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Recognition and management of critical illness by midwives: implications for service provision.

AIM
The aim of this study was to explore midwives' recognition and management of critical illness in obstetric women in order to inform service provision.


BACKGROUND
Critical illness is not confined to Intensive Care. Limited published work was located examining factors affecting critical care provision by midwives.


METHODS
A multi-method design incorporating a paper and pencil simulation (n = 11) and in-depth interviewing (n = 5) was conducted with midwives from a large London National Health Service Trust. This study details and discusses the findings.


RESULTS
Findings indicated that frequency and type of critical illness experience impact upon midwives' critical care knowledge and skills. Midwives, especially those who were more junior, expressed anxiety regarding this aspect of practice, and considered the support of senior midwives, medical and nursing staff as crucial to effective client management.


CONCLUSION
This study has yielded important insights into midwives' management of critical illness. Possible mechanisms to enhance the quality of service provision, and midwife support in this area are highlighted.