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International Journal of Trend in Scientific Research and Development (IJTSRD)
Volume 4 Issue 6, September-October 2020 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470
@ IJTSRD | Unique Paper ID – IJTSRD35698 | Volume – 4 | Issue – 6 | September-October 2020 Page 1501
Challenges in Implementing Innovations in
Midwifery Practice: An Overview
Mrs. Jasmi Manu
Associate Professor, HOD of OBS/GYN Nursing,
Rama College of Nursing, Rama University, Kanpur, Uttar Pradesh, India
ABSTRACT
Midwifery Nursing and women’s health emphasize the caring of women who
are in need of care in their reproductive life as well nurturing in the journey
from the womb to the beautiful world. As a midwife, she would be a great
specialist to care the women from menarche to menopause. On other aspect,
this branch of nursing provides optimum and comprehensivecareinprenatal,
natal and postpartum for the mothers and to get their newborns healthy and
charming. Innovations, research findings are many, in this era. Unfortunately,
in the health care system in a challenging facet to implement these innovative
practices in midwifery. We the midwives to think innovatively to implement
the findings and research evidences as a styleofqualitycaretothewomanand
child.
KEYWORDS: reproductive life, midwife, prenatal and innovative practices
How to cite this paper: Mrs. Jasmi Manu
"Challenges in Implementing Innovations
in Midwifery Practice: An Overview"
Published in
International Journal
of Trend in Scientific
Research and
Development(ijtsrd),
ISSN: 2456-6470,
Volume-4 | Issue-6,
October 2020,
pp.1501-1503, URL:
www.ijtsrd.com/papers/ijtsrd35698.pdf
Copyright © 2020 by author(s) and
International Journal ofTrendinScientific
Research and Development Journal. This
is an Open Access article distributed
under the terms of
the Creative
CommonsAttribution
License (CC BY 4.0)
(http://creativecommons.org/licenses/by/4.0)
INTRODUCTION
“A little knowledge that acts is worth infinitely more than
much knowledge that is idle.”
-Kahlil Gibran
Innovation is the action of introducinga new method,idea or
product . Research Innovation is the act of conservative
thinking, grouping knowledge, skills, attitude into new
original & rational ideas .The generation of new research
ideas or application of existing ideas to a new situation
resulting in improvementin nursingandhealthcaredelivery
system1. Implementation research is the wide range of
scientific study of barriers to and methods of promoting the
systematic application of research findings in practice,
including in public policy. The implementation of research
innovation in nursing is a greatest challenge in current
scenario. Implementation is “the use of strategies to adopt
and integrate evidence-based health interventions and
change practice patterns within specific settings.”2
IJTSRD35698
International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD35698 | Volume – 4 | Issue – 6 | September-October 2020 Page 1502
IMPEMENTING RESEARCH INNOVATIONS
Evidence based Nursing practice, Increased focus on
outcome research .Outcome researchisresearchdesignedto
assess and document the effectiveness of health care
services Promotion or research utilization will used to
Translate research findings into practice and nurses at all
levels are encouraged to take evidence in evidence based
patient care3. Implementation is a specified set of activities
designed to put into practice an activity or program of
known dimensions. innovations are many in nursing.
Unfortunately implementing or putting the new ideas in
practice will be challenge4.
Closing the Gap
“Closing the gap between research discovery and program
delivery is both a complex challenge and an absolute
necessity if we are to ensure that all populations benefit
from the Nation’s investments in new scientificdiscoveries.”
(National Institutes of Health).5The field of Implementation
Research seeks to close this gap:“supports the movement of
evidence-based interventions and approaches from the
experimental, controlled environment into the actual
delivery contexts where the programs, tools, and guidelines
will be utilized, promoted, and integrated into the existing
operational culture”6
IMPLEMENTATION OF RESEARCH FINDINGS IN
MIDWIFERY PRACTICE
Implementation research is the wide range of
scientific study of barriers to and methods of promoting the
systematic application of research findings in practice,
including in public policy.7 The implementation of research
innovation in nursing is a greatest challenge in current
scenario. Implementation is “the use of strategies to adopt
and integrate evidence-based health interventions and
change practice patterns within specific settings.”8
CHALLENGES:- “It’s not only about the numbers of
midwives, it’s about the skills of our frontline workers’’
Some of the significant challenges will be discussed below:-
Lack of knowledge on research innovations by the
nursing professionals
Misperception and negative attitudes on research
innovations
Lack of awareness on how to carry out the innovative
ideas in day to day clinical nursing
Overload of nursing assignments that leaves them with
0 time in research
Large amount of information The amount of research
information isoverwhelming-andLackingadequateand
correct information
Fear for one to have different practice from what other
nurses peers working 9
Contradictory patient expectations
Physician and patient factors
Proper allocation of roles (Strategy role)-training and
support strategies to implement researchinnovationsin
nursing
Limited access to up to date user-friendly technology
and computer system
Translationgapfromknowledgeof researchinnovations
and clinical practices
Afraid of failures; of opposition; of the unknown.
Reluctant to experiment.
Bound by custom & tradition.
Unaware of our strengths for achievement in nursing
Proper allocation of roles10
saving clinical time, cost-effectiveness andeaseofusein
considerations for community nurses when
implementing an innovation
Ownership, flexibility and the autonomy to adapt the
innovation
Pre-existing trusting nurse–patient relations
Organizational infrastructure and changes
Organizational changes – restructuring and the
decentralization of services – had a negative impact upon
implementation
Gaps in the literature
Organizational Factorsthebiggestchallengesreported
were “insufficient time on the job to implement new
ideas”, “nurse does not feel she/he has enough
authority to change patient care procedures”,
“administration will not allow implementation”,
“physicians will not cooperate with implementation”
and “nurse does not have time to read research”
Constraints within the organizations also.
Communicational Factors- Communication factors
measured the nurses’ perceptions of the presentation
and accessibility of the research
Quality of Research
Individual factors, which are considerednurse-related
barriers, “nurse does not feel capable of evaluating the
quality of the research” was reported as the highest
barrier. More than half of the surveys considered “the
nurse sees little benefit for self” and “the nurse is
unwilling to change/try new ideas” as challenges .
Likewise, about half of the respondents didnotconsider
“the nurse is isolated from knowledgeable colleagues
with whom to discuss the research” a resistors .. 11
Human Barriers-Fear of change, Inertia, Investment in
the status quo, Inherently difficult work of doing
something differently
Lacking adequate and correct information
Lack of administrative support
ENABLING MIDWIVES TO MAKE THE DIFFERENCE
Meeting women’s needs
The midwifery workforce
Developing the midwife’s role in public health and
addressing inequalities
Measuring the contribution midwives make
Supporting midwives
Developing a contemporary image of midwifery
Educating midwives
Developing midwives
Maximizing midwives’ influence 12
THE CONTEXT OF MIDWIFERY 2020
As we think about context of midwifery 2020 indicates the
various aspects such as Health and social context, Economic
context, The workforce, Context of midwifery practice,
Midwives as part of the multidisciplinary team, Changes in
midwifery education, Careers in midwifery
Conclusion:
Implementing innovation in maternal health is a lifelong,
updated approach to clinical decision makingandexcellence
in practice. Evidence-based nursing care is informed by
research findings, clinical expertise,andpatients'values,and
International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD35698 | Volume – 4 | Issue – 6 | September-October 2020 Page 1503
its use can improve maternal outcomes. Use of research
innovations in clinical practice is an expected standard of
practice for nurses and health care organizations, but
numerous challenges exist that create a gap between new
knowledge and implementation of that knowledge to
improve patient care. Using the levels of scientific proofs,
nurses can determinethestrengthofresearchstudies,assess
the findings, and evaluate the evidence for potential
implementation into best practice.
References:-
[1] ACOG and American AcademyofPediatrics,“Neonatal
encephalopathy and cerebral palsy: Defining the
pathogenesis and pathophysiology”. January2003,pp
4-12
[2] ACOG Committee opinion, “Committee on Obstetric
Practice, inappropriate use of thetermsFetal Distress
and Birth Asphyxia’. Compendium of selected
publications, No. 326, December 2005.
[3] ACOG Committee Opnion, “Committee on Obstetric
Practice- the APGAR Score”, Number 333, May2006
pp1-4.
[4] Gosman MD et al, “Introduction of an obstetric
specific medical emergency team for obstetric crises.
Implementation and experience.” AJOG, April
2008;367
[5] ACOG Committee on patient Safety and Quality
Improvement; Medical emergency Preparedness.
ACOG Committee Opinion, No. 353, December 2006.
[6] Ahmed, S. M. et al. Human Resources for Health, 9:3,
2011.
[7] The World Health Report 2006 - workingtogetherfor
health, World Health Organization, Geneva, 2006.
[8] Fauveau, V., Sherratt, D. R., and de Bernis, L., Human
resources for maternal health: multi-purpose or
specialists? Human Resources for Health,
6:21doi:10.1186/1478- 4491-6-21, 2008.
[9] Koblinsky, M. et al, The Lancet, Vol. 368, 2006. 5.
McCoy et al., Human Resources for Health, 6:16 doi:
10.1186/1478-4491-6-16, 2008.
[10] The World Health Report 2000, Health Systems:
Improving Performance, World Health Organization,
Geneva, 2000.
[11] Increasing Access to Health Workers in Remote and
Rural Areas through Improved Retention, Global
Policy Recommendations, WorldHealthOrganization,
Geneva, 2010.
[12] The National Primary Health Care Development
Agency of Nigeria, submitted as part of the Human
Resources for Health Awards for Excellence Program
for the Second Global Forum on HumanResourcesfor
Health, December 2010

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Challenges in Implementing Innovations in Midwifery Practice An Overview

  • 1. International Journal of Trend in Scientific Research and Development (IJTSRD) Volume 4 Issue 6, September-October 2020 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470 @ IJTSRD | Unique Paper ID – IJTSRD35698 | Volume – 4 | Issue – 6 | September-October 2020 Page 1501 Challenges in Implementing Innovations in Midwifery Practice: An Overview Mrs. Jasmi Manu Associate Professor, HOD of OBS/GYN Nursing, Rama College of Nursing, Rama University, Kanpur, Uttar Pradesh, India ABSTRACT Midwifery Nursing and women’s health emphasize the caring of women who are in need of care in their reproductive life as well nurturing in the journey from the womb to the beautiful world. As a midwife, she would be a great specialist to care the women from menarche to menopause. On other aspect, this branch of nursing provides optimum and comprehensivecareinprenatal, natal and postpartum for the mothers and to get their newborns healthy and charming. Innovations, research findings are many, in this era. Unfortunately, in the health care system in a challenging facet to implement these innovative practices in midwifery. We the midwives to think innovatively to implement the findings and research evidences as a styleofqualitycaretothewomanand child. KEYWORDS: reproductive life, midwife, prenatal and innovative practices How to cite this paper: Mrs. Jasmi Manu "Challenges in Implementing Innovations in Midwifery Practice: An Overview" Published in International Journal of Trend in Scientific Research and Development(ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-6, October 2020, pp.1501-1503, URL: www.ijtsrd.com/papers/ijtsrd35698.pdf Copyright © 2020 by author(s) and International Journal ofTrendinScientific Research and Development Journal. This is an Open Access article distributed under the terms of the Creative CommonsAttribution License (CC BY 4.0) (http://creativecommons.org/licenses/by/4.0) INTRODUCTION “A little knowledge that acts is worth infinitely more than much knowledge that is idle.” -Kahlil Gibran Innovation is the action of introducinga new method,idea or product . Research Innovation is the act of conservative thinking, grouping knowledge, skills, attitude into new original & rational ideas .The generation of new research ideas or application of existing ideas to a new situation resulting in improvementin nursingandhealthcaredelivery system1. Implementation research is the wide range of scientific study of barriers to and methods of promoting the systematic application of research findings in practice, including in public policy. The implementation of research innovation in nursing is a greatest challenge in current scenario. Implementation is “the use of strategies to adopt and integrate evidence-based health interventions and change practice patterns within specific settings.”2 IJTSRD35698
  • 2. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD35698 | Volume – 4 | Issue – 6 | September-October 2020 Page 1502 IMPEMENTING RESEARCH INNOVATIONS Evidence based Nursing practice, Increased focus on outcome research .Outcome researchisresearchdesignedto assess and document the effectiveness of health care services Promotion or research utilization will used to Translate research findings into practice and nurses at all levels are encouraged to take evidence in evidence based patient care3. Implementation is a specified set of activities designed to put into practice an activity or program of known dimensions. innovations are many in nursing. Unfortunately implementing or putting the new ideas in practice will be challenge4. Closing the Gap “Closing the gap between research discovery and program delivery is both a complex challenge and an absolute necessity if we are to ensure that all populations benefit from the Nation’s investments in new scientificdiscoveries.” (National Institutes of Health).5The field of Implementation Research seeks to close this gap:“supports the movement of evidence-based interventions and approaches from the experimental, controlled environment into the actual delivery contexts where the programs, tools, and guidelines will be utilized, promoted, and integrated into the existing operational culture”6 IMPLEMENTATION OF RESEARCH FINDINGS IN MIDWIFERY PRACTICE Implementation research is the wide range of scientific study of barriers to and methods of promoting the systematic application of research findings in practice, including in public policy.7 The implementation of research innovation in nursing is a greatest challenge in current scenario. Implementation is “the use of strategies to adopt and integrate evidence-based health interventions and change practice patterns within specific settings.”8 CHALLENGES:- “It’s not only about the numbers of midwives, it’s about the skills of our frontline workers’’ Some of the significant challenges will be discussed below:- Lack of knowledge on research innovations by the nursing professionals Misperception and negative attitudes on research innovations Lack of awareness on how to carry out the innovative ideas in day to day clinical nursing Overload of nursing assignments that leaves them with 0 time in research Large amount of information The amount of research information isoverwhelming-andLackingadequateand correct information Fear for one to have different practice from what other nurses peers working 9 Contradictory patient expectations Physician and patient factors Proper allocation of roles (Strategy role)-training and support strategies to implement researchinnovationsin nursing Limited access to up to date user-friendly technology and computer system Translationgapfromknowledgeof researchinnovations and clinical practices Afraid of failures; of opposition; of the unknown. Reluctant to experiment. Bound by custom & tradition. Unaware of our strengths for achievement in nursing Proper allocation of roles10 saving clinical time, cost-effectiveness andeaseofusein considerations for community nurses when implementing an innovation Ownership, flexibility and the autonomy to adapt the innovation Pre-existing trusting nurse–patient relations Organizational infrastructure and changes Organizational changes – restructuring and the decentralization of services – had a negative impact upon implementation Gaps in the literature Organizational Factorsthebiggestchallengesreported were “insufficient time on the job to implement new ideas”, “nurse does not feel she/he has enough authority to change patient care procedures”, “administration will not allow implementation”, “physicians will not cooperate with implementation” and “nurse does not have time to read research” Constraints within the organizations also. Communicational Factors- Communication factors measured the nurses’ perceptions of the presentation and accessibility of the research Quality of Research Individual factors, which are considerednurse-related barriers, “nurse does not feel capable of evaluating the quality of the research” was reported as the highest barrier. More than half of the surveys considered “the nurse sees little benefit for self” and “the nurse is unwilling to change/try new ideas” as challenges . Likewise, about half of the respondents didnotconsider “the nurse is isolated from knowledgeable colleagues with whom to discuss the research” a resistors .. 11 Human Barriers-Fear of change, Inertia, Investment in the status quo, Inherently difficult work of doing something differently Lacking adequate and correct information Lack of administrative support ENABLING MIDWIVES TO MAKE THE DIFFERENCE Meeting women’s needs The midwifery workforce Developing the midwife’s role in public health and addressing inequalities Measuring the contribution midwives make Supporting midwives Developing a contemporary image of midwifery Educating midwives Developing midwives Maximizing midwives’ influence 12 THE CONTEXT OF MIDWIFERY 2020 As we think about context of midwifery 2020 indicates the various aspects such as Health and social context, Economic context, The workforce, Context of midwifery practice, Midwives as part of the multidisciplinary team, Changes in midwifery education, Careers in midwifery Conclusion: Implementing innovation in maternal health is a lifelong, updated approach to clinical decision makingandexcellence in practice. Evidence-based nursing care is informed by research findings, clinical expertise,andpatients'values,and
  • 3. International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD35698 | Volume – 4 | Issue – 6 | September-October 2020 Page 1503 its use can improve maternal outcomes. Use of research innovations in clinical practice is an expected standard of practice for nurses and health care organizations, but numerous challenges exist that create a gap between new knowledge and implementation of that knowledge to improve patient care. Using the levels of scientific proofs, nurses can determinethestrengthofresearchstudies,assess the findings, and evaluate the evidence for potential implementation into best practice. References:- [1] ACOG and American AcademyofPediatrics,“Neonatal encephalopathy and cerebral palsy: Defining the pathogenesis and pathophysiology”. January2003,pp 4-12 [2] ACOG Committee opinion, “Committee on Obstetric Practice, inappropriate use of thetermsFetal Distress and Birth Asphyxia’. Compendium of selected publications, No. 326, December 2005. [3] ACOG Committee Opnion, “Committee on Obstetric Practice- the APGAR Score”, Number 333, May2006 pp1-4. [4] Gosman MD et al, “Introduction of an obstetric specific medical emergency team for obstetric crises. Implementation and experience.” AJOG, April 2008;367 [5] ACOG Committee on patient Safety and Quality Improvement; Medical emergency Preparedness. ACOG Committee Opinion, No. 353, December 2006. [6] Ahmed, S. M. et al. Human Resources for Health, 9:3, 2011. [7] The World Health Report 2006 - workingtogetherfor health, World Health Organization, Geneva, 2006. [8] Fauveau, V., Sherratt, D. R., and de Bernis, L., Human resources for maternal health: multi-purpose or specialists? Human Resources for Health, 6:21doi:10.1186/1478- 4491-6-21, 2008. [9] Koblinsky, M. et al, The Lancet, Vol. 368, 2006. 5. McCoy et al., Human Resources for Health, 6:16 doi: 10.1186/1478-4491-6-16, 2008. [10] The World Health Report 2000, Health Systems: Improving Performance, World Health Organization, Geneva, 2000. [11] Increasing Access to Health Workers in Remote and Rural Areas through Improved Retention, Global Policy Recommendations, WorldHealthOrganization, Geneva, 2010. [12] The National Primary Health Care Development Agency of Nigeria, submitted as part of the Human Resources for Health Awards for Excellence Program for the Second Global Forum on HumanResourcesfor Health, December 2010