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Nurses and midwives collectively, represent the largest workforce category in rural and remote areas of Australia. Maintaining currency of practice and attaining annual licensure with the Australian Health Practitioners Regulatory Authority (AHPRA) present challenges for individual nurses and midwives and for their health service managers. Engagement with information and communication technologies, in order for geographically isolated clinicians to access ongoing education and training, is considered a useful strategy to address such challenges. This paper presents a pre- and post-test study design. It examines the impact of an online continuing professional development (CPD) program on Australian rural nurses and midwives. The aims of the program were to increase basic skill acquisition in the utilisation of common computer software, the use of the Internet and the enhancement of email communication. Findings from the study demonstrate that participants who complete a relevant CPD program gain confidence in the use of information and communication technologies. Further, increased confidence leads to increased access to contemporary, reliable and important health care information on the Internet, in addition to clinicians adopting email as a regular method of communication. Health care employers commonly assume employees are skilled users of information and communication technologies. However, findings from this study contradict such assumptions. It is argued in the recommendations that health care employees should be given regular access to CPD programs designed to introduce them to information and communication technologies. Developing knowledge and skills in this area has the potential to improve staff productivity, raise health care standards and improve patient outcomes.

Introduction Although the incidence is rare (<1%), patients receiving care in hospital maternity wards are at risk of developing pressure injuries. These injuries create a significant economic burden worldwide. Reported risk factors for pressure injuries include epidural analgesia, immobility during labour, and increased temperature and excessive moisture, especially during birthing. Traditionally used moisture management devices often damage skin integrity, further heightening the risk for pressure injury. Here we describe an innovative moisture management product designed to better meet women's needs during pregnancy and birth. Methods Clinicians worked together with the product manufacturer to develop an improved disposable absorbent sheet for moisture control before, during, and after birth. Pregnant women (n = 79) used either the disposable sheet or sanitary pads alone, or the disposable sheet in conjunction with sanitary pads for moisture control; in-patients and their midwives (n = 93) then completed surveys to evaluate the effectiveness of the various moisture control measures. Because multiple personnel caring for a single patient over the course of several shift changes, more surveys were completed by midwives than by patients. Four factors were considered during product evaluation: comfort, moisture management, mobility, and absorbency. Results Both midwives and patients rated the comfort level of the new disposable absorbent sheet with sanitary pads significantly higher than that of the disposable absorbent sheet or sanitary pads alone. Additionally, most patients reported that they were comfortable lying on the sheet and that using the sheet enabled them to worry less about embarrassing body fluid stains on their sheets or clothing. Similarly, the majority of midwives reported that the disposable absorbent sheet appeared to be comfortable and not restrictive. It also effectively managed moisture. Discussion This study demonstrates the efficacy of the new disposable absorbent sheet for moisture management in patients treated in hospital maternity wards. Clinical Significance Redesigning the disposable absorbent sheet for maternal moisture management in collaboration with clinical experts has heightened awareness of the importance of efficient and safe moisture management while facilitating a Wellness Model of Care within the maternity setting. [ABSTRACT FROM AUTHOR]

The article looks at the Australian rural maternity services. The Australian Government shifted maternity services to a primary care model in 2009 because of inequities in maternity services experienced by pregnant women living in rural and remote areas. To address these issues and improve the quality of choices for rural women and their families, changes must be made to registration processes for nurses and midwives to accommodate the needs of clinicians employed in rural and remote settings.

Summary: Background: The relocation of women from their rural communities to birth in a centralised hospital is becoming increasingly common as maternity units close in rural areas of Australia. The significance for Aboriginal women when they are denied the support of kin around the time of birth but have that support re-established postnatally is explored. Methods: This paper gathered data from multiple sources including in-depth interviews with three Aboriginal mothers and one partner; observational field notes; and during debriefing, the knowledge and experience of an Aboriginal midwife. Thematic analysis was utilised to both explore and critique the collected data. Findings and discussion: Aboriginal women are particularly disadvantaged by maternity unit closures in rural areas of the south eastern Australian state of New South Wales (NSW). However, contrary to the expectation that this would result in postnatal mental health problems, the support the Aboriginal participants in this study received from kin may have had a mediating effect which enhanced their well-being and possibly prevented mental ill health. Recommendations: Recommendations relate to strategies and policies that have the potential to increase community governance and feelings of cultural safety for Aboriginal childbearing women living in rural areas. Conclusion: While the practice of forcing Aboriginal women to relocate around the time of birth has a negative impact on perinatal health outcomes, kinship support may be a mediating factor. [Copyright &y& Elsevier]

Summary: Background: This paper describes how women experienced what came to be labelled as ‘bullying’ by a small number of midwives when they were evacuated from their rural and remote areas of NSW, Australia to a maternity unit to birth. Research question: What is the experience of women who are required to travel away from their NSW rural/remote communities to birth? Participants and methods: Forty-two participants together with a number of their partners/support people were interviewed indepth for this qualitative, exploratory study. Upon thematic analysis of the transcribed interviews, an unexpected finding was that four participants (plus one partner) described experiences which were interpreted as bullying, by a small number of midwives working with them. Women identifying as Aboriginal were especially likely to share stories of midwifery bullying. Results, discussion and conclusion: Emotional and cultural safety of women must be a prime consideration of midwives. Strategies to reverse power differentials between midwives and women are urgently required to eradicate bullying by any midwife. [Copyright &y& Elsevier]

The article discusses 2 events that highlight current initiatives undertaken by the Rural Nursing and Midwifery Faculty (RNMF). The public hearing, for the Commonwealth Senate Inquiry into the Factors Affecting the Supply of Health Services and Medical Professionals, held on May 11, 2012, focused on several issues impacting the rural nurses and midwives. The Royal College of Nursing, Australia (RCNA) National Conference, highlighted methods to support the future of rural nursing.