRAM 1

CONTRIBUTORS

Prepared and updated by Curriculum Scientific Group

Dr. Shadia Abdullah Yousuf Ms. Marietjie Bester

Supervision by

Prof. Zubair Amin Dr. Sami Alshammari

Reviewed and Approved by

Dr. Sami Al Haider

2 ADVANCED NURSING MIDWIFERY PROGRAM

COPYRIGHTS AND AMENDMENTS All rights reserved. © 2017 Saudi Commission for Health Specialties (SCFHS). This material may not be reproduced, displayed, modified, or distributed without prior written permission of the copyright holder. No other use is permitted without prior written permission of the SCFHS. For permission, contact the SCFHS, Riyadh, Kingdom of Saudi Arabia. Any amendment to this document shall be approved by the Specialty Scientific Council and the SCFHS’s Executive Council, and shall be considered effective from the date of publishing the updated electronic version on the SCFHS’s website, unless a different implementation date has been stipulated. P.O. Box: 94656 Postal Code: Riyadh 11614 Contact Center: 92-001-9393 Website: www.scfhs.org.sa


ACKNOWLEDGMENTS The hard work and dedication of the team in constructing the Advanced Nursing Diploma in Midwifery are reflected in the outcome. Valuable feedback and resources have been provided by the midwifery program at North-West University, Potchefstroom Campus in Potchefstroom, South Africa, which enriched the content of this program. We thank the Nursing Scientific Board members for their valuable feedback on this manual. Special thanks to the Oncology and other diploma teams whose manuals were used as references for constructing this program. We wish to express our appreciation to the members of the Continuous Training Committee of the Saudi Commission for Health Specialties, who provided valuable feedback and support throughout the development of the Advanced Nursing Diploma in Midwifery. We also thank Professor Karin Minnie and Dr. Antoinette du Preez at North-West University, Potchefstroom for their support. Finally, we express special gratitude to Dr. Zubair Amin and Dr. Sami Al-Shammari for their guidance in formulating this program.


TABLE OF CONTENTS

Working Team 1 Acknowledgements 3 Introduction 7 Program Overview 8 Program Objectives 8 Admission Requirements 9 General Training Requirements 9 Program Requirements 9 Leave and Interruption of Training 10 Clinical Placement 11 Teaching Methods 12 Methods of Assessment 12 Summary of Assessment 13 Curriculum Plan 14 Module 1: Health Assessment of Women and Newborns. 15 Module 2: Principles of Midwifery (anatomy, physiology, pharmacology, health education, and counseling). 17 Module 3: Normal pregnancy (antenatal, natal, postnatal, and normal newborns) 19 Module 4: Biostatistics 21 Module 5: Research and Evidence Base 22 Module 6: Epidemiology 24 Module 7: High-Risk Pregnancy (antenatal, natal, postnatal, and high-risk newborns) 26 Module 8: Women’s Health 29 Module 9: Ethics in Nursing 31 Module 10: Nursing Informatics 33 Module 11: Nursing Management and Leadership 35 Module 12: Professional Performance 36 Additional Online Modules 37

Appendices:

Appendix I: Teaching Resources/textbooks 42 Appendix II: References used in Program Development 45 Appendix III: Resources for Program Execution 46 Appendix IV: Comprehensive In-Training Evaluation Report - ITER 47 Appendix V: Competency Checklists 49

Table of Contents


Appendix VI: Oral Presentation Assessment Rubric 61 Appendix VII: Case Study Assessment Rubric 62 Appendix VIII: Research Project Assessment Rubric 64


Advanced Nursing Diploma in Midwifery

Introduction As women are the cornerstones of the family, women’s health is a prerequisite for a healthy newborn, family, and community. Midwifery care contributes to positive outcomes, including the wellbeing of women during the childbearing period, fewer complications during labor, and better newborn health. Therefore, midwives influence and enhance the future health and wellbeing of the community. Each woman has the right to receive appropriate midwifery care. Saudi Arabia is a developing country and has a comparatively high fertility rate, recorded at 2.7 in 2017 (World Bank Data 2017). The Ministry of Health’s annual report states that morbidity and mortality rate among the country’s women and children remain high. Saudi Arabia’s estimated birth rate is 18.4 births/1,000 population. The World Health Organization (WHO 2016) reports that the major reasons for the maternal mortality rate (MMR) are inadequate coverage of antenatal care, lack of trained assistance at delivery, insufficient essential obstetric care, and a poor referral system. In addition, there has been an increase in the number of cesarean births among Saudi women, which reached 67% (Al-Kadri, Al-Anazi & Tamim 2015). This could be due to lack of health awareness among pregnant women and inadequate maternity care provided by the country’s midwives (WHO 2014). Moreover, many studies suggest that having skilled midwives in antenatal, intrapartum, or postnatal care is one of the key elements in reducing maternal and prenatal mortality (WHO 2014). The quality of care that women, babies, and families receive during pregnancy, birth, and the early weeks after birth influences the life chances of newborns, particularly in the case of mothers with complex needs and high-risk factors. Appropriate access to well-trained midwives is a crucial part of Saudi Vision 2030, whose strategies include building a healthy society by providing quality health services (Council of Economic and Development Affairs 2016). A well-developed midwifery program would strengthen the knowledge and skills of midwives in maternal care, leading to improvements in the quality of birth experiences, reducing maternal and infant deaths, and decreasing the cost (WHO 2016 a & b). In many developed countries, such as the UK, the USA, Germany, and Australia, as well as in developing countries such as those in Africa, midwives are the main care providers during pregnancy, labor, and birth (Sandall, Soltani, Gates, Shennan & Devane 2013). Midwives need to receive a high standard of education and training in order to provide quality care (WHO 2016). Research has found that where midwives are the main care providers during pregnancy; women are less likely to give birth prematurely or lose their babies before 24 weeks of gestation. Women also reported being happier with the care they received, and had fewer epidurals, fewer assisted births, and fewer episiotomies (Sandall, Soltani, Gates, Shennan,& Devane 2013).

Midwifery in Saudi Arabia Developing the Midwifery Diploma program in Saudi Arabia provides an opportunity to improve efficiency in women’s healthcare. In the Kingdom of Saudi Arabia, the Ministry of Health initiated a midwifery program in the 1980s, as one of its diploma programs. Unfortunately, the program was discontinued, with very few students graduating (after secondary school). Currently, there are about 1,710 diploma-holding midwives working in different Saudi cities. The majority of Saudi nurses working in antenatal, labor, and postnatal care lacks midwifery training.



No statistics could be found on the number of registered Saudi midwives. Most of the midwives who work in Saudi hospitals (both private and government) are expatriates. Recently, a midwifery association was established under the umbrella of the Saudi Obstetrics and Gynecology Society. Having well-trained midwives from the same culture as their patients, and thus familiar with pregnant woman’s needs, culture, beliefs, language, and diet, would benefit women and their families. Working alongside other healthcare professionals, midwives contribute to quality and cost-effective complementary maternity services for women, newborns, and families across the country (Chief Nursing Officers of England, Northern Ireland, Scotland and Wales 2010). Internationally, the literature shows that midwives are the key professionals in ensuring that women have safe and emotionally satisfying experiences during pregnancy, childbirth, and the postnatal period. In collaboration with other healthcare providers, midwives are the most appropriate care providers to attend women during pregnancy, labor, birth, and the postnatal period. Therefore, this program aims to provide a framework for training Saudi nurses and midwives, equipping them with the competencies required to provide safe and quality maternal care within the scope of midwifery practice.

Program Overview This program is designed to provide opportunities for professional nurses to develop specialized knowledge and clinical competency in midwifery, based on national and international standards. The learner is trained to meet the health needs of women and their newborns during the lifespan through the provision of culturally sensitive care. The program aims to consolidate midwives’ critical thinking and clinical experience in the field of women’s health from premarital to menopause age, within the primary, secondary, and tertiary preventive levels. The learner will be introduced to issues and trends in midwifery, with emphasis on evidence-based practice, quality principles, and research findings. The learner will also be guided on self-learning and leadership skills in the field of midwifery. Upon the completion of the program, the learner will earn an Advanced Nursing Diploma in Midwifery. The Saudi Commission for Health Specialties (SCFHS) supervises this program.

Program Objectives: Upon completion of the Advanced Nursing Diploma in Midwifery, the learner will be able to: 1. Apply knowledge of nursing and health sciences, social sciences, public health, and ethics

to provide quality maternity care. 2. Deliver safe, holistic, and quality maternity care. 3. Apply critical and analytical skills in providing evidence-based maternity care for women

during their lifespan for a better outcome. 4. Demonstrate competency in dealing with various ethical issues related to women’s health,

in accordance with Islamic Sharia rules and regulations. 5. Use effective communication skills to interact with women, families, and the interdisciplinary

healthcare team. 6. Provide appropriate health education and counseling according to the needs of women and

their families. 7. Demonstrate competency in independent and interdependent roles within the obstetrics

multidisciplinary health team.



8. Apply infection-control measures when caring for women and newborns in various health

settings 9. Implement concepts and skills of leadership and management in maternity-care-based

planning, management, and collaboration in various health settings. 10. Demonstrate self-directed professional development activities to maintain high professional

standards of care and behavior. 11. Effectively use healthcare technology to improve maternity care and midwifery efficiency.

Admission Requirements To be eligible to enroll in the program, the candidate must meet the application requirements established by the SCFHS. Please refer to the official SCFHS executive policy for the up-to-date admission process; as this can be subject to change (see https://www.scfhs.org.sa/en/about/Pages/ExecutiveCouncil.aspx). The candidate must also: • Hold a Bachelor of Science in Nursing (BSN) degree from an accredited nursing program or

equivalent. • Have a minimum of two years’ clinical experience in nursing (including internships). • Provide a minimum of two professional letters of reference. • Pass an oral interview. • Have a valid nursing license. • Have basic computer knowledge/skills. • Be physically fit (provide a recent physical examination report).

General Training Requirements The learner shall abide by the SCFHS training rules and regulations The learner shall be enrolled in full-time and continuous training for the entire training period. Training will be conducted in an institution accredited by the SCFHS. The learner should be actively involved in maternity care with gradual progress in their levels of responsibility The language of instruction in this specialty diploma program is English.

Program Requirements 1. The required period for the completion of the Advanced Midwifery Diploma program is two

calendar years. Each calendar year comprises eleven (11) months of study, including registration, orientation, and the examination period, and one (1) month of holiday.

2. Theoretical and clinical experience components are integrated. The midwifery program comprises 11 modules (six Core and five Specialty), which are distributed throughout the two calendar years. The program is arranged to enable the learner to progress from basic concepts, principles, and topics, to advanced and complex topics.

3. In the first six weeks of each calendar year, the learner is required to attend classes from 8 am to 5 pm to cover the essential theoretical elements that will support later training.

4. After the first six weeks, there is one study day per week for lectures and discussion. 5. The six (6) Core modules: Ethics, Leadership, Epidemiology, Biostatistics, Research and

Evidence-Based Practice, and Informatics shared among all the specialty programs.



6. The five (5) Specialty modules: Health Assessment of Women and Newborns, Principles of

Midwifery, Normal Pregnancy and Newborns, High-Risk Pregnancy and Newborns, and Women’s Health.

7. The learner is required to perform the following (see Logbook): a. Care for 100 normal pregnant women (perform examination of pregnant women,

including abdominal palpation [Leopold’s maneuvers]). b. Provide comprehensive health education to 50 pregnant women (antenatal clinic and

antenatal ward). c. Take and interpret 50 cardiotocographs (antenatal clinic, maternal-fetal monitoring

units, and antenatal ward). d. Perform 50 vaginal examinations. e. Witness five normal deliveries. f. Monitor 10 women in the first stage of childbirth. g. Manage normal births (2nd, 3rd, and 4th stages of labor). h. Conduct 50 normal deliveries. i. Perform suturing and management of 10 patients with perineal trauma (episiotomies

and 1st and 2nd degree tears). j. Assist 50 high-risk deliveries (instrumental deliveries, e.g., forceps delivery; vacuum

delivery; caesarean sections; breech birth; shoulder dystocia; postpartum hemorrhage; and cord prolapse).

k. Provide care to 50 newborns after normal birth (immediate care and assessment). l. Assess and care for 20 neonates immediately after a cesarean section. m. Care for 50 high risk women across pregnancy, labor, and birth (bleeding in early and

late pregnancy; gestational diabetes; hypertensive disorders; cardiac, medical, and surgical conditions during pregnancy; management of postpartum complications, such as postpartum hemorrhage, postpartum pre-eclampsia and eclampsia, embolism, puerperal infection, sepsis, and severe mental depression).

n. Provide nursing care to 50 women in the puerperium. o. Provide health education and counseling to 20 women with complications in the

puerperium, regarding family planning, breastfeeding, and infant care. p. Practice actual or simulated midwifery emergencies, e.g., neonatal and adult

resuscitation, breech birth, shoulder dystocia, postpartum hemorrhage, and cord prolapse.

q. Provide nursing care to 20 neonates without complications. r. Provide nursing care to 10 high-risk neonates. s. Examine 10 women and their babies six weeks after birth. t. Provide nursing care to 10 women regarding abortion-related health issues. u. Provide care to 20 women regarding pre-pregnancy and family planning issues

(comprehensive history-taking regarding health, obstetrical, gynecological, and reproductive history; preconception counseling; family planning counseling; and provision of commonly available family planning methods).

v. Conduct 10 Pap smears. w. Insert five intrauterine contraceptive devices (IUD).

Leave and Interruption of Training Reference must be made to the official SCFHS executive policy on leave and interruption of training, as this can be subject to change (see https://www.scfhs.org.sa/en/Pages/default.aspx).



In general, learners are entitled to four weeks’ annual leave, in addition to leave for one of the Eids. Learners are also entitled to sick leave, maternity leave, emergency leave, and scientific leave according to the official SCFHS executive policy on leave and interruption of training. Emergency leave will be treated as an interruption of training according to the stated policy. Learners are required to compensate for any such leave with an equivalent number of days before being eligible to receive the program’s certificate of completion. Any leave not utilized within the year shall not roll over to the following year.

Clinical Placement The learner will be trained in the nursing simulation laboratory during the first six weeks of each calendar year. This will be followed by training in different units according to the module’s requirements. The training areas are as follows: • Antenatal unit (antenatal ward, maternal-fetal monitoring unit, and gynecological and

obstetrical outpatient department) • Labor and delivery unit • Operating theatre • Postnatal unit (counseling, referring, and interpreting laboratory results) • Nursery and neonatal intensive care unit • Gynecology unit and infertility clinic (gynecological and obstetrical outpatient department)

Teaching Methods:

Theoretical Part: Interactive lectures and discussion Computer-assisted interactive instructional programs Weekly reading assignments Case study presentations Research project

Methods of Assessment The evaluation and assessment of learners are conducted in accordance with the SCFHS training and examination rules and regulations. Assessment is divided into two parts: ○ Formative assessment (continuous assessment process during training period) ○ Summative assessment (end of the program) Learners undergo both formative and summative assessment. The training centers execute formative assessment, while the SCFHS conducts summative assessment. Learners are required to sit the written promotion examination to advance to the second year. The learner is required to pass all continuous assessments stipulated by the specialty’s scientific committee in order to fulfill the training requirements of the given calendar year. Reference should be made to the executive policy on continuous assessment and annual promotion for further details (see https://www.scfhs.org.sa/en/examinations/Regulations/Assessment%20Conduct%20Regulations.pdf).



The summative examination includes both a written assessment of knowledge and a clinical objective structured clinical examination (OSCE) of clinical skills.

Formative/continuous assessment Formative/continuous assessment enables those involved in the training process (i.e., preceptors) to provide objective feedback. It also involves evaluating interactive training activities, such as case studies, seminars, and a research project. A report must be submitted to the Regional Training Supervisory Committee of the Specialty for review and follow-up of learners’ progress (see Appendix IV ITER). The formative assessment reviews learners’ performance in relation to knowledge, attitude, and skills during training period. A learner must satisfactorily pass all parts of the assessment. The formative/continuous assessment process includes the following components: To test knowledge: quizzes, promotion exam and additional other assessments. • Quizzes are conducted at the end of each module by the training centers. • The promotion examination is held at the end of the first year of the program. Passing this

examination enables the learner to advance to the program’s second year. The promotion examination includes written and clinical assessments. The exam is conducted by the SCFHS. ○ The written examination assesses learners’ theoretical knowledge and critical thinking

skills in relation to the topics covered during the year, based on the blueprint. The examination format and scoring system is based on the Saudi Commission Examination Rules and Regulations (see the SCFHS website: www.scfhs.org.sa).

○ The objective structured clinical evaluation (OSCE) assesses learners’ clinical skills, including data gathering, patient management, communication, and counseling. This examination will include a specific number of stations designed to achieve the training objectives. The examination format will be based on the Saudi Commission Examination Rules and Regulations (see www.scfhs.org.sa).

• The assigned preceptor should provide documented feedback every month and as needed. • The assigned clinical instructor should provide documented feedback every three months

and as needed. • The assigned head nurse/nurse manager should provide documented feedback every

month and as needed. • Complete the clinical competency checklist (see Appendix V: Competency Checklists). • Logbook: Each learner shall submit a complete logbook at the end of each year. • Complete the online module: 10 topics in each year. • Seminar presentation: Each learner shall present one seminar each year. The assigned

clinical instructor and the program director should approve the seminar topic, and the clinical instructor should evaluate the seminar (see Appendix VI: Oral Presentation Rubric).

• Case study report evaluation: Each learner shall undertake a case study of a patient receiving care in a clinical setting. The case study should include the patient’s past medical/surgical history, obstetric history, and clinical diagnosis/treatment history; the current medical diagnosis; the nursing diagnosis, with appropriate assessment findings; and the current medical/nursing care plans, with an assessment of optimal outcomes. The clinical instructor should evaluate the case study (see Appendix VII: Case Study Assessment Rubric).



• Research project: Each learner shall conduct a research project in an area of interest at the

end of the training. The project should be approved by the clinical instructor and the ethics committee of the applicable training center. The clinical instructor evaluates the research project (see Appendix VIII: Research Project Assessment Rubric).

Summative Assessment The SCFHS conducts these assessments centrally: • Final Examinations (end of the program) • The end-of-program examinations are comprehensive. The learner will be awarded the

advanced diploma certificate on successful completion of these examinations. ○ The final written examination assesses learners’ theoretical knowledge and critical

thinking skills in relation to all of the topics and clinical experience covered during the program, based on the blueprint. The examination format and scoring system is based on the Saudi Commission Examination Rules and Regulations, available from the SCFHS website (www.scfhs.org.sa).

○ The final clinical examination is an OSCE that assesses learners’ clinical skills, including data gathering, patient management, communication, and counseling. This examination will include a specific number of stations designed to achieve the training objectives. The examination format is based on the Saudi Commission Examination Rules and Regulations, available from the SCFHS website (www.scfhs.org.sa).

Certification • A certificate of completion will be issued when the learner has successfully achieved all

training program requirements, including passing all continuous assessment examinations and having all required competencies verified.

• Learners who successfully complete the program will receive the Diploma certificate in “Advanced Nursing Diploma in Midwifery” after passing the final written and clinical examinations.

Summary of Assessment

A. Formative assessment (training center): The formative assessment covers the learner’s performance during the clinical rotation, participation in academic activities (presentation and case study), completion of the logbook (to reflect their clinical exposure), and clinical evaluation (to reflect their attitude and professional performance) during the year. In addition, learners sit the promotion examination (written) at the end of the first year, which is conducted by the SCFHS.

B. Summative assessment (Exit assessment): The final examination includes a written component and the objective structured clinical evaluation (OSCE) at the end of the second year, and is conducted by the SCFHS. Those who pass the final written examination will sit the final OSCE examination.



Curriculum Plan

Module Duration Didactics Clinical

1 Health Assessment of Women and Newborns

8 weeks 2 days/week (128 hrs)

3 days/week (192 hrs) Simulation and clinical rotation

2 Principles of Midwifery (anatomy physiology, pharmacology, health education, and counseling)


3 days/week (144 hrs) Simulation, workshop and clinical rotation

3 Normal pregnancy (antenatal, natal, postnatal, and newborn)

22 weeks

1 day/week (176 hrs)


4 Biostatistics 2 weeks 2 days/week (32 hrs)

3 days/week (48 hrs) Computer lab

5 Research & Evidence-Based Practice


3 days/week (96 hrs) Library and computer lab (3 days/week) Simulation, workshop and clinical rotation

6 Epidemiology 2 weeks 2 days/week (32 hrs)

3 days/week (48 hrs) Computer lab and online modules

7 High-Risk Pregnancy (antenatal, natal, postnatal, and high-risk newborns)

26 weeks

2 days/week (416 hrs)


8 Women’s Health 4 weeks 1 day/week (32 hrs)


9 Ethics 4 weeks 1 day/week (32 hrs)

4 days/week (128 hrs) Simulation, clinical rotation, and online module

10 Informatics 4 weeks 1 day/week (32 hrs)

4 days/week (128 hrs) Computer lab and clinical rotation

11 Leadership & Management 4 weeks 1 day/week (32 hrs)

4 days/week (128 hrs) Clinical rotation



12 Professional Performance 2 weeks 2 days/week

(32 hrs) 3 days/week (48 hrs) Rotation in specialty area of interest

Total 88 weeks

1,104hrs 2,416hrs

Holiday 8 weeks

Grand total: 3,520 hrs

Advanced Midwifery

Module Descriptions All modules offered in the midwifery diploma program are listed below, with a brief description of each module.

Module 1: Health Assessment of Women and Newborns This module provides learners with essential health assessment skills and interview techniques pertaining to women’s health and newborn. The module covers history-taking, inspection, palpation, percussion, auscultation, and reporting. It focuses on various laboratory investigations concerning women and newborns’ health that will assist learners in their decision-making.

Learning Objectives: At the end of the module, the learner will be able to: ■ Describe the various components of a comprehensive health assessment for women and

newborns. ■ Determine the four basic assessment techniques of physical examination. ■ Employ accurate interview techniques. ■ Competently demonstrate health assessment skills. ■ Integrate knowledge of physiological changes during pregnancy and pathophysiological

diseases affecting women in conducting health assessments. ■ Accurately analyze and interpret collected data. ■ Correctly document data.

Module Outline: 1. General and obstetric client history. 2. General approaches to physical examination of women and newborns. 3. Comprehensive system assessment (head-to-toe assessment) of women and newborns. 4. Assessment of nutritional states and spiritual and behavioral changes in women and

newborns. 5. Assessment of childbearing women during antenatal, natal, and postnatal periods. 6. CTG monitoring. 7. Laboratory investigations. 8. Document progress of labor and care provided.



Competencies: ■ Prepare the appropriate equipment for health assessment procedures. ■ Utilize the principles of interviewing techniques in assessing women and newborns. ■ Accurately obtain complete personal and obstetrical history. ■ Perform physical examination techniques in a correct sequence and interpret the findings. ■ Perform abdominal palpation. ■ Assess the progress of labor. ■ Interpret cardiotocograph (CTG) strips. ■ Conduct immediate newborn assessment. ■ Analyze, interpret, and document data collected.


Module 2: Principles of Midwifery (anatomy, physiology, pharmacology, health education, and counseling)

This module introduces the learner to concepts and principles that enhance midwifery practice. The anatomy and physiology of the reproduction system (from gametogenesis through to birth and the neonatal period) and the physiological changes during the antenatal, natal, postnatal, and neonatal periods are introduced. In addition, this module reviews the basics of pharmacology and focuses on pharmacological and pharmacokinetic principles, especially their application to midwifery practice. The implications of common drugs used in antenatal, labor, postpartum, and neonatal periods are emphasized. The midwife’s roles and responsibilities in administering and prescribing medications are also emphasized. Finally, this module also covers the concepts and principles of health education and counseling.

Learning Objectives: At the end of the module, the learner will be able to: • Describe the anatomy and physiology of the female reproductive system. • Recognize the stages of fetal formation from conception to birth. • Describe the indications, contraindications, and side-effects of and monitor the common

medications used during the reproductive period. • Determine the medications used for immediate newborn care. • Identify the midwife’s role in medication administration. • Implement health promotion activities to enhance women’s and newborns’ health through

counseling and education. • Demonstrate skill in counseling and educating women.

Module Outline: • Anatomy and physiology of reproductive system:

a. Female pelvis and the reproductive organs b. Female urinary tract c. Hormonal cycles

• Fetal formation and development (from conception to delivery): a. Fertilization b. Embryonic development c. Fetal formation d. Placenta formation e. Fetal circulation

• Physiological changes during pregnancy: a. Physical changes b. Psychological changes

• Hormonal and vitamin therapy during pregnancy and lactation: a. Hormonal therapy b. Vitamins and mineral supplements c. Tocolysis d. Induction and augmentation of labor

• Pain management during labor: a. Nurse’s role in supporting pain relief b. Natural pain relief

Module 2: Principles of Midwifery


c. Systemic analgesics d. Regional analgesics e. Complications f. Contraindications

• Medications after birth: a. Emergency resuscitation drugs b. Vitamin K c. Anti-Rh antibodies

• Basic principles for counseling. • Basic principles for health education.

Competencies: • Implement the principles of drug calculation and administration. • Administer the appropriate medications during labor and resuscitation. • Identify the health education needs of women and their families. • Conduct health education and counseling for women during the antenatal, intrapartum, and

postnatal periods. • Advocate for women and newborns. • Provide guidance and assistance to women according to their needs.


Module 3: Normal Pregnancy This module provides learners with the knowledge and skills needed to manage women during normal antenatal, natal, and postnatal periods using a family-centered approach. The evidence-based care and management of normal newborns are also introduced. The clinical component includes experiences in primary health care centers; hospital antenatal, labor, and postpartum units; and the hospital nursery.

Learning Objectives: At the end of the module, the learner will be able to: • Demonstrate knowledge of normal physiological changes during pregnancy. • Comprehend the various components of care for the women during pregnancy (antenatal,

natal, and postnatal). • Deliver comprehensive nursing care to women during pregnancy (antenatal, natal, and

postnatal). • Provide immediate care of the newborn. • Integrate knowledge of physiological changes during pregnancy and pathophysiological

diseases affecting women during their care.

Module Outline: • Normal physiological changes in women throughout the antenatal, natal, and postnatal

periods. • Common physiological needs of women during the three trimesters. • Nursing and medical management for the minor discomforts of pregnancy during the three

trimesters. • Nutritional needs during pregnancy, postpartum, and lactation. • Process of labor. • Management of labor. • Physiological changes during postpartum. • Management of postpartum. • Management of normal newborn. • Lactation in pregnancy: physiology and management.

Competencies: • Demonstrate the knowledge required to provide care and advice to women and their families

during pregnancy, labor, birth, and postpartum. • Provide culturally appropriate and sensitive care. • Obtain complete health and obstetrical history. • Perform a complete physical examination of the woman and the newborn. • Identify risk factors before and during pregnancy, labor, birth, and postpartum. • Provide appropriate evidence-based care to women during the pregnancy cycle. • Prepare the equipment required for labor and delivery. • Utilize the principles of interviewing techniques in assessing women and newborns. • Accurately perform abdominal palpation. • Competently assess the progress of labor.

Module 3: Normal Pregnancy


• Correctly interpret the various types of CTG strips during labor • Safely conduct a normal birth. • Conduct immediate newborn assessment care. • Participate in collaborative, interdisciplinary partnerships with health professionals to

enhance the care of pregnant women and their families. • Use technology related to labor and delivery. • Act as an advocate for women in all aspects of their care. • Implement the principles of infection control.


Module 4: Biostatistics This module is intended to help learners understand the fundamental concepts and methods of statistics as applied to health-related fields. This includes basic concepts in descriptive and inferential statistics as they apply to health and nursing research, such as measurement scales, frequency distributions, and measures of central tendency and distribution. Additionally, it provides learners with the main concepts for testing statistical hypotheses; constructing and interpreting confidence intervals; and applying selected nonparametric techniques, including correlation coefficients, linear regression, probability theory, binomial distribution, and parametric and non-parametric tests of significant differences.

Learning Objectives: At the end of the module, the learner will be able to: • Demonstrate familiarity with statistical terminology and the purpose of statistics. • Identify ways of organizing data. • Define and compute measures of central tendency and variability. • Demonstrate understanding of the analysis of statistical data within the context of the

research process. • Provide necessary statistical background for analyzing data and drawing inferences from

that analysis. • Exhibit understanding of the logic of hypothesis testing.

Module Outline: • Descriptive statistics, frequencies, shapes, measures of central tendency. • Univariate descriptive statistics measures of variability: range standard deviation scores

within a distribution, z-scores, standardized distribution. • Bivariate descriptive statistics. • Correlation (Pearson r as descriptive). • Inferential statistics, probability, sampling distributions and error, standard error of the mean,

central limit theorem, hypothesis testing, power analysis, type I & II errors, level of significance/critical regions, confidence interval, one-tailed and two-tailed tests, parametric tests, between subjects versus within subjects, bivariate inferential statistics, t-tests for independent groups, paired t-tests (dependent groups), ANOVA.

• Non-parametric tests, chi square, goodness of fit, test for independence, bi-variate inferential statistics, Pearson r as inferential, multi-variate statistics, simple linear regression, and factor analysis.

Clinical Competencies: • Use SPSS program. • Enter and organize raw data. • Analyze data and draw inferences. • Select appropriate tests.


Module 5: Nursing Research and Evidence-Based Practice This module focuses on the framework of research processes, as applied to nursing and evidence-based practice. It is designed to present basic concepts and methods of nursing research. Emphasis is placed on critique and utilization of current nursing research. The module highlights the role of research in establishing a knowledge base for nursing practice and nursing research approaches. The evidence-based part develops beginning competency in accessing and evaluating scientific knowledge, as a base for promoting evidence-based practice in nursing care. The module focuses on documenting and interpreting evidence for improving patient outcomes. In addition, the module highlights basic understanding of how evidence is developed, including the research processes applied to nursing practice.

Learning objectives: At the end of the module, the learner will be able to: • Define and understand the basic concepts of research methodologies. • Differentiate between different research designs. • Describe the scientific process and its use in nursing research. • Design a research proposal project. • Demonstrate research process steps in the proposal and/or conduct a nursing research

project. • Identify research problems and literature review processes related to nursing practice. • Discuss appropriate statistical techniques in data analysis. • Critique current studies in nursing practice. • Discuss the utilization of research findings. • Define the historical perspective of evidence-based practice (EBP). • Apply EBP principles in nursing practice.

Module Outline: • Overview of nursing research. • Research methodology and processes. • Designs for nursing research. • Collection of research data • Critical appraisal and utilization of nursing research. • EBP and research-based practice.

Clinical Competencies: • Design a research proposal. • Conduct a literature search on midwifery issues. • Gather references to support the research topic. • Select a research title of interest in the field of midwifery. • Write a research study. • Prepare a manuscript for publication.

Module 5: Nursing Research and Evidence-Based Practice


Teaching methods: A variety of teaching methods will be utilized: • Classroom lectures • Group work/discussions • Article critique • Critical analysis of papers


Module 6: Epidemiology This module is an introduction to epidemiology and the epidemiological approach to population-based health care. The basic principles and methods of epidemiology are presented, together with many of the applications of epidemiology in clinical practice and public health. It covers the dynamics of disease transmission, measuring the occurrence of disease, validity and reliability of screening tests, randomized trials, cohort studies, case control, cross-sectional studies, inferences, bias, confounding, and interaction. The laboratory session will focus on analyzing and evaluating epidemiological reports.

Learning Objectives: At the end of this module, the learner will be able to: • Demonstrate the mechanisms and dynamics of disease transmission in populations and the

risk factors that determine their distribution. • Calculate the measures of morbidity and mortality, incidence, and prevalence. • Assess the validity and reliability of diagnostic and screening tests. • Explain the different mechanisms used to describe disease prognosis in quantitative terms

for groups of patients. • Assess the efficacy of preventive and therapeutic measures via randomized trials. • Design and conduct epidemiological studies (cohort, cross-sectional, retrospective, and

prospective). • Differentiate between association and causation. • Recognize the potential biases, confounders, and interacting factors in an epidemiological

study. • Explain the role of genetic and environmental factors in disease causation. • Apply epidemiologic methods to evaluate screening programs. • Identify sources of information on disease occurrence. • Critique medical and health research studies.

Module Outline: • Definition of epidemiology and defining health. • Dynamics of disease transmission-infectious disease epidemiology. • Measuring the occurrence of disease. • Assessing the reliability and validity of diagnostic and screening tests. • Assessing the efficacy of preventive and therapeutic measures: randomized trials, cohort

studies, case control, and cross-sectional studies • Estimating risk-determining association and the potential for prevention. • From association to causation: deriving inferences from epidemiologic studies. • Bias, confounding, and interaction. • Identifying the roles of genetic and environmental factors in disease causation. • Ethical and professional issues in epidemiology.

Module 6: Epidemiology


Additional Resources: The following resources are available online: 1. Super Course: Epidemiology, the Internet, and Global Health: http://www.pitt.edu/~super1/ 2. Epidemiology materials from the Department of Epidemiology and Biostatistics, University

of California, San Francisco: http://www.epibiostat.ucsf.edu/epidem/epidem.html 3. Coggon, D., Rose, G., & Barker, D.J.P. (2003). Epidemiology for the uninitiated, 5th ed.

BMJ Books: Chennai.


Module 7: High-risk pregnancy (antenatal, natal, postnatal and newborns) This module provides the knowledge and skills needed in managing women with high-risk pregnancy throughout the process, using a family-centered approach. It introduces the evidence-based care and management of high-risk newborns. The module also assists learners to provide appropriate health education programs for the groups. The clinical part of the module provides learners with procedural awareness and skills in managing women with abnormal antenatal, labor, and puerperium conditions. It also focuses on the care of high-risk newborns. Clinical experience will be acquired at hospitals in high-risk areas and special care units for newborns.

Learning objectives: At the end of the module, the learner will be able to: • Describe different methods for fetal and uterine monitoring during labor. • Interpret fetal and uterine monitor readings. • Evaluate the progress of abnormal labor. • Comprehend the underlying causes of some gestational-related complications. • Provide essential care in cases of high-risk pregnancy and complicated labor. • Provide competent nursing care for high-risk newborns. • Develop counseling and education programs for women with high-risk pregnancy and their

families. • Provide evidence-based care for women and newborns in critical conditions. • Assist in complicated deliveries.

Module outline: • Assessment and management of diseases in pregnancy

a. Diabetes mellitus b. Cardiac diseases c. Chronic hypertension d. Chronic renal failure e. Haematological disorders f. Systemic lupus erythematus g. Trauma in pregnant women h. Epilepsy

• Assessment and management of gestational related complications: a. Hyperemesis gravidarum b. Antepartum bleeding (early, late) c. Pregnancy-induced hypertension (preeclampsia, eclampsia) d. Other problems associated with bleeding e. Disorders of amniotic fluids (polyhydramnios, oligohydramnios) f. Multiple pregnancy g. Preterm rupture of membrane

• Assessment and management of complications in labor: a. Dystocia b. Preterm labor and birth c. Post-term pregnancy d. Induction of labor

Module 7: High-risk pregnancy


e. Prolonged labor f. Obstructed labor g. Malpositions and malpresentations h. Hemorrhagic complications i. Prolapse of umbilical cord j. Amniotic fluid embolism k. Intrapartum fetal monitoring and care l. Nursing care and management

• Assessment and management of complications in puerperium: a. Postpartum hemorrhage b. Puerperal infection c. Thrombophlebitis d. Urinary tract infection e. Postpartal pregnancy-induced hypertension f. Mastitis g. Nursing care and management

• Management in operative labor: a. Instrumental-assisted vaginal delivery b. Caesarean delivery c. Emergency midwifery practice

• Emergency care of high-risk newborn: a. Initial care b. Continued care c. Resuscitation of the newborn d. Sensory enrichment of the newborn

• High-risk infant: a. Disorders of gestational age and birth weight b. Congenital disorders c. Metabolic and endocrine disorders d. Acquired disorders e. Nursing care and management

Competencies: • Demonstrate the knowledge required to provide care and advice to women and their families

during high-risk pregnancy, labor, birth, and postpartum. • Provide culturally appropriate and sensitive care. • Obtain complete health and obstetrical history. • Perform a complete physical examination of the woman and newborn. • Identify risk factors before and during pregnancy, labor, birth, and postpartum. • Refer high-risk pregnancy to appropriate medical specialist. • Provide appropriate evidence-based care to women during high-risk pregnancy. • Prepare the equipment required for labor and delivery. • Utilize the principles of interviewing techniques in assessing women and newborns. • Accurately perform abdominal palpation. • Competently assess the progress of labor. • Identify abnormal CTG strips during labor. • Safely assist in complicated birth. • Assist in cesarean sections.

Module 7: High-risk pregnancy


• Assist in instrumental delivery. • Conduct emergency care of newborns. • Participate in collaborative, interdisciplinary partnerships with obstetricians and pediatricians

to prevent high-risk pregnancy complications. • Use technology in dealing with high-risk pregnancy. • Act as an advocate for high-risk women in all aspects of their care. • Implement principles of infection control.


Module 8: Women’s health This module introduces the learner to a broad range of health disorders experienced by women from adolescence through to senescence. Selected topics include issues of menstruation, infertility, violence, infectious diseases, chronic medical illness, and mental disorder among women. In addition, the module covers the concepts and skills required for midwives to provide evidence-based care and guidance on gynecological problems, with emphasis on the development of critical thinking, wise judgment, and decision-making. Clinical experiences will include simulations and direct patient care.

Learning objectives: At the end of the module, the learner will be able to: • Comprehend different laboratory investigations for gynecological disorders. • Interpret the readings of common laboratory findings. • Compare medical and surgical approaches to pregnancy termination. • Comprehend the underlying causes of infertility. • Provide essential care to abused women. • Develop family planning program counseling and education to women and their families. • Value evidenced-based nursing knowledge to guide practice or women with gynecological

disorders.

Module outline: • Pre-menstrual syndrome • Menstruation and menopause • Sexually transmitted diseases • Infertility disorders • Benign and malignant growths in the reproductive system • Reproductive surgery • HIV • Osteoporosis • Rape and sexual assault • Family planning • Termination of pregnancy • Grief and loss

Competencies: • Demonstrate understanding of basic concepts related to gynecological disorders in women. • Obtain comprehensive biopsychosocial data of women with gynecological disorders • Use appropriate communication skills. • Provide basic and advanced nursing care to gynecological clients. • Plan and prioritize nursing care plans according to the needs of women with gynecological

disorders. • Incorporate evidence-based knowledge in the care of gynecological clients. • Facilitate and coordinate access to other members of the multidisciplinary team in

performing their role of caring for women with gynecological disorders. • Apply critical thinking approaches in caring for women with gynecological disorders.

Module 8: Women’s health


• Conduct teaching and learning strategies appropriate for women with gynecological

disorders and their families. • Comply with Saudi reporting regulations for birth and death registration. • Competently insert an IUD.


Module 9: Ethics in Nursing This module provides an opportunity to study the ethical and legal issues arising in health care and related fields. It aims to deepen learners’ understanding of health care ethics and law, and to enhance their ability to think systematically about the moral and legal issues that health care professionals may face in their work. It provides learners with an opportunity to: (1) develop the ethical practice capabilities demonstrated by nurses working as advanced clinicians in the health care sector; and (2) continually develop and transform ethical professional practice through the process of critical evaluation and reflection.

Learning Objectives: At the end of this module, the learner will be able to: • Examine the nature and role of ethical theories in guiding sound ethical decision-making in

workplace settings. • Discuss the ethical and legal context of professional nursing practice. • Examine key ethical issues occurring in nursing and related health care contexts. • Discuss processes for achieving desired moral outcomes in nursing and healthcare

domains. • Analyze conflicting duties and rights inherent in moral dilemmas. • Discuss the impact of current issues related to health care delivery. • Use ethical reasoning to synthesize standards of practice, ethical principles, and

legal/regulatory requirements in the resolution of ethical dilemmas.

Module Outline: • Introduction to Moral and Legal Concepts:

a. Introduction to the concepts and theories used. b. The distinction between consequentialist and deontological theories of ethics. c. The relationship between law, morality, and the nature of moral and legal rights.

• Credentialing & licensing: a. Professional nursing practice. b. Accountability and responsibility in professional practice. c. Nursing code of ethics.

• Autonomy and Paternalism: a. Ethical and legal issues raised in informed consent, consent to treatment, confidentiality,

patient choice, and medical paternalism. b. Ethical principles and human rights as a decision-making framework in relation to:

i. the relationship between law, ethics, and standards of professional practice ii. cross-cultural ethics iii. patients’ rights to health care and being treated with respect

• Life and Death: a. Difficult ethical issues relating to the creation and destruction of human life. b. Moral and legal status of the embryo; issues raised by reproductive technologies; the

definition of death; moral and legal problems regarding physician-assisted suicide; euthanasia, and the withdrawal of medical treatment.


• Public Health:

a. Justice and resource allocation or “rationing” of medical treatment b. Research ethics c. Discrimination and health care d. Issues raised by new technologies


Module 10: Nursing Informatics This module introduces learners to the emerging field of nursing informatics (theory and applications) and its effect on administration, clinical practice, education, and research. Here, great emphasis is placed on the critical factors that shape nursing informatics as a specialty, i.e., roles, competencies, skills, and the legislative acts that direct utilization. Learners will explore different health information systems to appreciate the utilization of nursing informatics for documentation, discharge planning, communication, professional development, networking, and health team collaboration and research.

Learning Objectives: At the end of this module, the learner will be able to: • Describe the foundations of nursing informatics as an emerging field in the nursing

profession, and identify the key factors and legislative organizations that help to shape nursing informatics.

• List and discuss evolving models and theories of informatics that define the role and competencies of nursing informatics.

• Explain the implications of nursing informatics for nursing practice, administration, education, and research.

• Demonstrate skills in acquiring and retrieving nursing information using health information systems within the institution, the Web, and various electronic resources.

• Apply approaches that safeguard data and information integrity, while maintaining privacy and confidentiality.

Module Outline: • Introduction and overview.

a. The evolution of informatics in health care b. The foundations nursing informatics c. The process of nursing informatics

• Nursing informatics goals, standards, and scope of practice. • Nursing informatics competencies:

a. Computer literacy skills (software and hardware, data storage, input and output devises, workstations, etc.).

b. Information literacy skills (application software that support nursing practice, internet, LAN, WAN, Web, etc.).

• Key nursing informatics organizations shaping nursing informatics and influencing healthcare: a. The International Medical Informatics Association (IMIA) recommendations (centering on

health care professionals educational need to acquire knowledge and skills in information processing and information and communications technology).

b. The Technology Informatics Guiding Education Reform (TIGER) initiative recommendations for health informatics / medical and nursing informatics education to deliver better patient care.

• Models and theories of informatics that indicate the quality of information. • Internet, search engines, and electronic databases and resources. • Selecting health care information systems that support health care organization (e.g., care

plans, documentation and staffing, decision support systems, etc.).

Module 10: Nursing Informatics


• System implementation, maintenance, and development. • Computer-based electronic patient records. • Data integrity, security, and confidentiality. • Intranet, extranet, and network integration. • Community-based health information networks (information technology in patient education). • Integrating computers and information technology in nursing education and practice:

a. Telemedicine and telehealth a. Research- and evidence-based resources for nursing:

– http://www.joannabriggs.org/index.html – http://ebn.bmjjournals.com

Competencies: • Use information and communications technology in the management of client/patient-related

data. • Identify different models of computerized health care service electronic records. • Differentiate between models of health information management systems. • Analyze the implications for healthcare delivery arising from telehealth and telemedicine. • Recognize the impact of the information technology revolution on nursing practices. • Apply skills to access, create, store, and retrieve nursing–related information from the Web

and Internet. • Demonstrate ways of integrating nursing informatics in the nursing areas of administration,

education, clinical practice, and research. • Utilize security regulations to safeguard the data and information of clients and the

organization. • Recognize ethical issues related to nursing informatics. • Assess the future of information technology and its impact on nursing practices.

Additional resources: The following resources are available online. • Wood, F. & Wright, P. (1996). The Impact of Information on Clinical Decision Making by

General Medical Practitioners. Information Research, 2(1). http://InformationR.net/ir/2- 1/paper11.html

• NINR. (1997). Nursing Informatics: Enhancing Patient Care. http://www.nih.gov/ninr/ research/vol4/

• AMIA Working Group – Nursing Informatics: www.amia.org • TIGER Informatics Competencies Collaborative (TICC) Team Report: www.tigersummit.com


Module 11: Nursing Management and Leadership This module examines managerial and leadership concepts, issues, roles, and functions, as applied to the role of the professional nurse in various nursing specialties.

Learning Objectives: • Apply theories of effective leadership and management within selected health care arenas. • Utilize the skills of nursing processes, critical thinking, ethical decision-making,

communication, and therapeutic nursing intervention in managing the culturally competent and cost-effective care of groups of clients across the wellness/illness continuum.

• Collaborate with interdisciplinary health care team members in prioritizing and coordinating high quality and cost-effective healthcare.

• Demonstrate leadership and management of a care-giving team comprising individuals with varied cultural and ethnic origins, and varied levels of clinical knowledge and competencies.

• Utilize skills of inquiry and research to enhance their knowledge base, facilitate change, and improve the quality of care.

• Demonstrate professional accountability for effective leadership within nursing practice and for advancement of the profession.

Module outline: • Definition and application of leadership and management (theories of effective leadership;

followership; management and leadership styles). • Organizational and personal mission, vision, and goals. • SWOT analysis and strategic planning. • Critical thinking, problem-solving, and effective decision-making. • Quality and risk management. • Budgeting, costs, care-delivery models, and staffing. • Communication, motivation, and team-building. • Change and conflict management. • Role transition and delegation.


Module 12: Professional Performance This module will be designed according to each learner’s area of interest.

Learning Objectives: • Utilize the skills of nursing processes, critical thinking, ethical decision-making,

communication, and therapeutic nursing intervention in the area of interest. • Demonstrate competencies in the area of interest. • Utilize skills of inquiry and evidence-based practice in the area of interest.

Module outline: The content will be defined according to the area of interest.


Additional online universal topics The SCFHS has developed universal topics as learning resources for trainees. Twenty topics have been selected for midwifery learners. Each leaner must complete the additional topics during the training period. At the end of each Learning Unit, there will be an online formative assessment. After a learner completes all of the topics, they will undergo a combined summative assessment in the form of context-rich multiple-choice questions. All learners must meet the predetermined competency threshold in the summative assessment. Alternatively, these topics can be assessed in a summative manner along with the specialty examination.

Distribution of additional online universal topics across the two calendar years of the program

Complete in first year Complete in second year

Safe drug prescribing Sepsis; SIRS; DIVC

Hospital-acquired infections (HAIs) Recognition and management of diabetic emergencies

Antibiotic stewardship Management of diabetic complications

Blood transfusion Comorbidities of obesity

Acute pain management Abnormal ECG

Chronic pain management Pre-operative assessment

Management of fluids in hospitalized patients

Post-operative care

Management of electrolyte imbalances Patient advocacy

Occupational hazards of health care workers (HCWs)

Ethical healthcare: treatment refusal; patient autonomy

Evidence-based approach to smoking cessation

Role of doctors in death and dying

Online Module: Introduction 1. Safe drug prescribing: At the end of the Learning Unit, the learner should be able to:

a. Recognize the importance of safe drug prescribing in healthcare. b. Describe the various adverse drug reactions with examples of commonly prescribed

drugs that can cause such reactions. c. Apply principles of drug-drug interactions, drug-disease interactions, and drug-food

interactions in common situations. d. Apply principles of prescribing drugs in special situations, such as renal failure and liver

failure. e. Apply principles of prescribing drugs in elderly, pediatrics age-group patients, and in

pregnancy and lactation.

Additional online universal topics


f. Promote evidence-based cost effective prescribing. g. Discuss the ethical and legal framework governing safe-drug prescribing in Saudi

Arabia. 2. Hospital-acquired infections (HAIs): At the end of the Learning Unit, the learner should

be able to: a. Discuss the epidemiology of HAIs with special reference to HAIs in Saudi Arabia. b. Recognize HAIs as one of the major emerging threats in healthcare. c. Identify the common sources of HAIs. d. Describe the risk factors of common HAIs, such as ventilator-associated pneumonia,

MRSA, CLABSI, and vancomycin resistant enterococcus (VRE). e. Identify the role of healthcare workers in preventing HAIs. f. Determine appropriate pharmacological (e.g., selected antibiotic) and non-

pharmacological (e.g., removal of indwelling catheter) measures in treating HAIs. g. Propose a plan to prevent HAIs in the workplace.

3. Sepsis; SIRS; DIVC: At the end of the Learning Unit, the learner should be able to a. Explain the pathogenesis of sepsis, SIRS, and DIVC. b. Identify patient-related and non-patient related predisposing factors of sepsis, SIRS,

and DIVC. c. Recognize a patient at risk of developing sepsis, SIRS, and DIVC. d. Describe the complications of sepsis, SIRS, and DIVC. e. Apply the principles of managing patients with sepsis, SIRS, and DIVC. f. Describe the prognosis of sepsis, SIRS, and DIVC.

4. Antibiotic stewardship: At the end of the Learning Unit, the learner should be able to: a. Recognize antibiotic resistance as one of the most pressing public health threats

globally. b. Describe the mechanism of antibiotic resistance. c. Determine the appropriate and inappropriate use of antibiotics. d. Develop a plan for safe and proper antibiotic usage, including the right indications,

duration, types of antibiotics, and discontinuation. e. Remain appraised of local guidelines in the prevention of antibiotic resistance

5. Blood transfusion: At the end of the Learning Unit, the learner should be able to: a. Review the different components of blood products available for transfusion. b. Recognize the indications and contraindications of blood product transfusion. c. Discuss the benefits, risks, and alternatives to transfusion. d. Undertake consent for a specific blood product transfusion. e. Perform the steps necessary for safe transfusion. f. Develop understanding of the special precautions and procedures necessary during

massive transfusions. g. Recognize transfusion-associated reactions and provide immediate management.

Online Module: Diabetes and Metabolic Disorders 1. Recognition and management of diabetic emergencies: At the end of the Learning

Unit, the learner should be able to: a. Describe the pathogenesis of common diabetic emergencies, including their

complications. b. Identify risk factors and groups of patients vulnerable to such emergencies. c. Recognize a patient presenting with a diabetic emergency. d. Institute immediate management. e. Refer the patient to the appropriate next level of care. f. Counsel patients and their families to prevent such emergencies.



2. Management of diabetic complications: At the end of the Learning Unit, the learner should be able to: a. Describe the pathogenesis of important complications of Type 2 diabetes mellitus. b. Screen patients for such complications. c. Provide preventive measures for such complications. d. Treat such complications. e. Counsel patients and families with special emphasis on prevention.

3. Comorbidities of obesity: At the end of the Learning Unit, the learner should be able to: a. Screen patients for the presence of common and important comorbidities of obesity. b. Manage obesity-related comorbidities. c. Provide dietary and lifestyle advice for prevention and management of obesity.

4. Abnormal ECG: At the end of the Learning Unit, the learner should be able to: a. Recognize common and important ECG abnormalities. b. Institute immediate management, if necessary.

Online Module: Acute Care 1. Pre-operative assessment: at the end of the Learning Unit, the learner should be able to:

a. Describe the basic principles of pre-operative assessment. b. Perform a pre-operative assessment of uncomplicated patients, with special emphasis

on: i. General health assessment ii. Cardiorespiratory assessment iii. Medications and medical device assessment iv. Drug allergies v. Pain relief needs

c. Categorize patients according to risks. 2. Post-operative care: At the end of the Learning Unit, the learner should be able to:

a. Devise a post-operative care plan, including monitoring of vitals, pain management, fluid management, medications, and laboratory investigations.

b. Hand-over patients properly to the appropriate facilities. c. Describe the process of post-operative recovery in a patient. d. Identify common post-operative complications. e. Monitor patients for possible post-operative complications. f. Institute immediate management of post-operative complications.

3. Acute pain management: At the end of the Learning Unit, the learner should be able to: a. Review the physiological basis of pain perception. b. Proactively identify patients who might be in acute pain. c. Assess a patient with acute pain. d. Apply various pharmacological and non-pharmacological modalities available for acute

pain management. e. Provide adequate pain relief for uncomplicated patients with acute pain. f. Identify and refer patients with acute pain who can benefit from specialized pain

services. 4. Chronic pain management: At the end of the Learning Unit, the learner should be able to:

a. Review the bio-psychosocial and physiological bases of chronic pain perception. b. Discuss various pharmacological and non-pharmacological options available for chronic

pain management. c. Provide adequate pain relief for uncomplicated patients with chronic pain. d. Identify and refer patients with chronic pain who can benefit from specialized pain

services.



5. Management of fluids in hospitalized patients: At the end of the Learning Unit, the learner should be able to: a. Review the physiological basis of water balance in the body. b. Assess a patient for their hydration status. c. Recognize a patient with over- and under-hydration. d. Order fluid therapy (oral and/or intravenous) for a hospitalized patient. e. Monitor fluid status and response to therapy through history, physical examination, and

selected laboratory investigations. 6. Management of electrolyte imbalances: At the end of the Learning Unit, the learner

should be able to: a. Review the physiological bases of electrolyte and acid-base balances in the body. b. Identify the diseases and conditions likely to cause or associated with electrolyte and

acid-base imbalances. c. Correct electrolyte and acid-base imbalances. d. Perform careful calculations, checks, and other safety measures while correcting

electrolyte and acid-base imbalances. e. Monitor response to therapy through history, physical examination, and selected

laboratory investigations.

Online Module: Ethics and Healthcare 1. Occupational hazards of Health Care Workers (HCWs): At the end of the Learning Unit,

the learner should be able to: a. Recognize common sources and risk factors of occupational hazards for HCWs. b. Describe common occupational hazards in the workplace. c. Develop familiarity with the legal and regulatory frameworks governing occupational

hazards for HCWs. d. Develop a proactive attitude to promote workplace safety. e. Protect yourself and colleagues against potential occupational hazards in the

workplace. 2. Evidence-based approach to smoking cessation: At the end of the Learning Unit, the

learner should be able to: a. Describe the epidemiology of smoking and tobacco usages in Saudi Arabia. b. Review the effects of smoking on the smoker and their family members. c. Effectively use pharmacologic and non-pharmacologic measures to treat tobacco usage

and dependence. d. Effectively use pharmacologic and non-pharmacologic measures to treat tobacco usage

and dependence among special population groups, such as pregnant women, adolescents, and patients with psychiatric disorders.

3. Patient advocacy: At the end of the Learning Unit, the learner should be able to: a. Define patient advocacy. b. Recognize patient advocacy as a core value governing medical practice. c. Describe the role of patient advocates in the care of patients. d. Develop a positive attitude towards patient advocacy. e. Be a patient advocate in conflicting situations. f. Be familiar with local and national patient advocacy groups.

4. Ethical and Healthcare: treatment refusal; patient autonomy: At the end of the Learning Unit, the learner should be able to: a. Predict situations where a patient or family is likely to decline the prescribed treatment. b. Describe the concept of a “rational adult” in the context of patient autonomy and

treatment refusal.



c. Analyze the key ethical, moral, and regulatory dilemmas in treatment refusal. d. Recognize the importance of patient autonomy in the decision-making process. e. Counsel patients and their families declining medical treatment in light of the patients’

best interests. 5. Role of doctors in death and dying: At the end of the Learning Unit, the learner should

be able to: a. Recognize the important role a doctor can play during the dying process. b. Provide emotional and physical care to a dying patient and their family. c. Provide appropriate pain management for a dying patient. d. Identify suitable patients for referral to palliative care services.


Appendices

Appendix I

Teaching Resources/textbooks American Psychological Association. (2011). Publication Manual of the American Psychological

Association, 6th ed. Washington, DC. Butt, J.B. & Rich, K.L. (2015). Nursing Ethics: Across the Curriculum and Into Practice, 4th ed.

Jones & Bartlett Learning, L.L.C: Burlington, MA, USA. ISBN: 978-1-284-05950-2. Cunningham, F.G., Leveno, K.J., Bloom, S.L, Spong, C.Y., Dashe, J.S., Hoffman, B.L., &

Casey, B.M. (2018). Williams Obstetrics, 25th ed. McGraw-Hill. Davidson, M., London, M., & Ladewig, P. (2015). Olds’ Maternal-Newborn Nursing & Women’s

Health: across the lifespan, 10th ed. Pearson: Boston. ISBN-13: 978-0133954036, ISBN-10: 013395403X.

Davidson, M., London, M., & Ladewig, P. (2012). Clinical handbook for maternal-newborn

nursing and women’s health care. Prentice Hall: Upper Saddle River, N.J. Doenges, M., Moorhouse, M., & Murr, A. (2014). Nursing care plans: Guidelines for

individualizing client care across the lifespan, 10th ed. F.A. Davis: Philadelphia. Hacker, N.F., Gambone, J.C., & Hobel, C.J. 2016. Hacker & Moore’s Essentials of Obstetrics &

Gynecology, 6th ed. Elsevier: Philadelphia. Foster, I. R. & Lasser, J. (2010). Professional Ethics in Midwifery Practice. Jones & Bartlett

Learning: Boston. Gordis, L. (2014). Epidemiology, 5th ed. W.B. Saunders Co: New York. Gravetter, F. & Wallnau, L. (2013). Essentials of Statistics for the Behavioral Sciences, 8th ed.

Thomas Wadsworth: Belmont, CA. ISBN-13: 9780495812203, ISBN-13: 978-1133956570. Hacker, N., Moore, G., & Gambone, J. (2013). Essentials of Obstetrics & Gynecology, 4th ed.

Elsevier Saunders. Hebda, T.L., Hunter, K., & Czar, P. (2018). Handbook of Informatics for Nurses & Healthcare

Professionals, 6th ed. Hoffman, B.L, Schorge, J., Bradshaw, K., Halvorson, L., Schaffer, J., & Corton, M.M. (2016).

Williams Gynecology. McGraw-Hill. Huston, C.J. (2017). Professional Issues in Nursing: Challenges & Opportunities, 4th ed. Wolters

& Kluwer: Philadelphia.

Appendices


International Confederation of Midwives. (2013). Essential competencies for basic midwifery practice. www.internationalmidwives.org

Leeuwen, A. & Poelhuis, D. (2013), Davis’s Comprehensive Handbook of Laboratory and

Diagnostic Tests with Nursing Implications, 5th ed. F.A. Davis: Philadelphia. ISBN-13: 978-0-8036-3664-4.

Lewis, L. (2015). Fundamental of Midwifery: A Textbook for Students. Wiley-Blackwell: UK Marshall, J. & Raynor, M. (eds.) (2014). Myles Textbook for Midwives. Churchill Livingstone:

UK. ISBN: 978-0-7020-5145-6. McGonigle, D. & Mastrian, K.G. (2014). Nursing informatics and the foundation of knowledge,

4th ed. Jones & Bartlett Learning, LLC. Murray, S.S. & McKinney, E.S. (2013). Foundations of Maternal-Newborn Nursing. Elsevier

Health Sciences. ISBN 9781455733064. North-West University. (2017). Midwifery Practice. Faculty of Health Sciences, North-West

University, Potchefstroom Campus. Polit, D.F., Beck, C.T., & Hungler, B. (2018). Essentials of Nursing Research: Methods,

Appraisal, and Utilization, 9th ed. Lippincott. Polit, D.F. & Hungler, B.P. (1999). Nursing Research, Principles and Methods, 6th ed. Lippincott. Posner, G.D., Dy, J., Black, A., & Jones, G.P. (2013). Oxorn-Foote Human labor and birth.

6th ed. McGraw-Hill: New York. Schorge, J., Schaffer, J., Halvorson, L., Hoffman, B., Bradshaw, K., & Cunningham, G. (2012).

Williams Gynecology. McGraw-Hill. Schneider, Z. (2016). Nursing and midwifery research: methods and appraisal for evidence-

based practice, 5th ed. Elsevier Australia: Chatswood, N.S.W. ISBN: 9780729542302. Tappero, E.P. & Honeyfield, M.E. (2014). Physical Assessment of the Newborn: A

Comprehensive Approach to the Art of Physical Examination. NICU INK Book Publishers. ISBN 10: 1887571183, ISBN 13: 9781887571180.

Tharpe, N.L., Farley, C., & Jordan, R.G. (2017). Clinical Practice Guidelines for Midwifery and

Women’ Health, 5th ed. Jones & Bartlett Learning: Boston. Thede, L.Q. & Sewell, J. (2010). Informatics and Nursing: Competencies and Applications, 3rd

ed. Wolters Kluwer Health / Lippincott Williams & Wilkins. Van Leeuwen, A.M. & Bladh, M.L. (2013). Davis’s Comprehensive Handbook of Laboratory and

Diagnostic Tests with Nursing Implications, 7th ed. F.A. Davis: Philadelphia. ISBN: 9780803659438.

Appendices


Weber, J. & Kelly, J. (2014). Health Assessment in Nursing, 5th ed. Lippincott: Philadelphia. Yoder-Wise, P. (2014). Leading and Managing in Nursing, 5th ed. Mosby Inc.

Electronic resources: http://www.pregnancy.com.au/midwifery/midwifery-resources/index.shtml http://www.midirs.org/


Appendix II

References used in Program Development American College of Nurse-Midwives. (2011). Standards for the Practice of Midwifery. American College of Nurse-Midwives. (2012). Definition of Midwifery and scope of Practice of

Certified Nurse-Midwives and Certified Midwives. Al-Kadri, H.M., Al-Anazi, S.A., & Tamim, H.M. (2015). Increased cesarean section rate in

Central Saudi Arabia: a change in practice or different maternal characteristics. International Journal of Women’s Health, 7: 685–692. Published online July 10, 2015. doi: 10.2147/IJWH.S85215

Chief Nursing Officers (2010) Midwifery 2020: Delivery of Expectations. Department of Health,

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216029/dh_119470.pdf

International Confederation of Midwives. (2011) Essential Competences for Basic Midwifery

Practice 2010. International Confederation of Midwives. www.internationalmidwives.org Ministry of Health. (2016). Annual Report 2015-2016. Riyadh. Sandall, J., Soltani, H., Gates, S., Shennan, A., & Devane, D. (2013). Midwife-led continuity

models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews 2013, 8, Art. No.: CD004667. doi: 10.1002/14651858. CD004667.pub3.

Council of Economic and Development Affairs (2016). National Transformation Program 2020.

http://vision2030.gov.sa/sites/default/files/NTP_En.pdf World Bank (n.d.). Fertility rate. Data retrieved on 30/7/2017. http://data.worldbank.org/

indicator/SP.DYN.TFRT.IN World Health Organization (WHO). (2011). Strengthening Midwifery Toolkit, Module 4. WHO:

Geneva. WHO. (2014). Investment in midwifery can save millions of lives of women and newborns. Joint

news release, June 3, 2014. WHO, UNFPA, International Confederation of Midwives. WHO. (2016a). Maternal mortality Fact sheet. Updated November 2016, http://www.who.int/

mediacentre/factsheets/fs348/en/ WHO. (2016b). Nursing and midwifery: WHO Global Strategic Directions for Strengthening

Nursing and Midwifery 2016–2020. http://www.who.int/hrh/nursing_midwifery/nursing-midwifery/en/


Appendix III

References for Program Execution For further information about leave, refer to chapter 7 of the General Bylaws of Training in Postgraduate Programs, authored by the SCFHS, 1439AH, available at: http://www.scfhs.org.sa/en/MESPS/Pages/Regulations--.aspx The SCFHS Digital Library provides instructors and trainees with access to diverse electronic learning resources, including full-text evidence-based reports of best practices, such as the Ovid Medical Collection, Mosby’s Nursing Consult, LexiComp, PubMed Central, and up-to-date Digital Library. These are available at: http://www.scfhs.org.sa/en/elibrary/Pages/default.aspx Trainees will record their learning activities in an electronic logbook, which can be reviewed by their instructors. The instructions for users are available from the SCFHS, at: http://www.scfhs.org.sa/en/MESPS/TrainingProgs/ElectrobookCases/Pages/default.aspx Instructors and trainees should refer to the SCFHS General Examination Rules and Regulations, 1439AH, available at: http://www.scfhs.org.sa/en/examinations/Pages/default.aspx For further information on the evaluation, promotion, and completion of training, refer to the Rules of Procedure for Training of Saudi Board Specialties, authored by the SCFHS 1439AH, available at: http://www.scfhs.org.sa/en/Reglations/Pages/default.aspx


Appendix IV


Comprehensive In-Training Evaluation Report (ITER)

Learner’s name: Training Center:

SFCHS #: Level of training: first year ( ); second year ( )

Clinical Area:

Key Never=0 Rarely=1 Occasionally=2 Frequently=3 Always=4

Meeting Expectations*

Competencies 0 1 2 3 4 N/A Midwifery expertise 1 Demonstrate basic and clinical

midwifery knowledge

2 Conduct accurate nursing assessment and diagnosis

3 Plan appropriate midwifery care based on analysis and evidences

4 Implement nursing and midwifery management and care competently

5 Evaluate the progress of the client based on planned outcomes and revise the care plan confidently

Procedures and clinical skills 6 Perform midwifery skills

competently

Communication 7 Present accurate information 8 Document accurately according to

the organizational policies

9 Participate in teaching others (clients, family, and colleagues)

Collaboration 10 Interact with other health

professionals (nurses, physicians, others) in a professional manner

11 Provide consultations to colleagues 12 Manage conflicts between clients

and staff

Appendix IV


Technology 13 Use information technology

competently

14 Comprehend different technological resources

Leadership and management 15 Manage time effectively 16 Implement institutional policies and

procedures

17 Maximize patient benefits 18 Manage conflicts between clients

and colleagues

Health Advocate 19 Advocate for client & family

members

Scholar

20 Attend continuous education programs/courses

21 Implement an ongoing plan for self-education

22 Conduct one research project 23 Complete logbook Professional 24 Demonstrate a professional attitude 25 Comprehend nursing & midwifery

legal obligations

26 Demonstrate punctuality and report absence or sickness through the correct channels according to the institutional policies

27 Adhere to code of ethics and morals of the profession

28 Accept constructive criticisms and advice

29 Participate in professional activities 30 Submit assignments on time Total (Please comment on the strengths and weaknesses of the candidate. Make direct reference to the specific objectives and give specific examples wherever possible.) Score:

Completed by preceptor: Date: Signature: Program director name: Date: Signature: Leaner’s name: Date: Signature: *Never: 0%, Rarely: ≤30%, Occasionally: > 30-60%, Frequently: > 60-90%, Always: > 90%

ADVANCED NU

RSING MIDWI

FERY PROGRA

M 49

Appe

ndix

V

Com

pete

ncy

Che

cklis

ts fo

r Adv

ance

d M

idw

ifery

AD

VAN

CED

MID

WIF

ERY

Posi

tion

title

: Tra

inee

U

nit:

____

____

____

____

____

____

____

____

____

N

ame:

___

____

____

____

____

____

____

____

____

____

____

____

____

__

Le

arne

r sel

f-ass

essm

ent

Valid

atio

n of

com

pete

ncy

Com

pete

ncy

Met

hod

of

Inst

ruct

ion

(use

in

stru

ctio

n ke

y as

in

dica

ted1 )

N

ever

do

ne

N

eeds

re

view

/pra

ctic

e

C

ompe

tent

Dat

e

Initi

als

Ev

alua

tion

met

hod

(use

ev

alua

tion

key

as

indi

cate

d2 ) M

odul

e 3:

Nor

mal

pr

egna

ncy:

Ant

enat

al

care

His

tory

-taki

ng –

Firs

t an

tena

tal v

isit

His

tory

-taki

ng –

follo

w u

p vi

sit t

o an

tena

tal c

linic

Phys

ical

exa

min

atio

n of

pr

egna

nt w

oman

–

incl

udin

g br

east

ex

amin

atio

n

Abdo

min

al e

xam

inat

ion

of p

regn

ant w

omen

–

Leop

old

man

euve

rs

Appendix V

50

ADVANCED NU

RSING MIDWI

FERY PROGRA

M

Taki

ng a

nd in

terp

retin

g of

car

diot

ocog

ram

Asse

ssm

ent o

f fet

al

wel

lbei

ng

Hea

lth e

duca

tion

of

preg

nant

wom

en

1 Met

hod

of I

nstr

uctio

n ke

y: P

=Pro

toco

l/pro

cedu

re r

evie

w,

E=Ed

ucat

ion

sess

ion,

S=S

elf

lear

ning

pac

kage

, C

= C

linic

al p

ract

ice,

D

=Dem

onst

ratio

n.

2 Met

hod

of E

valu

atio

n ke

y: O

=Obs

erva

tion

in a

clin

ical

set

ting,

RD

=Ret

urn

dem

onst

ratio

n, T

= W

ritte

n te

st, V

= Ve

rbal

revi

ew.

Appendix V

ADVANCED NU

RSING MIDWI

FERY PROGRA

M 51

ADVA

NC

ED M

IDW

IFER

Y Po

sitio

n tit

le: T

rain

ee

Uni

t: __

____

____

____

____

____

____

____

____

__

Nam

e: _

____

____

____

____

____

____

____

____

____

____

____

____

____

Le

arne

r sel

f-ass

essm

ent

Valid

atio

n of

com

pete

ncy

C

ompe

tenc

y

Met

hod

of

Inst

ruct

ion

(use

in

stru

ctio

n ke

y as

in

dica

ted1 )

N

ever

do

ne

N

eeds

re

view

/pra

ctic

e

C

ompe

tent

Dat

e

Initi

als

Ev

alua

tion

met

hod

(use

ev

alua

tion

key

as

indi

cate

d2 )

Mod

ule

3: N

orm

al

preg

nanc

y: C

are

durin

g in

trap

artu

m

perio

d

Adm

issi

on o

f a w

oman

in

labo

r

Vagi

nal e

xam

inat

ion

O

bser

vatio

n, c

are,

and

re

cord

keep

ing

in th

e fir

st

stag

e of

labo

r, in

clud

ing

parto

gram

Prep

arat

ion

for d

eliv

ery

M

anag

emen

t of t

he 2

nd

and

3rd s

tage

of a

de

liver

y

Epis

ioto

my:

infil

tratio

n,

cutti

ng, a

nd s

utur

ing

Appendix V

52

ADVANCED NU

RSING MIDWI

FERY PROGRA

M

Imm

edia

te c

are

of th

e ne

onat

e

Exam

inat

ion

of th

e pl

acen

ta

1 Met

hod

of I

nstr

uctio

n ke

y: P

=Pro

toco

l/pro

cedu

re r

evie

w,

E=Ed

ucat

ion

sess

ion,

S=S

elf

lear

ning

pac

kage

, C

= C

linic

al p

ract

ice,

D

=Dem

onst

ratio

n.

2 Met

hod

of E

valu

atio

n ke

y: O

=Obs

erva

tion

in a

clin

ical

set

ting,

RD

=Ret

urn

dem

onst

ratio

n, T

= W

ritte

n te

st, V

= Ve

rbal

revi

ew.

Appendix V

ADVANCED NU

RSING MIDWI

FERY PROGRA

M 53

ADVA

NC

ED M

IDW

IFER

Y Po

sitio

n tit

le: T

rain

ee

Uni

t: __

____

____

____

____

____

____

____

____

__

Nam

e: _

____

____

____

____

____

____

____

____

____

____

___

Clu

ster

Are

a: M

idw

ifery

Lear

ner s

elf-a

sses

smen

t Va

lidat

ion

of c

ompe

tenc

y

Com

pete

ncy

Met

hod

of

Inst

ruct

ion

(use

in

stru

ctio

n ke

y as

in

dica

ted1 )

N

ever

do

ne

N

eeds

re

view

/pra

ctic

e

C

ompe

tent

Dat

e

Initi

als

Ev

alua

tion

met

hod

(use

ev

alua

tion

key

as

indi

cate

d2 )

Mod

ule

3: N

orm

al

preg

nanc

y: C

are

durin

g po

stpa

rtum

Han

dove

r of m

othe

r and

ba

by to

pos

tnat

al w

ard

staf

f

Nur

sing

car

e du

ring

puer

periu

m, i

nclu

ding

fu

ndal

ass

essm

ent

Assi

stin

g m

othe

r to

put

baby

to th

e br

east

for

brea

stfe

edin

g

Six

wee

ks p

ostp

artu

m

exam

inat

ion

1 Met

hod

of I

nstr

uctio

n ke

y: P

=Pro

toco

l/pro

cedu

re r

evie

w,

E=Ed

ucat

ion

sess

ion,

S=S

elf

lear

ning

pac

kage

, C

= C

linic

al p

ract

ice,

D

=Dem

onst

ratio

n.

2 Met

hod

of E

valu

atio

n ke

y: O

=Obs

erva

tion

in a

clin

ical

set

ting,

RD

=Ret

urn

dem

onst

ratio

n, T

= W

ritte

n te

st, V

= Ve

rbal

revi

ew.

Appendix V

54

ADVANCED NU

RSING MIDWI

FERY PROGRA

M

ADVA

NC

ED M

IDW

IFER

Y Po

sitio

n tit

le: T

rain

ee

Uni

t: __

____

____

____

____

____

____

____

____

__

Nam

e: _

____

____

____

____

____

____

____

____

____

____

___

Clu

ster

Are

a: M

idw

ifery

Lear

ner s

elf-a

sses

smen

t Va

lidat

ion

of c

ompe

tenc

y

Com

pete

ncy

Met

hod

of

Inst

ruct

ion

(use

in

stru

ctio

n ke

y as

in

dica

ted1 )

N

ever

do

ne

N

eeds

re

view

/pra

ctic

e

C

ompe

tent

Dat

e

Initi

als

Ev

alua

tion

met

hod

(use

ev

alua

tion

key

as

indi

cate

d2 ) M

odul

e 3:

Nor

mal

pr

egna

ncy:

Car

e of

th

e ne

onat

e

Neo

nata

l res

usci

tatio

n

Rec

eivi

ng th

e ba

by

deliv

ered

via

ces

area

n se

ctio

n

Phys

ical

exa

min

atio

n of

th

e ne

wbo

rn

Bath

ing

the

new

born

Cor

d ca

re

N

ursi

ng o

f neo

nate

in

incu

bato

r

Oxy

gen

ther

apy

Ph

otot

hera

py

M

easu

ring

of n

eona

te’s

bl

ood

gluc

ose

Appendix V

ADVANCED NU

RSING MIDWI

FERY PROGRA

M 55

1 M

etho

d of

Ins

truc

tion

key:

P=P

roto

col/p

roce

dure

rev

iew

, E=

Educ

atio

n se

ssio

n, S

=Sel

f le

arni

ng p

acka

ge,

C=

Clin

ical

pra

ctic

e,

D=D

emon

stra

tion

2 Met

hod

of E

valu

atio

n ke

y: O

=Obs

erva

tion

in a

clin

ical

set

ting,

RD

=Ret

urn

dem

onst

ratio

n, T

= W

ritte

n te

st, V

= Ve

rbal

revi

ew.

Appendix V

56

ADVANCED NU

RSING MIDWI

FERY PROGRA

M

ADVA

NC

ED M

IDW

IFER

Y Po

sitio

n tit

le: T

rain

ee

Uni

t: __

____

____

____

____

____

____

____

____

__

Nam

e: _

____

____

____

____

____

____

____

____

____

____

___

Clu

ster

Are

a: M

idw

ifery

Lear

ner s

elf-a

sses

smen

t Va

lidat

ion

of c

ompe

tenc

y

Com

pete

ncy

Met

hod

of

Inst

ruct

ion

(use

in

stru

ctio

n ke

y as

in

dica

ted1 )

N

ever

do

ne

N

eeds

re

view

/pra

ctic

e

C

ompe

tent

Dat

e

Initi

als

Ev

alua

tion

met

hod

(use

ev

alua

tion

key

as

indi

cate

d2 ) M

odul

e 7:

Hig

h-ris

k pr

egna

ncy

and

birt

h

Nur

sing

car

e of

pre

gnan

t w

omen

with

co

mpl

icat

ions

, e.g

., pr

eecl

amps

ia,

gest

atio

nal d

iabe

tes,

ca

rdia

c co

nditi

ons,

pr

emat

ure

labo

r

Nur

sing

car

e of

pat

ient

on

mag

nesi

um s

ulfa

te

Man

agem

ent o

f in

duct

ion

of la

bor

Man

agem

ent o

f in

stru

men

t del

iver

y

Appendix V

ADVANCED NU

RSING MIDWI

FERY PROGRA

M 57

Pre-

op p

repa

ratio

n of

pa

tient

for a

ces

area

n se

ctio

n

Man

agem

ent o

f obs

tetri

c em

erge

ncy,

suc

h as

po

stpa

rtum

hem

orrh

age

1 Met

hod

of I

nstr

uctio

n ke

y: P

=Pro

toco

l/pro

cedu

re r

evie

w,

E=Ed

ucat

ion

sess

ion,

S=S

elf

lear

ning

pac

kage

, C

= C

linic

al p

ract

ice,

D

=Dem

onst

ratio

n.

2 Met

hod

of E

valu

atio

n ke

y: O

=Obs

erva

tion

in a

clin

ical

set

ting,

RD

=Ret

urn

dem

onst

ratio

n, T

= W

ritte

n te

st, V

= Ve

rbal

revi

ew.

Appendix V

58

ADVANCED NU

RSING MIDWI

FERY PROGRA

M

ADVA

NC

ED M

IDW

IFER

Y Po

sitio

n tit

le: T

rain

ee

Uni

t: __

____

____

____

____

____

____

____

____

__

Nam

e: _

____

____

____

____

____

____

____

____

____

____

___

Clu

ster

Are

a: M

idw

ifery

Lear

ner s

elf-a

sses

smen

t Va

lidat

ion

of c

ompe

tenc

y

Com

pete

ncy

Met

hod

of

Inst

ruct

ion

(use

in

stru

ctio

n ke

y as

in

dica

ted1 )

N

ever

do

ne

N

eeds

re

view

/pra

ctic

e

C

ompe

tent

Dat

e

Initi

als

Ev

alua

tion

met

hod

(use

ev

alua

tion

key

as

indi

cate

d2 )

Mod

ule

8: W

omen

’s

heal

th

Com

preh

ensi

ve h

isto

ry-

taki

ng o

f wom

en re

gard

ing

gene

ral,

gyne

colo

gica

l, ob

stet

rical

, and

re

prod

uctiv

e he

alth

Phys

ical

exa

min

atio

n of

pr

e-pr

egna

ncy

wom

en

Hea

lth e

duca

tion

rega

rdin

g lo

cally

ava

ilabl

e an

d cu

ltura

lly a

ccep

tabl

e co

ntra

cept

ives

Perfo

rmin

g a

Pap

smea

r

Appendix V

ADVANCED NU

RSING MIDWI

FERY PROGRA

M 59

Inse

rtion

of a

n in

tra-u

terin

e co

ntra

cept

ive

devi

ce

Rem

oval

of a

n in

tra-

uter

ine

cont

race

ptiv

e de

vice

1 Met

hod

of I

nstr

uctio

n ke

y: P

=Pro

toco

l/pro

cedu

re r

evie

w,

E=Ed

ucat

ion

sess

ion,

S=S

elf-l

earn

ing

pack

age,

C=

Clin

ical

pra

ctic

e,

D=D

emon

stra

tion.

2 M

etho

d of

Eva

luat

ion

key:

O=O

bser

vatio

n in

a c

linic

al s

ettin

g, R

D=R

etur

n de

mon

stra

tion,

T=

Writ

ten

test

, V=

Verb

al re

view

.

Appendix V

60

ADVANCED NU

RSING MIDWI

FERY PROGRA

M

ADVA

NC

ED M

IDW

IFER

Y Po

sitio

n tit

le: T

rain

ee

Uni

t: __

____

____

____

____

____

____

____

____

__

Nam

e: _

____

____

____

____

____

____

____

____

____

____

___

Clu

ster

Are

a: M

idw

ifery

Lear

ner s

elf-a

sses

smen

t Va

lidat

ion

of c

ompe

tenc

y

Com

pete

ncy

Met

hod

of

Inst

ruct

ion

(use

in

stru

ctio

n ke

y as

in

dica

ted1 )

N

ever

do

ne

N

eeds

re

view

/pra

ctic

e

C

ompe

tent

Dat

e

Initi

als

Ev

alua

tion

met

hod

(use

ev

alua

tion

key

as

indi

cate

d2 ) H

ospi

tal/u

nit s

peci

fic

com

pete

ncie

s

Adm

inis

tratio

n of

blo

od

and

bloo

d pr

oduc

ts

Dru

g ca

lcul

atio

ns

Fa

ll pr

even

tion

In

fect

ion

cont

rol

El

ectro

nic

reco

rd

keep

ing

1 Met

hod

of I

nstr

uctio

n ke

y: P

=Pro

toco

l/pro

cedu

re r

evie

w,

E=Ed

ucat

ion

sess

ion,

S=S

elf-l

earn

ing

pack

age,

C=

Clin

ical

pra

ctic

e,

D=D

emon

stra

tion.

2 M

etho

d of

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Appendix VI


Oral Presentation Assessment Rubric

Item/scale 4 - Excellent 3 – Good 2 - Fair 1 – Need improvement

Delivery Speaks in different volume. Continues direct eye contact, seldom look at notes and emphasize the key points

Speaks with satisfactory different volume. Consistent use direct eye contact but returns to note frequently

Speaks in uneven volume monotone Show minimal eye contact, reading mostly from the notes

Speaks in low volume and monotonous tone Show no eye contact, read from the notes entirely

Content/Organization Provides clear purpose and subject with examples Demonstrate full understanding by answering question

Somewhat clear purpose and subject, with some examples Answer questions without elaboration

Attempt to define purpose and subject, provides weak examples Uncomfortable with information, answer some questions

Does not define subject and purpose clearly, provides no examples Does not grasp the information and unable to answer questions

Enthusiasm Demonstrates strong enthusiasm about the topic during presentation

Show some enthusiasm about the topic

Show little enthusiasm about the topic

Show no interest about the topic


Appendix VII


Case Study Assessment Rubric Leaner’s Name:

Grade Items

4 - Excellent 3 – Good 2 - Fair 1 – Needs improvement

Background (briefly summarize the client’s condition)

Adequate introduction to the case study client’s condition, including relevant information

Fair introduction to the client’s condition, with little unrelated information

Very general background with non-specific information

Inappropriate background

Client profile (age, medical & obstetric history, past history)

Thorough, relevant, and clear client profiles

Generic client data, perhaps failing to discuss one history type

Some client data missing and unclear; overly wordy and ineffective communication

No relevant information provided regarding the client; difficult to read and understand

Physical assessment findings

Thorough physical assessment findings

General findings

Some missing findings

Incomplete findings

Medical & nursing diagnosis

Accurate medical diagnosis and complete nursing diagnosis

Medical & nursing diagnoses written superficially

Some missing details from medical & nursing diagnoses

Inappropriate medical & nursing diagnoses

Medical management and nursing plan

Comprehensive medical management and nursing care plan

General medical management and nursing care plan

Missing some aspects of medical management, and only general nursing care plan

Incomplete medical management and nursing care plan

Appendix VII


Conclusion Clear and

concise case summary

Wordy or overly case summary

Inadequate case summary

Fails to provide a relevant conclusion on the case

Formatting Thoroughly follows guidelines

Generally follows formatting guidelines, with minimal errors

Several errors Fails to adhere to general formatting

Grammar No grammatical/spelling mistakes

Minimal grammatical/spelling errors (<10 errors)

Several significant grammatical/spelling errors (> 10 errors)

Difficulty to read due to many grammatical/spelling errors

Total marks= /32


Appendix VIII


Research Project Assessment Rubric

Rubric for research project assessment

Learner’s name: Learner’s number: Supervisor: Date of submission:

0= non-existent; 1 = acceptable

Criteria 0 1 Proposed title: Clear and accurate—reflects the main aspects of the study

Key words: Core concept definitions

Introduction, background, and problem statement: comprehensive, applicable and contextual literature study

Research question: Research question linked to research problem

Research aim/s and objectives: Aim/s and objectives are formulated clearly

Research design and methods: Correct choice of research design implemented

Study context: Setting/context clearly described

Population and sampling Number of participants adequate to achieve research aims

Clear description and justification of sampling technique

Ethical considerations described

Data collection Clear description of data collection method(s)

Clear description of data collection tool/technique(s)

Data collection tool/technique(s) generate the necessary data to answer research question

Data analysis Clear description of data analysis method(s)

Clear link between purpose/rationale of data analysis and the data collected

Clear description of how data will be stored and managed

Appendix VIII


Rigor Clear link between methods to ensure rigor and overall research approach

Clearly defined strategies and techniques to ensure rigor

Overall technical management Plagiarism: No more than 5% plagiarism

Scientific reference ability: Adherence to APA reference method

Overall writing is clear and easy to understand

Adherence to research project specifications

Total: /22 Comments:

Evaluator: Signature: Date:

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Advanced Nursing Practice Diploma in Midwifery

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