Critical Care and HDC
There is a difference between the term critical care and HDC based on the level of care delivered to the patient. HDC is specifically required in obstetrics for ensuring the provision of HDC to pregnant women who are at an increased risk of development of complications during various phases of pregnancy. Several reports regarding HDC have demonstrated the importance of delivery of this level of care by midwives. Various levels of care have been identified along with the development of a regional critical care network. Incorporation of evidence-based practice in critical care and need for workforce was also included in these reports. Several models of HDC delivery by midwives have been developed among which the Critical Care Outreach Teams and Medical Emergency Team (MET) models are the most significant. According to the report of DOH (1996), Continuity of care model and the midwifery care model have also been presented for ensuring the provision of HDC to high-risk pregnant women. Early warning scoring system has been implemented for early detection of the possibility of complications during labour and pregnancy. Implementation will be performed through an elevation of the physiological parameters of health that have been set to predict requirement of HDC. The numbers of women receiving HDC are very less as determined by the statistics. HDC is not a new concept in obstetrics rather it was addressed during 1991-1993 in the reports of DOH in the UK. There are an increased number of women with maternal complications requiring this type of care for supporting the health of both the mother and newborn.
The increased number of such women has resulted in the need for the development of HDC for preventing further deterioration of the health of pregnant women during various phases of pregnancy. Changes in the NHS have caused modernisation of the system (DOH, 2000). Variations have occurred in the educational system of midwifery in the UK due to these advancements. Education and training of the midwives is necessary to ensure their competence for the delivery of HDC to high-risk pregnant women. Competence of midwives has to be based on the standards set for supporting the provision of HDC. Midwifery education is aimed at developing the skills and competence among the midwives to provide HDC in the maternity setting. The major shift in midwifery education occurred by movement of midwifery education from NHS to HEIs.
Curriculum of midwifery education is developed by the Nursing and Midwifery Council (NMC) which creates the content and framework to ensure the delivery of skills and competence to midwives. The curriculum is aimed at making the midwives more knowledgeable professionals having the ability to care for pregnant women.