Part 2: A model for evidence-based decision-making in midwifery care
National and local health-care policies, along with professional standards and guidance, call for midwives to play a key role in delivering evidence-based, safe, personalised care in partnership with women. However, the tools to guide this complex process have been missing. This paper introduces, explains and demonstrates the utility of a model of evidence-based decision-making for midwifery. Uniquely, the model uses a very broad definition of evidence, which includes evidence from the woman, the midwife, research and resources, in an environmental context. The model addresses a gap in theory and practice about how partnership decision-making works within increasingly complex maternity services. Testing and evaluating the model in different maternity settings would assist in the development and refinement of this model.
This is the second part of a two-part paper in which a new model of evidence-based decision-making for midwifery is proposed. In part 1, the case was made for a fit-for-purpose decision-making model on which to base personalised care in increasingly complex maternity care systems (Ménage, 2016). Crucially, this model calls for a radical and far broader definition of the evidence on which to base decision-making. Part 2 introduces the new model and explains the different sources of evidence to be considered in partnership with women. A clinical scenario is used to show how this model can be used in practice. This paper argues that the model makes an important contribution to midwifery theory by providing a comprehensive framework on which to base decision-making that reflects the realities of modern midwifery care. In addition, it could be an important tool for use in midwifery education, ongoing professional development, supervision and change management.
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