Powys Teaching Health Board have been running community skills and drills training for midwives and paramedics for fifteen years and since 2007 has offered the course ASAP to midwives and paramedics from across the UK. We will share our reflections on why community midwives need specific community skills and drills training and how our course has been developed and evaluated over the years. Maternity services in Powys are completely midwife-led and midwives work out in the community, our partners for providing care to women when additional needs arise at birth are paramedics. Transfer times to an obstetric unit for consultant care ranges from ½ to 2 hours dependant on where a woman lives. Due to the remote rural location and number of ambulances available we cannot guarantee a specific response time. Hence it was essential to develop a specific skills and drills training for community midwives and paramedics.
There is an abundance of ‘skills and drills’ training available for those working in maternity care, but these tend to focus on care within the hospital setting due to the fact most births happen within these (Wickham, Nightingale & Champion, 2012). Midwives within the community may be in a situation where they are working alone and need to respond to an emergency situation. Where such training has been conducted within a ‘home-like’ environment they have been rated positively (Pauley & Dale, 2016). Further to this, such training encourages the development of teamwork and practical skills to be practised within a ‘safe’ environment (Kirkham, 2018).
We developed a course specifically to meet the needs of midwives working in the community, we concentrated on team working being a partnership of midwives and paramedics, realistic with the equipment that community midwives have. We were keen to ensure that the setting for the training was a close to real life as possible so set up our training days in a remote Welsh farm house.
The aim was to develop and deliver a realistic training programme, which would meet the needs of community midwives and encourage partnership working with local paramedics and Health visitors.
To enable staff to practice key emergency skills
To encourage team work and communication
All trainees are asked to score how important they felt the training was to their practice. They all scored 4 or 5 [average 4.9/5] demonstrating the value of the course. They are asked to score their overall enjoyment of the course; the average score was 4.9/ 5 indicating a high level of satisfaction. Trainees rated the obstetric emergency scenario sessions average score of 4.9/5. Attendees were scored how confident they felt in dealing with emergencies within the community both before and after the training. Before the training attendees scored themselves an average confidence score of 3.4/5. Following the training scores average confidence score for the groups had increased to 4.9/5. The course has been integrated into standard practice making it sustainable and we have shared our findings across the UK allowing transfer across services.