NMHS20770 Midw: The Wider Perspective

Academic Year 2022/2023

The module content will provide a strong theoretical and practical grounding that will enable students to develop the necessary knowledge to provide midwifery care to women with pre-existing medical conditions in pregnancy. This module affords students a range of learning opportunities that aim to develop and enhance their knowledge of underlying Cardiac, Respiratory, Neurological, Endocrine, Haematological, and Autoimmune disorders in pregnancy.
Common Gynaecological conditions, Infertility disorders, Assisted Human Reproduction technologies, Mental health disorders, and Infectious diseases will be explored and their effects on pregnancy evaluated. The module will facilitate the development of Clinical skills acquisition related to Venepuncture, Wound care and Intravenous fluid administration. The Specialist areas linked to this module include Community Midwifery, Gynaecology, Operating Theatre and Recovery, and Mental Health. The importance of interdisciplinary working relationships will be emphasized and incorporated within this module.

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Curricular information is subject to change

Learning Outcomes:

On successful completion of the module, the student will be able to:
• Discuss the underlying pathophysiology of pre-existing medical conditions.
• Identify specific pre-existing medical health issues and evaluate their impact on pregnancy and the puerperium.
• Illustrate the midwifery specific care and management of women with pre-existing medical conditions.
• Prioritize and promote interdisciplinary collaboration in the care and management of women with pre-existing medical
conditions.

Indicative Module Content:

CARDIAC DISORDERS IN PREGNANCY
Congenital & Acquired disorders

RESPIRATORY DISORDERS IN PREGNANCY
Asthma
Pneumonia,
Influenza
Cystic Fibrosis

NEUROLOGICAL DISORDERS IN PREGNANCY
Epilepsy
Multiple Sclerosis
Myasthenia Gravis
Glasgow Coma Scale
Subarachnoid haemorrhage

ENDOCRINE DISORDERS IN PREGNANCY
Gestational Diabetes
Type 1 & Type 2 Diabetes- Pathophysiology
Thyroid – Hyperthyroidism, Hypothyroidism,

HAEMATOLOGICAL DISORDERS IN PREGNANCY
Anaemias
Thalassemia
Sickle Cell
Thrombocytopenia- Gestational/Idiopathic

AUTOIMMUNE DISORDERS IN PREGNANCY
Systemic Lupus Erythematous
Antiphospholipid Syndrome

VACCINATIONS IN PREGNANCY

GYNAECOLOGICAL CONDITIONS
Minor & Major Gynae surgery
Bleeding in Early Pregnancy
2nd Trimester Miscarriage
Molar Pregnancy
Ectopic Pregnancy

THEATRE & RECOVERY
Pre/Peri and Post-operative Care
Safety within the theatre – Time Out
Maintaining a sterile field

INFERTILITY
Assisted Human Reproduction technologies
I.V.F, ISCI, Egg & Sperm donation

MENTAL HEALTH DISORDERS
Postnatal depression
Puerperal psychosis
Schizophrenia
Affective disorders

INFECTIOUS DISEASES
HIV, Hepatitis B&C, Syphilis

CLINICAL SKILLS LABORATORIES

RESPIRATORY- Oxygen, Nebulisers, Peak Flow
ENDOCRINE -Glucometers & Insulin management
Hypoglycaemic & Hyperglycaemic event scenarios
RENAL-Urinary Catheterisation – Insertion, Care & Management, Obtaining a CSU
HAEMATOLOGICAL-Venepuncture- Insertion, Care & Management (HSEland as prior learning)
WOUND CARE & DRAINS- Non-touch technique
INTRAVENOUS FLUID WORKSHOP


Student Effort Hours: 
Student Effort Type Hours
Lectures

30
Laboratories

8
Autonomous Student Learning

67
Online Learning

20
Total

125
Approaches to Teaching and Learning:
Teaching and learning methods focus on student-centered approaches and reflect adult learning principles. Lectures and problem-based learning are complemented by a variety of student-centered methods, such as active learning, and clinical case discussions.
Teaching methods to develop clinical competencies are undertaken via instruction in the clinical skills laboratory, using a variety of methods, such as simulation exercises, demonstrations, role play, and role modeling. Learning is also promoted by enabling students to reflect on their practice and by providing feedback from observations of their skills by peers and academic staff.
In order to promote learning through reflection on experience, and to promote the integration of theory and practice, case study approaches are also employed.
 
Requirements, Exclusions and Recommendations

Not applicable to this module.


Module Requisites and Incompatibles
Not applicable to this module.
 
Assessment Strategy  
Description Timing Open Book Exam Component Scale Must Pass Component % of Final Grade
Class Test: This test will be on the subject of Diabetes and Haemaglobinopathies. 1 hour End of Trimester Exam n/a Standard conversion grade scale 40% Yes

40
Continuous Assessment: You are going to complete a short piece of writing and submit it to PeerScholar. All students will then assess 2 other students work. All work will be assessed anonymously. Week 8 n/a Standard conversion grade scale 40% Yes

30
Continuous Assessment: You are going to complete a short piece of writing and submit it to PeerScholar. All students will then assess 2 other students work. All work will be assessed anonymously. Week 4 n/a Standard conversion grade scale 40% Yes

30

Carry forward of passed components
Yes
 
Remediation Type Remediation Timing
In-Module Resit Prior to relevant Programme Exam Board
Please see Student Jargon Buster for more information about remediation types and timing. 
Feedback Strategy/Strategies

• Feedback individually to students, post-assessment
• Peer review activities
• Self-assessment activities

How will my Feedback be Delivered?

Following the submission of your work, each student will log into Peerscholar and will assess (against a marking criteria) 2 pieces of student work anonymously. Each student will reflect on the feedback given and take the comments forward to their next work. The second submission to PeerScholar will be graded by the instructor who will also take into account the comments given in the first submission

Confidential Maternal Death Enquiry Ireland (2017), Cork, Available at: https://www.ucc.ie/en/media/research/maternaldeathenquiryireland/Confidential-Maternal-Death-Enquiry-Report-2013---2015--Web.pdf

Crosby, D., Cullen, S. and Allen, C. (2018) Age considerations in the management of recurring miscarriage. Irish Journal of Medical Science, published online, June 2018 http://doi.org/10.1007/s11845-018-1853-7.

Cullen, S., Coughlan, B., Casey, B., Power, S. and Brosnan, M. (2017) Exploring parents’ experiences of care in an Irish hospital following second-trimester miscarriage. British Journal of Midwifery, 25(2).

Cullen, S., Coughlan, B., McMahon, A. Casey, B., Power, S. and Brosnan, M. (2018) Parents’ experiences of clinical care during second trimester miscarriage. British Journal of Midwifery 26(5).

Cullen, S., Power, S., Coughlan, B., Chaney, J., Butler, M. And Brosnan, M. (2016) An exploration of the prevalence and patterns of care for women presenting with mid-trimester loss. Irish Journal of Medical Science. Published online. February, 2016. DOI 10.1007/s11845-016-1413-y.

Department of Health (2016) ‘Creating a Better Future Together’ National Maternity Strategy. Dublin: HSE. Available at: http://health.gov.ie/wp-content/uploads/2016/01/Final-version-27.01.16.pdf

Health Information and Quality Authority (2016) Draft National Standards for better Safer Maternity Services. Cork: HIQA. Available at: https://www.hiqa.ie/sites/default/files/2017-01/Draft-Maternity-Standards_0.pdf

HSE (2010) Ultrasound Diagnosis of Early Pregnancy Miscarriage: Clinical Practice Guideline.

Marshall, J. and Raynor, M. (2014) Myles Textbook for Midwives.16th ed. London: Churchill Livingstone.

MBRRACEUK (2014) Saving Lives, Improving Mothers’ Care Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-2012 https://www.npeu.ox.ac.uk/downloads/files/mbrraceuk/reports/Saving%20Lives%20Improving%20Mothers%20Care%20report%202014%20Full.pdf

Mitchell, M., (2005) Preparing student midwives to care for bereaved parents. Nurse Education in Practice (5) 78–83

Mulvihill, A. and Walsh, T. (2013) Pregnancy loss in rural Ireland: An experience of disenfranchised grief. British Journal of Social Work. 44, pp. 2290-2306.

Murphy, F. A. and Merrell, J. (2009) Negotiating the transition: caring for women through the experience of early miscarriage. Journal of Clinical Nursing, 18, 1583–1591

National Perinatal Epidemiological Centre (NPEC) (2015) Severe maternal morbidity report. Cork: NPEC. Available at: https://www.ucc.ie/en/media/research/nationalperinatalepidemiologycentre/annualreports/SMMReport2015Web.pdf

NICE (2014) Intrapartum care for health women and babies. Clinical Guideline. London: NICE. Available at: https://www.nice.org.uk/guidance/cg190/resources/intrapartum-care-for-healthy-women-and-babies-35109866447557

Nursing and Midwifery Board of Ireland (2015) Scope of Nursing and Midwifery Practice Framework. Dublin: Nursing and Midwifery Board of Ireland

Nursing and Midwifery Board of Ireland (2014) Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives. Dublin: Nursing and Midwifery Board of Ireland.

Nursing and Midwifery Board of Ireland (2015) Practice Standards for Midwives, Dublin: Nursing and Midwifery Board of Ireland.

Raynour, M., Marshall, J. and Jackson, K. (2012) Midwifery Practice: Critical Illness, Complications and Emergencies Casebook, England: Open University Press.

RCOG (2011) The Investigation and Treatment of Couples with Recurrent First-trimester and Second-trimester Miscarriage

Robson, S.E. and Waugh, J. (2013) Medical disorders in pregnancy: a manual for midwives. 2nd ed. London: Wiley- Blackwell.

Wylie, L. and Bryce, H. (2016) The Midwives’ Guide to Key Medical Conditions. London: ELsevier

Further readings, research articles, national guidelines, confidential enquiries and other resources will be recommended to students during the course of the module.
Name Role
Miss Breda Connaughton Lecturer / Co-Lecturer
Ms Mary Curtin Lecturer / Co-Lecturer
Dr Carmel Davies Lecturer / Co-Lecturer
Dr Aoife Claire MacCormac Lecturer / Co-Lecturer
Dr Claire Magner Lecturer / Co-Lecturer
Ms Elizabeth Greene Tutor
Brid McCarthy Tutor