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Problem: No South Australian study has previously investigated the role of midwives in the promotion and provision of antenatal influenza immunisation., Background: Influenza acquired in pregnancy can have serious sequalae for both mother and foetus. Recent studies have demonstrated that influenza vaccine in pregnancy is both safe and effective. Despite this, evidence suggests that vaccine uptake in pregnancy is suboptimal in both Australia and worldwide., Aim: The aim of this study was to investigate the role of midwives in the promotion and provision of antenatal influenza vaccine and, to provide a statistical and thematic description of the barriers and enablers midwives encounter., Methods: This mixed method study incorporated a cross sectional on-line survey and in-depth interviews conducted with midwives, employed in urban and regional South Australia., Findings: Quantitative data were available for 137 midwives and 10 midwives participated in the interviews. Recruitment for the interview phase was through the last question on the survey. Whilst all midwives indicated that education and vaccine promotion were part of their role, immunisation knowledge varied between Registered Nurse/Midwives (RM/RN) 80% and Registered Midwives (RM) 48.90% ( p  = 0.001). Quantitative data showed that only 43% of midwives felt sufficiently educated to provide the vaccine. Midwives who had received formal immunisation training were more likely to recommend the vaccine 93.7% ( p  = 0.001). Qualitative data confirmed these results and identified the lack of immunisation education as a barrier to practise., Conclusion: Midwives identified an immunisation knowledge deficit. Midwives who had received immunisation education were more likely to actively promote and provide the vaccine to pregnant women. These findings indicate the need for more immunisation education of midwives in both tertiary and practice settings., (© 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

Background: This paper reports on an Australian experience of co-locating a range of different primary health services into one building, with the aim of providing integrated services. It discusses some of the early challenges involved with moving services together and reasons why collaborative and integrated working relationships to improve the clients' journey, may remain elusive., Methods: Ethnographic observational data was collected within a GP plus site as part of day-to-day interactions between the research officer and health professionals. This involved observations of team processes within and across teams at the site. Observations were thematically analysed using a social anthropological approach., Results: Three main themes arose from the analysis: Infrastructural impediments to collaboration; Territorialism; and Interprofessional practice (IPP) simply not on the agenda. The experience of this setting demonstrates that dedicated staff and resources are needed to keep IPP on the agenda of health service organisations. This is especially important where organisations are attempting to implement new models of collaborative and co-located services. Furthermore, it shows that establishing IPP within newly co-located services is a process that needs time to develop, as part of teams building trust with each other in new circumstances, in order to eventually build a new cultural identity for the co-located services., Conclusions: Co-located health service systems can be complex, with competing priorities and differing strategic plans and performance indicators to meet. This, coupled with the tendency for policy makers to move on to their next issue of focus, and to shift resources in the process, means that adequate time and resources for IPP are often overlooked. Shared interprofessional student placements may be one way forward.

Background: Focusing on interprofessional relations in team performance to improve patient safety is an emerging priority in obstetrics. A review of the literature found little information on roles and teamwork in obstetric emergency training. Qualitative research was undertaken through a Clinical Simulation in Maternity programme which gives interprofessional rural clinicians the opportunity to learn collaboratively through simulated obstetric emergencies. This research aimed to determine how interprofessional simulation team training improved maternity emergency care and team performance., Method: This research used thematic inductive analysis using data from in-depth interviews. In total 17 participants and four facilitators who took part in the Clinical Simulation in Maternity workshops were invited to participate in an interview 1-2 weeks postworkshop and then again 3-6 months later. Data were deidentified then coded manually and with the assistance of computer program NVivo 7 (QSR International)., Findings: Of the major themes identified, Collaboration in Teambuilding was separated into four subthemes (Personal Role Awareness, Interpositional Knowledge, Mutuality and Leadership)., Conclusion: This research highlights the significance of interprofessional training, particularly through simulation learning in a team where rural clinicians are able to learn more about each other and gain role clarity, leadership skills and mutuality in a safe environment.