Overview

Childbirth is a major life event for women and their families. The few women who become critically ill during this time should receive the same standard of care for both their pregnancy related and critical care needs, delivered by professionals with the same level of competencies irrespective of whether they are provided in a maternity or general critical care setting (Royal College of Anaesthetists 2011). This module aims to support the midwife to achieve this statement.

This exciting module, Care of the Critically Ill Woman, has been designed with the support from clinicians with the aim of ensuring that the theory, practice and assessment elements are closely related throughout the programme. 

The module is appropriate for midwives who currently practice within a facility that may potentially care for critically ill women.  We can recognise the work done to identify and reduce risks, however it remains that some women pre,  during and following childbirth become critically ill (CEMACH 2007; Maternal Critical Care Working Group, 2011).  The aim of the module is to enhance evidence based knowledge and analytical skills in assessing, planning, implementing and evaluating care for such critically ill patients and their families; considering both acute and chronic conditions within the context of  contemporary healthcare policy.

The module reflects the professional expertise of midwives and the variance of critical care units.  Critical care in itself is dynamic and the module demonstrating themes of   evidence based practice, reflective practice and clinical decision making. The teaching methods address core issues to critical care including physiology, assessment, nursing and medical interventions/management to a diverse population and their families and innovations within practice. 

This 15 credit level 6 module will improve the midwife's skills and knowledge in order for them to provide more confident and competent care to women experiencing acute ill health and requiring an escalation of treatment in relation to childbearing.

The midwife will gain skills of clinical judgement and practice and the ability to communicate their management plans effectively to the multidisciplinary team.

This module is available as an elective within BSc (Clinical Practice).

This module is also available as a free standing elective.

Module aims

To enable the midwife to assess and distinguish between the majority of women with uncomplicated pregnancies and the small but growing minority who have the potential to become acute/ critically ill during pregnancy, labour or the post natal period. Then to enhance the knowledge, skills, confidence and attitudes of midwives caring for these women.

Entry requirements

Hold a first level Professional Registration as a Midwife with the Nursing & Midwifery Council (NMC) and currently practice within a facility that may potentially care for critically ill women.

Module content

Using a blended learning approach including taught, self directed and practical activities the following content will be addressed:

• Rationale for requiring higher levels of care during acute, high dependency and critical care episodes 
• Defining critical care and the team approach in the provision of critical care
• Overview of medical and haematological disorders in pregnancy, delivery and post natal period to include sepsis, shock and disseminated intravascular coagulation
• Review of the acute physiological presentation during pregnancy
• Management of the critically ill to include: assessment (MEOWS), monitoring, evaluation, resuscitation, transfer and the psychological needs of the woman and family
• Review of critical care skills - including A to E assessment, management of arterial and central venous catheters, monitoring and simple techniques involved in airway management

Teaching and assessment

The principal learning and teaching methods used in the module may include:

• Lectures, seminars and workshops: The core of each module delivery mode is a series of face to face tutor-led or group-led seminars or workshops.
• Web-based learning using the Keele Learning Environment (KLE), Blackboard.
• Group work and peer support. All modules use focused group work and class discussions within face to face tutor time.
• Directed independent study. Most of the study hours for each module comprise independent learning by expecting participants to add depth and breadth to their knowledge of topics, to practice skills and to reflect on critical incidents and their practice.