Are specially trained midwives the right professionals to perform the newborn physical examination?
The newborn infant physical examination (NIPE) is a screening tool and holistic assessment of the newborn, and abnormalities detected are referred as per individual Trust procedures. The extension of the role of the midwife has enabled specially trained midwives to undertake the NIPE, which had previously been the exclusive remit of medical practitioners. However, the clinical effectiveness of midwives in this role has not been measured in a robust manner. The introduction of the NIPE SMART tool should facilitate comprehensive and systematic audit of clinical effectiveness of practitioners in conducting NIPE, and standardisation of the examination and documentation. Even so, the eligibility criteria to have NIPE undertaken by a midwife varies between NHS Trusts, and calls for standardisation of such criteria have remained unanswered.
It is widely accepted that the midwife, having received specialist training, is the appropriate health professional to conduct the newborn infant physical examination (NIPE) on low-risk infants (Mitchell, 2003b; Townsend et al, 2004; Clarke and Simms, 2012; Ironton, 2012; Fryer and Evans, 2015; Rogers et al, 2015). Although NIPE is standardised nationally, Trusts invoke different criteria regarding which low-risk neonates are eligible to have NIPE undertaken by a midwife (McDonald et al, 2012; Rogers et al, 2015). This article explores the available literature on midwifeled NIPE, using the Critical Appraisal Skills Programme (2013) and Cluett and Bluff's (2006) critiquing tool to conduct a comprehensive analysis.
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