Study On The Construction Of The Certification System For Nurse Practitioner In Midwifery

Objectives1.To understand the attitude of midwives and obstetricians towards the development of nurse practitioner,and to provide reference for the development of competence evaluation index system and certification system of nurse practitioner in midwifery.2.In order to provide reference for the development of nurse practitioner in midwifery in China,and to establish the certification system of nurse practitioner in midwifery in accordance with China’s national conditions.3.To evaluate the reliability and validity of the competence evaluation index system of nurse practitioner in midwifery in the certification system,and to understand the status quo of midwives’ practice ability.Methods1.With the phenomenological method of qualitative research,24 midwives and obstetricians were selected from a third class A hospital and a third class A women and children’s hospital in two cities of Guangdong province to conduct a semi-structured interview,to understand the attitude and influencing factors of medical staff towards the development of nurse practitioner,and to provide a theoretical basis for the development of nurse practitioner.2.With Strong advanced practice nursing mode and registered nurse framework based on core competence in our country,combining with literature review and management status of nurse practitioners from all over the world,to develop the certification system content item pool of nurse practitioner in midwifery,through 2 rounds of expert consultation to build its certification system content,with analytic hierarchy process to determine the index weight of each part.3.Using the questionnaire survey method,using the questionnaire designed by the ability evaluation index system of nurse practitioner in midwifery,using the convenience sampling method to investigate the practice ability of 690 clinical midwives,to understand the status of midwives’ practice ability,at the same time to test the reliability and validity of the ability evaluation index system.Results1.The results of the qualitative study showed that the attitudes of midwives and obstetricians towards the development of nurse practitioner were identified as four themes,which were consensus attitude,imperfect midwifery discipline and management system,insufficient independent practice ability,and low support and recognition of the midwifery profession.2.The results of the two rounds of expert consultation showed that the expert authority coefficients of the two rounds were 0.897 and 0.916 respectively.Kendall coordination coefficients were statistically significant(P<0.001).Finally formulated by the application conditions of 8 indicators,duty scope 7 first-level indicators,50 second-level indicators,ability evaluation of 7 first-level indicators,19 second-level indicators,102 third-level indicators,8 indicators of qualification certification of certification index system content for nurse practitioner in midwifery.3.Questionnaire survey was carried out using the questionnaire designed by the competence evaluation index system of nurse practitioner in midwifery.A total of 740 questionnaires were sent out and 723 were received,among which 690 were valid.The total Cronbach’s coefficient of the questionnaire was 0.993,Spearman-Brown’s coefficient and Guttman’s split-half reliability coefficient were 0.933,and Cronbach’s coefficients of each dimension were 0.969～0.988.The I-CVI of each item ranged from 0.80 to 1.00,and the average S-CVI was 0.992.The results of exploratory factor analysis showed that seven common factors were extracted,which could explain more than 78.45%of the variation.The total score of midwives’ practice ability was 425(402,475).Conclusions1.Midwives and obstetricians are in favor of developing nurse practitioner,but the development of nurse practitioner is affected by many factors such as national laws,policies and social approval.2.The certification index system of nurse practitioner in midwifery is scientific and reliable,which can guide the gradual development of nurse practitioner in China.3.The reliability and validity of the ability evaluation index system of nurse practitioner in midwifery is good,midwifery practice ability is above the medium level.