Accreditation Programme For Nursing And Midwifery .

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Revised on 8 April 2019CONFIDENTIALAccreditation Programme for Nursing and MidwiferyEducational InstitutionsSELF-ASSESSMENT TOOL AND REVIEW TEAMREPORT (MIDWIFERY)March 2019Bangladesh Nursing and Midwifery Council1

Midwifery Educational Institution: Self-Assessment and Review Team Report Template1) The Midwifery Educational InstitutionNMEI provides a self-assessment for each of the criteria of the accreditation standards in the space indicated in the document.Name of Midwifery Educational InstitutionAddress of Midwifery Educational InstititutionDate of submission of report to Bangladesh Nursing and Midwifery Council2) The Review TeamDuring the site visit, the review team members validate the self-assessment for each of the criteria. They use this document to comment on theirobservations and to indicate whether they consider the criteria is met, partially met, or unmet in the space provided.Names of the ReviewersDate of Site Visit2

STANDARD I: ADMINISTRATION AND LEADERSHIP (10 Criteria, Total marks 20)The governance of the Midwifery Educational Institution supports good quality education.CriteriaMidwifery Educational InstitutionMidwifery Educational Institution Report1.1 The Head (Principal/NursingInstructor-in-Charge) of theMidwifery Educational Institutiona.* is a registered nurse, aregistered midwife, orregistered nurse-midwifewith a BachelorDegree/Master's inNursing/ Public Health/Community Health/Midwifery/MPH/Women’sHealth/SRHR/ ReproductiveHealth with minimum 2years of service experiencein administration.b.has minimum 5 yearsexperience as an educator.Review TeamReview Team ReportMeta. Yes ⃝ Partial ⃝ No ⃝b. Yes ⃝ Partial ⃝ No ⃝During the site visit the reviewers will verify the personal datasheet (PDS) of the Principal/Nursing Educator-in-Charge.3PartiallyMetUnmet

1.2 The Head of the MidwiferyEducational Institution hasautonomy in decision makingwithin his/her jurisdiction:a. Administration of theconcerned educationalinstitutionb. Students (related toacademic progression,discipline, etc.)a.Yes ⃝ Partial ⃝ No ⃝Provide a brief overview of the reporting and governancestructure.b.Yes ⃝ Partial ⃝ No ⃝Provide 1 or 2 examples to show decision-making autonomy orlack thereof related to the administration of the students.c. Educators(e.g., hiring, performanceappraisal, teachingassignments, promotions)c.Yes ⃝ Partial ⃝ No ⃝Provide 1 or 2 examples to show decision making autonomyand/or lack of autonomy related to the educators.d. Support staff (e.g., hiring,performance appraisal, jobdescription)e. * Implementation of thecurriculum andcompetencies approved bythe BNMC and MoHFW andUniversity1.3 The duties and responsibilitiesd.Yes ⃝ Partial ⃝ No ⃝Provide examples to show decision making autonomy or lackthereof related to the support staff.e.Yes ⃝ Partial ⃝ No ⃝If yes or in part, briefly describe.a. Yes ⃝ Partial ⃝ No ⃝4

are assigned by the authority forthe employee.If no or in part, briefly describe.Complete the Appendix A form List of the support staff and theirpositions.1.4 The administrative andinformation systems in theMidwifery Educational Institutionshould be well organized andeffective.a. Duties are assigned basedon job descriptions.b. An academic calendar isused.c. A master plan for studentplacements is used.a. Yes ⃝ Partial ⃝ No ⃝Comment (if any).b. Yes ⃝ Partial ⃝ No ⃝Comment (if any).c. Yes ⃝ Partial ⃝ No ⃝Comment (if any).d. Yes ⃝ Partial ⃝ No ⃝d. There is a notice board/web site/ other informatione. system to informemployees and students ofthe institute.e. Yes ⃝ Partial ⃝ No ⃝Comment (if any).5

1.5 The Midwifery EducationalInstitution maintains wellorganized and up-to-date records ofa. Yes ⃝ Partial ⃝ No ⃝a.b.c.d.e.f.Student admissionStudent registrationStudent transcriptsStudent master roll callStudent personal filesExamination roll callbookg. Other administrativefile systems (if yes,please indicate whattype of administrativefile systems)h. Student’s log book1.6. The educators of the MidwiferyEducational Institution aresupported in updating their clinicalexpertise, midwifery knowledge,and competencies as educators,and in participating in continuousprofessional development eg:b. Yes ⃝ Partial ⃝ No ⃝c. Yes ⃝ Partial ⃝ No ⃝d. Yes ⃝ Partial ⃝ No ⃝e. Yes ⃝ Partial ⃝ No ⃝f.Yes ⃝ Partial ⃝ No ⃝g. Yes ⃝ Partial ⃝ No ⃝h. Yes ⃝ Partial ⃝ No ⃝If yes to g., please indicate what type of other administrative filesystems.Yes ⃝ Partial ⃝ No ⃝a. Yes ⃝ No ⃝b. Yes ⃝ No ⃝a) Online English courseb) Online mentorshipc) Massive Open OnlineCourse (MOOC)c. Yes ⃝ No ⃝6

1.7 Guest teachers who are hiredare experts in their respective fieldsas per DGNM guideline.Yes ⃝No ⃝Briefly describe the process for hiring guest teachers.Complete the Appendix B form, Guest Teachers Hired in thePrevious Year.1.8 The Midwifery EducationalInstitution develops partnershipswith practice-related organizationsto ensure that the environment ofclinical placements supportsstudent learning.Yes⃝No ⃝Comment (if any)Complete the AppendixC form Clinical Placement Sites.1.9 The Midwifery EducationalInstitution hasa. A prospectus with thea. Yes ⃝ Partial ⃝ No ⃝information of background,Please provide a brief description.Vision, mission, objective,course, achievement, futureplan etc.b. Yes ⃝ Partial ⃝ No ⃝b. A yearly master plan;Human resource, budget,physical resourcec. A resource plan that isfollowed eg teaching andlearning materials1.10 The midwifery educationalinstitution’s organogram isclear, current, and publiclydisplayedPlease provide a brief description.c. Yes ⃝ Partial ⃝ No ⃝Please provide a brief description.Yes ⃝ Partial ⃝ No ⃝Please provide brief description7

STANDARD II: STUDENT TYPE AND INTAKE ( 3 Criteria, Total marks 6 )The Midwifery Educational Institution admits students who have the academic background and ability tomeet the requirements of the programme.CriteriaMidwifery Educational InstitutionMidwifery Educational Institutional Report2.1 The Midwifery EducationalInstitution admits studentswith a background educationaccording to governmentadmission policy.Review TeamReview Team ReportMetYes ⃝ No ⃝2.2 The Midwifery EducationalInstitution admits studentswho are medically andphysically fit. The medical fitness ofstudentsthe physical fitness ofstudents;the immunizationstatus of students. Yes ⃝ No ⃝ Yes ⃝ No ⃝ Yes ⃝ No ⃝8PartiallyMetUnmet

2.3 Students admitted into theMidwifery EducationalInstitution demonstrateintention to serve peopleanywhere in the health caredelivery system:a.Yes ⃝ Partial ⃝ No ⃝a. a willingness to servein health care9

STANDARD III: TEACHING STAFF AND LEARNING ( 11 Criteria, Total marks 22)The students of the Midwifery Educational Institution are taught by well-qualified Educators in theclassroom and in clinical placements.CriteriaMidwifery Educational InstitutionMidwifery Educational Institution ReportReview TeamReview Team ReportMet3.1 All educators:a. * Are registered nurses,registered midwives, orregistered nursemidwivesa. Yes ⃝No⃝Comment (if any)b. Demonstrateknowledge andcompetencies in theareas that they teachb. Yes ⃝ Partial ⃝ No ⃝Comment (if any)c. * have a minimum of abachelor’s degree innursing/midwifery/public health nursing.c. Yes ⃝ No⃝Comment (if any)Complete Appendix D form Qualifications of EducatorsDuring the site visit reviewers will verify the personal data sheets10PartiallyMetUnmet

(PDS).3.2 The educator use wellrecognized teaching methods tofoster student learninga. adult educationa. Yes ⃝ Partial ⃝ No ⃝approachesb. self-directed learningc. e-learningd. clinical simulations.3.3 The educator provideclassroom and clinical learningexperiences based on the mostcurrent evidence basedinformation.3.4 The educator developclinical reasoning, problemsolving, and critical thinking instudents.b. Yes ⃝ Partial ⃝ No ⃝c. Yes ⃝ Partial ⃝ No ⃝d. Yes ⃝ Partial ⃝ No ⃝Yes ⃝ Partial ⃝ No ⃝Provide an example showing how educator teach students to useevidence-based research in their practice.Yes ⃝ Partial ⃝ No ⃝If yes, describe (provide some specific examples showing howeducators teach students to think critically and to solveproblems).11

3.5 Other health professionalswho are guest lecturers hold agraduate degree and possessclinical and educationalexpertise in the specialty areathey teach eg, scenario based,problems and solution etc.Yes ⃝ Partial ⃝ No ⃝(Complete Appendix B form)Comment.3.6 There is;a. a ratio of 1 educator to40 students or less inmidwifery theorycoursesa. Yes ⃝ Partial ⃝ No ⃝Complete Appendix EformNumbers of Students per Course.b. Yes ⃝ Partial ⃝ No ⃝b. 1 educator to 8 studentsor less in clinicalplacements and in thelaboratory.Comment (if any).Complete Appendix F form Numbers of Students per ClinicalGroup.3.7 There should not be morethan 25% part-time educators.Indicate the percentage of part-time educators at the NI.12

3.8 The individuals who areresponsible for students in theclinical setting:Identify the individuals who are responsible for students in theclinical setting.i. Subject teacher ⃝ii. Principal/educator⃝iii. Clinical educators/clinical supervisor ⃝a. hold a minimum of abachelor’s degree innursing/public healthnursing, anda. Yes ⃝ Partial ⃝ No ⃝b. possess clinicalexpertise and soundknowledge in theirspecialty area.b. Yes ⃝ Partial ⃝ No ⃝Complete PDS forms of Clinical Educators.3.9 The Nursing and MidwiferyEducational Institutioncollaborates with supervisors,mentors, registered nurses andmidwives in the clinical practiceareasYes ⃝ Partial ⃝ No ⃝Yes ⃝ Partial ⃝ No ⃝3.10 Educators supportstudents in clinical practicesDescribe the collaborations with supervisors/ mentors, registerednurses and registered midwives in the clinical practice area.3.11 Clinical educatorsresponsible for students inclinical placements superviseand teach students in theclinical practice areas in whichthey have clinical expertise.Yes ⃝ Partial ⃝ No ⃝See 3.8.13

STANDARD IV: CURRICULUM DELIVERY (7 criteria, total Marks 14)The delivery of the national curriculum for midwives fosters good student outcomes.CriteriaMidwifery Educational InstitutionMidwifery Educational Institution Report4.1 The Midwifery EducationalInstitution provides learningexperiences that will enablemidwife students to attain thecompetencies in theInternational Confederation ofMidwives (ICM) essentialcompetencies for midwiferypractices in Bangladesh.Review TeamReview Team ReportMetYes ⃝ Partial ⃝ No ⃝Complete Appendix G form Mapping Competency-IndicatorsTaught.4.2 Midwifery EducationalInstitution offers midwiferystudents opportunities for;a.multidisciplinarylearningb. inter-professionalteamworkcollaboration.4.3 The Nursing and Midwiferya. Yes ⃝ Partial ⃝ No ⃝b. Yes ⃝ Partial ⃝ No ⃝Provide a number of examples.14PartiallyMetUnmet

Educational Institutiona. assess studentknowledge with arange of methods. (i.e.:case presentations,buzz group, posters,role play,demonstration)a. Yes ⃝ Partial ⃝ No ⃝b. assess skillsdevelopment. (i.e.OSCE's, skills lab)c. uses reliable, evidencebased evaluationmethods; (i.e. MCQ,case based questions)b. Yes ⃝ Partial ⃝ No ⃝c. Yes ⃝ Partial ⃝ No ⃝d. communicate theresults with thestudents.Briefly describe methods to evaluate knowledge and methods toevaluate skill developmentd. Yes ⃝No⃝Briefly describe how results are communicated a) in classes (i.e.orally? In writing?) b) in labs? c) in clinical?Classes:Labs:15

Clinical Placements:4.4* The EducationalInstitution maintainsa good balance of classroomand practice learningexperiences through masterplan.4.5The MidwiferyEducational Institution hasaccess to clinical learning sitesrequired for implementing thecurriculum (Minimum 100bedded hospital).Yes ⃝ Partial ⃝ No ⃝Complete Appendix H form Hours of Classroom Courses, ClinicalPractice Experience and Labs.Yes ⃝ Partial ⃝ No ⃝Complete Appendix I form Clinical Placement Sites by Year ofProgram.4.6The MidwiferyEducational Institutionensures clinical experiences byplacing students in otherhealth care facilities,if thereare no/ less opportunities forevidence based midwiferypractices (i.e. such asmidwifery-led care, EmONC,VIA, CMR, PAC etc)Yes ⃝ Partial ⃝ No ⃝Briefly describe how the NMEI ensures subject-based clinicalexperiences (see Appendix I).4.7 The Midwifery EducationalInstitution provides supervisedYes ⃝ Partial ⃝ No ⃝Briefly describe the type of supervision of clinical placement16

clinical learning experiencesthat support midwifery theoryin a variety of practice settings.provided in the curriculum (see Appendix I).17

STANDARD V: RESOURCES (9 criteria, Total Marks 18)The Nursing and Midwifery Educational Institution has the resources to provide a good learningenvironment for teaching and learning.CriteriaNursing and Midwifery Educational InstitutionNursing and Midwifery Educational Institution reportReview TeamReview Team ReportMet5.1 The Midwifery EducationalInstitution provides adequateaccommodation and supportto students during theprogram, including:a. Fully furnished hostelfor studentsb. Students' washroomsc. Visiting roomd. Guard’s roome. Transportation forstudents to clinicalsitesf. Common roomg. Conference rooma. Yes ⃝ Partial ⃝ No ⃝b. Yes ⃝ Partial ⃝ No ⃝c. Yes ⃝No ⃝d. Yes ⃝No ⃝e. Yes ⃝No ⃝f.Yes ⃝ Partial ⃝ No ⃝g. Yes ⃝ Partial ⃝ No ⃝Comment (if any)18PartiallyMetUnmet

5.2 * The EducationalInstitution ensures studentsand educators have safedrinking water.Yes ⃝No ⃝Briefly describe how the safety of the drinking water is assured.5.3 The Midwifery EducationalInstitution has adequateclassroom space to supportstudent learning with at least 1classroom for 50 students.Select one of the following:i.50 students or less per1 classroom⃝ii.More than 50 students per 1 classroom⃝Comment (if any).5.4 There should be at least 1bathroom for 20 students.Select one of the following:20 students or less per bathroom⃝More than 20 students per bathroom ⃝5.5. The Midwifery EducationalInstitution has appropriatelyequipped lab space fora.b.c.d.e.f.g.fundamental* mputersa.b.c.d.e.f.g.Yes ⃝Yes ⃝Yes ⃝Yes ⃝Yes ⃝Yes ⃝Yes ⃝No⃝ student/teacher ratioNo⃝ student/teacher ratioNo⃝ student/teacher ratioNo⃝ student/teacher ratioNo⃝ student/teacher ratioNo⃝ student/teacher ratioNo⃝ student/teacher ratioComment (if any)19

5.6 The students have accessto computers and to theinternet to support theirlearning. The number ofcomputersa. 40 for collegeb. 25 for institutea. Yes ⃝No ⃝b. Yes ⃝No ⃝Comment (if any).5.7 The Midwifery EducationalInstitution hasa) well furnished libraryeg, light, fan, sittingarrangement etc.a. Yes ⃝ Partial ⃝ No ⃝b) up-to-date books andtext bookb. Yes ⃝ Partial ⃝ No ⃝c)c. Yes ⃝ Partial ⃝ No ⃝an online library forstudentsd) journals, andmagazines.e) textbook:student ratioof 1:6d. Yes ⃝ Partial ⃝ No ⃝e. Yes ⃝ Partial ⃝ No ⃝Provide a comment on the adequacy of the library and itsresources including whether it deploys a qualified librarian, uses a20

standard seating arrangement, and is opened from 8 am to 8pm.5.8 The Midwifery EducationalInstitution isa. at least 30,000 squarefeetb. prayer roomsc. sports facilities (indoorand outdoor)d. an audiovisual roome. an individual office forthe Head of theNursing Institutionf. room for educatorsg. an office room for theaccountant and cashierh. a general office roomi. washroom foreducators5.9 Human resources must berecruited as per BNMC o⃝No⃝No⃝No⃝No⃝c. Yes ⃝No ⃝Describe human resource recruitment as it relates to the BNMCpolicy.21

APPENDIX A: LIST OF SUPPORT STAFF AND THEIR POSITIONSSUPPORT STAFF – NAMEPOSITION22

APPENDIX B: GUEST TEACHERS HIRED IN THE PREVIOUS YEARGUEST TEACHER – NAMEACADEMIC QUALIFICATIONSDATES OF THEIR CONTRACTCOURSE(S) TAUGHT23

APPENDIX C: PARTNERSHIPS WITH SERVICE ORGANIZATIONSSERVICE ORGANIZATION – NAMECLINICAL PLACEMENT SITESCOURSE (S)24

APPENDIX D: QUALIFICATIONS OF EDUCATORSEDUCATOR – NAMEACADEMIC QUALIFICATIONSPROFESSIONAL QUALIFICATIONS25

APPENDIX E: NUMBERS OF STUDENTS PER COURSELIST OF COURSESNUMBERS OF STUDENTS IN EACH26

APPENDIX F: NUMBERS OF STUDENTS PER CLINICAL GROUPList of Clinical GroupsNumbers of Students in each27

APPENDIX G: MAPPING COMPETENCY-INDICATORS TAUGHT IN COURSESFor each of the competency indicators listed below, please identify in the column beside it, which course or courses students are being taught thisindicator.COMPETENCY-INDICATORSIDENTIFY IN WHICH COURSE(S) THEINDICATOR IS BEING TAUGHT1. General Competencies1a1bAssume responsibility for own decisions and actions as an autonomous practitioner.KNOWLEDGE Principles of accountability and transparency Principles and concepts of autonomy Principles of self-assessment and reflective practice Personal beliefs and their influence on practice Knowledge of evidence-based practicesSKILLS & BEHAVIOURS Demonstrate behaviour that upholds the public trust in the profession Participate in self-evaluation, peer review and other quality improvement activities Balance the responsibility of the midwife to provide best care with the autonomy of the woman to make her own decisions Explain the midwife’s role in providing care that is based on relevant law, ethics, andevidenceAssume responsibility for self-care and self-development as a midwifeKNOWLEDGE Strategies for managing personal safety particularly within the facility or community settingSKILLS & BEHAVIOURS Display skills in management of self in relation to time management, uncertainty, change and coping with stress Assume responsibility for personal safety in various practice settings Maintain up-to-date skills and knowledge concerning protocols, guidelines and safe practice Remain current in practice by participating in continuing professional education (for example, participating in learningopportunities that apply evidence to practice to improve care such as mortality reviews or policy reviews.) Identify and address limitations in personal skill, knowledge, or experience Promote the profession of midwifery, including participation in professional organizations at the local and national level28

COMPETENCY-INDICATORS1cAppropriately delegate aspects of care and provide supervisionKNOWLEDGE Policies and regulation related to delegation Supportive strategies to supervise others Role of midwives as preceptors, mentors, supervisors, and role modelsSKILLS & BEHAVIOURS Provide supervision to ensure that practice is aligned with evidence-based clinicalpractice guidelines Support the profession’s growth through participation in midwifery education inthe roles of clinical preceptor, mentor, and role mode1dUse research to inform practiceKNOWLEDGE Principles of research and evidence-based practice Epidemiologic concepts relevant to maternal and infant health Global recommendations for practice and their evidence base (e.g. World Health Organisation guidelines)SKILLS & BEHAVIOURS Discuss research findings with women and colleagues Support research in midwifery by participating in the conduct of research1eUphold fundamental human rights of individuals when providing midwifery careKNOWLEDGE Laws and/or codes that protect human rights Sexual, reproductive health rights of women and girls Development of gender identity and sexual orientation Principles of ethics and Human Rights within midwifery practiceSKILLS & BEHAVIOURS Provide information to women about their sexual and reproductive health rights Inform women about the scope of midwifery practice and women’s rights and responsibilities Provide information and support to individuals in complex situations where there are competing ethical principles andrights Practice in accordance with philosophy and code of ethics of the ICM and national standards for health professionals Provide gender sensitive careIDENTIFY IN WHICH COURSE(S) THEINDICATOR IS BEING TAUGHT29

COMPETENCY-INDICATORS1fAdhere to jurisdictional laws, regulatory requirements, and codes of conduct for midwifery practiceKNOWLEDGE The laws and regulations of the jurisdiction regarding midwifery National/state/local community standards of midwifery practice Ethical principles ICM and other midwifery philosophies, values, codes of ethicsSKILLS & BEHAVIOURS Practise according to legal requirements and ethical principles Meet requirements for maintenance of midwifery registration Protect confidentiality of oral information and written records about care of women and infants Maintain records of care in the manner required by the health authority Comply with all local reporting regulations for birth and death registration Recognize violations of laws, regulations, and ethical codes and take appropriate action Report and document incidents and adverse outcomes as required while providing care1gFacilitate women to make individual choices about careKNOWLEDGE Cultural norms and practices surrounding sexuality, sexual practices, marriage, the childbearing continuum, and parenting Principles of empowerment Methods of conveying health information to individuals, groups, communitiesSKILLS & BEHAVIOURS Advocate for and support women to be the central decision makers in their care Assist women to identify their needs, knowledge, skills, feelings, and preferences throughout the course of care Provide information and anticipatory guidance about sexual and reproductive health to assist women’s decision making Collaborate with women in developing a comprehensive plan of care that respects her preferences and decisionsIDENTIFY IN WHICH COURSE(S) THEINDICATOR IS BEING TAUGHT30

COMPETENCY-INDICATORS1hDemonstrate effective interpersonal communication with women and families, health care teams, and community groupsKNOWLEDGE Role and responsibilities of midwives and other maternal infant health providers Principles of effective communication Principles of effectively working in health care teams Cultural practices and beliefs related to childbearing and reproductive health Principles of communication in crisis situations, e.g. grief and loss, emergenciesSKILLS & BEHAVIOURS Listen to others in an unbiased and empathetic manner Respect one others’ point of view Promote the expression of diverse opinions and perspectives Use the preferred language of the woman or an interpreter to maximise communication Establish ethical and culturally-appropriate boundaries between professional and non-professional relationships Demonstrate cultural sensitivity to women, families, and communities Demonstrate sensitivity and empathy for bereaved women and family members Facilitate teamwork and inter-professional care with other care providers (including students) and community groups/agencies Establish and maintain collaborative relationships with individuals, agencies, institutions that are part of referral networks Convey information accurately and clearly and respond to the needs of individuals1iFacilitate normal birth processes in institutional and community settings, including women’s homesKNOWLEDGE Normal biologic, psychological, social, and cultural aspects of reproduction and early life Practices that facilitate and those that interfere with normal processes Policies and protocols about care of women in institutional and community settings Availability of resources in various settings Community views about and utilization of health care facilities and place(s) of birthSKILLS & BEHAVIOURS Promote policies and a work culture that values normal birth processes Utilize human and clinical care resources to provide personalized care for women andtheir infants Provide continuity of care by midwives known to womanIDENTIFY IN WHICH COURSE(S) THEINDICATOR IS BEING TAUGHT31

COMPETENCY-INDICATORS1jAssess the health status, screen for health risks, and promote general health and well-being of women and infantsKNOWLEDGE Health needs of women related to reproduction Health conditions that pose risks during reproduction Health needs of infants and common risksSKILLS & BEHAVIOURS Conduct a comprehensive assessment of sexual and reproductive health needs Assess risk factors and at-risk behaviour Order, perform, and interpret laboratory and/ or imaging screening tests Exhibit critical thinking and clinical reasoning informed by evidence when promoting health and well being Provide health information and advice tailored to individual circumstances of women and their families Collaborate with women to develop and implement a plan of care1kPrevent and treat common health problems related to reproduction and early lifeKNOWLEDGE Common health problems related to sexuality and reproduction Common health problems and deviations from normal of newborn infants Treatment of common health problems Strategies to prevent and control the acquisition and transmission of environmental and communicable diseasesSKILLS & BEHAVIOURS Maintain/promote safe and hygienic conditions for women and infants Use universal precautions consistently Provide options to women for coping with and treating common health problems Use technology and interventions appropriately to promote health and prevent secondary complications Recognize when consultation or referral is indicated for managing identified health problems, including consultation withother midwives Include woman in decision-making about referral to other providers and servicesIDENTIFY IN WHICH COURSE(S) THEINDICATOR IS BEING TAUGHT32

COMPETENCY-INDICATORS1lIDENTIFY IN WHICH COURSE(S) THEINDICATOR IS BEING TAUGHTRecognize abnormalities and complications and institute appropriate treatment and referral.KNOWLEDGE Complications/pathologic conditions related to health status Emergency interventions/life-saving therapies Limits of midwifery scope of practice and own experience Available referral systems to access medical and other personnel to manage complications Community/facility plans and protocols for accessing resources in timely mannerSKILLS & BEHAVIOURS Maintain up-to-date knowledge, life-saving skills, and equipment for responding to emergency situations Recognize situations requiring expertise beyond midwifery care Maintain communication with women about nature of problem, actions taken, and referral if indicated Determine the need for immediate intervention and respond appropriately Implement timely and appropriate intervention, inter-professional consultation and/or timely referral taking account oflocal circumstances Provide accurate oral and written information to other care providers when referral is made. Collaborate with decision-making if possible and appropriate1m Care for women who experience physical and sexual violence and abuse.KNOWLEDGE Socio-cultural, behavioural, and economic conditions that often accompany violence and abuse Resources in community to assist women and children Risks of disclosureSKILLS & BEHAVIOURS Protect privacy and confidentiality Provide information to all women about sources of help regardless of whether there is disclosure about violence Inquire routinely about safety at home, at work Recognize potential signs of abuse from physical appearance, emotional affect, related risk behaviours such as substanceabuse Provide special support for adolescents and victims of gender-based violence including rape Refer to community resources, assist in locating safe setting as needed33

Competency- IndicatorsIdentify which course (s) theindicator is being taught2. Pre-Pregnancy and Antenatal2a Provide pre-pregnancy careKNOWLEDGE Anatomy and physiology of female and male related to reproduction and sexual development Socio-cultural aspects of human sexuality Evidence based screening for cancer of reproductive organs and other health problems such as diabetes, hypertension,thyroid conditions, and chronic infections that impact pregnancySKILLS & BEHAVIOURS Identify and assist in reducing barriers related to accessing and using sexual andreproductive health services Assess nutritional status, current immunization status, health behaviours such as use of substances, existing medicalconditions, and exposure to known teratogens Carry out screening procedures for sexually transmitted and other infections, HIV, cervical cancer Provide counseling about nutritional supplements such as iron and folicacid, dietary intake, exercise, updating immunizations as needed, modifying risk behaviours, and prevention of sexuallytransmitted infections, family planning, and methods of contraception.2b Determine health status of womanKNOWLEDGE Physiology of menstrual and ovulatory cycle Components of a comprehensive health history including psycho-social responses to pregnancy and safety at home Components of complete physical exam Health conditions including infections and genetic conditions detected by screening blood and biologic samples34

2b SKILLS & BEHAVIOURS Confirm pregnancy and estimate gestational age from history, physical exam, laboratory test and/or ultrasound Obtain comprehensive health history Perform a complete physical examination Obtain biologic samples for laboratory tests(e.g. venipuncture, finger puncture, urine samples, and vaginal swabs) Provide information about conditions that may be detected by screening Assess status of immunizations, and update as indicated Discuss findings and potential implications with woman and mutually determine plan of care2cAssess fetal well-being KNOWLEDGE Placental physiology, embryology, fetal growth and development, and indicators of fetal well-being Evidence-based guidelines for use of ultrasoundSKILLS & BEHAVIOURS Assess fetal size, amniotic fluid volume, fetal position, activity, and heart rate from examination of maternal abdomen Determine whether there are indications for additional assessment/examination and refer accordingly Assess fetal movements and ask woman about fetal activity2d Monitor the progression of pregnancy KNOWLEDGE Usual p

Accreditation Programme for Nursing and Midwifery . Date of submission of report to Bangladesh Nursing and Midwifery Council_ 2) The Review Team During the site visit, the review team members validate the self-assessment for each of the criteria. . as per DGNM guideline. Yes ⃝No

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