Life Saving Skills: A Manual for Midwives; LSS Manual for Midwives: Clinical GuideTool Name: Life Saving Skills: A Manual for Midwives; LSS Manual for Midwives: Clinical Guide Origin / Source: American College of Nurse Midwives, Authors: Sandra Tebben Buffington & Margaret Ann Marshall Technical area: Maternal health and newborn health Basic Description: The LSS manual and training program was developed to help midwives prevent maternal and infant mortality and morbidity by identifying and taking timely and appropriate action when problems occur in pregnancy, labor and delivery and in the early postpartum period. The LSS manual and training program address the major causes of maternal and infant mortality. There are ten modules: introduction to maternal mortality, quality antenatal care, monitoring labor progress, episiotomies and repair of lacerations, prevention and treatment of hemorrhage, resuscitation (adult and infant), prevention and management of sepsis, hydration and rehydration, vacuum extraction, other emergencies (labor and delivery problems, postabortion care, symphysiotomy). The competency based program concentrates on the acquisition of advanced midwifery skills and the problem solving process. The skills are broken down into sequential steps and mastered with the use of the skills checklist. In addition to being included in the manual, the skills checklists are provided in a separate small notebook called the Clinical Guide for ease of use as a reference in the clinical setting and for training and supervision purposes. The program has been developed as a continuing education resource for practicing midwives and can be customized to meet local needs and standards of practice. Country Applications: Ghana, Uganda, Tanzania, Tajikistan, Vietnam, Cambodia, Indonesia, Peru, Ethiopia, Guinea, Bangladesh, India, Honduras, Mozambique, and elsewhere Language(s) Available:
Purpose: Training program for midwives to acquire advanced midwifery and emergency obstetric skills. Accompanying Clinical Guide is a compendium of checklists to evaluate the clinical competence and clinical progress of participants in the program. Technical Scope/Purpose: This training program addresses midwifery and other health care provider interventions in the realms of maternal and infant mortality, antenatal care, labor progress, episiotomies and laceration repairs, hemorrhage, resuscitation (adult and infant), sepsis, hydration and rehydration, vacuum extraction, intrapartum complications, post-abortion care, symphysiotomy). Skills Checklists found within the Clinical Guide are used to evaluate clinical progress of participants in each of the topics mentioned. Design: Training program with companion clinical skill checklists Method: Training program with skills checklist evaluation Frequency of Administration: Implemented in settings of need Key Users of the Information: Midwives (trainers and trainees) and other obstetric health care providers Objectives and Scope of the Tool: Each module has a set of goals and objectives: Module 1: The midwife will learn about the problems of women dying during pregnancy and childbirth, and role the midwife can play in preventing these problems (a set of 5 specific objectives accompany this goal). Module 2: The midwife will refresh her skills and learn new skills that will enable her to give excellent antenatal care to pregnant women.(a set of 4 objectives follow) Module 3: The midwife will review her knowledge and learn new skills to care for a woman during labor and delivery.(a set of 8 objectives follow) Module 4: The midwife will learn to prevent, diagnose, and repair lacerations. She will learn when to cut and how to repair episiotomies. ( a set of 8 objectives follow). Module 5: The midwife will learn to use the problem solving method to determine risk of hemorrhage and to find the cause of bleeding in a pregnant woman. Module 6: The midwife will learn the important signs and symptoms of a neonate in distress. The midwife will learn to resuscitate a baby. (4 objectives follow) Module 7: The midwife will learn the signs and symptoms of a woman and/or baby with sepsis. She will learn life-saving skills to help the mother and/or baby live, and prevent transmission of infection(specifically HIV/AIDS and hepatitis). (6 objectives). Module 8: The midwife will learn to monitor the woman's fluid intake and judge when she needs more fluid, especially when she is at risk for shock. The midwife will learn how to give appropriate fluids orally, intravenously, rectally, or intra-peritoneally as needed. (11 objectives) Module 9: The midwife will learn when and how to use vacuum extraction to assist a mother in delivery of her baby. Module 10: The midwife will learn to identify and manage several specific problems during labor and delivery, to save the lives of mothers and babies. A skills checklist accompanies each module. Tool Design: Tool is a training program for midwives with accompanying Clinical Guide containing a set of skills checklist. The skills checklist is used to monitor the progress of training participants and evaluate clinical skills. Implementation and Training: LSS training program is implemented at the institutional level within health care settings. The training program necessitates access to a health care facility in order to provide a venue for teaching clinical skills with real-life situations. The overall LSS training involves changing the overall system of health care within the region where it is implemented, from equipment changes and updates, recommendations for upgrading facilities, to changing overall health care standards. The skills checklist tool is a small portion of the much larger LSS approach to training obstetric health care providers. The training process is detailed in above sections: Basic Description, Technical Scope/Purpose, and Objectives and Scope of the Tool. Manuals and Guidelines (if applicable): The Life Saving Skills Manual for Midwives (a ten module set) with companion Clinical Guide (separate skills checklist spiral bound booklet). Also available is the LSS Manual for Policy Makers and Trainers. Data Processing and Analysis: not applicable Cost:
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