Proficiency: Professional practice – Monitoring maternal and fetal wellbeing
Proficiency Outcome as a practising midwife: ‘Prioritising people: You put the interests of people using or needed nursing or midwifery
services first. You make their care and safety your main concern and make sure that their dignity is preserved and their needs are recognised,
assessed and responded to. You make sure that those receiving care are treated with respect, that their rights are upheld and that any
discriminatory attitudes and behaviours towards those receiving care are challenged (NMC 2015) The Code: Professional standards of practice
and behaviour for nurses and midwives, page 4.
Practise‘ effectively: You assess need and deliver or advise on treatment or give help (including preventative or rehabilitative care) without too
much delay and to the best of your abilities, on the basis of the best evidence and best practice. You communicate effectively, keeping clear
and accurate records and sharing skills, knowledge and experience where appropriate. You reflect and act on any feedback you receive to
improve your practice NMC (2015) page 7
Preserve safety: You make sure that patient and public safety, is protected. You work within the limits of your competence, exercising your
professional ‘duty of candour’ and raising concerns immediately whenever you come across situations that put patients or public safety at risk.
You take necessary action to deal with any concerns where appropriate NMC (2015) page 11.
Midwife at the point of registration - can perform the activity satisfactorily without supervision, assistance and/or guidance; with
acceptable speed and quality or work with understanding and appropriate application, identify the problem, relevant information and
uncertainties (Competent and able to account for their actions)
Refer to: Benner (1984) Assessment Level 3 (Appendix 1 LSA Guidance for Clinical Mentors and Academic assessors supporting a midwife
undertaking an LSA practice programme 2013 Page 7)
This is linked to:
NMC (2015) The Code: Professional standards of practice and behaviour for nurses and midwives.
NMC (2009) Pre registration standards for midwifery education, Standard 17, p31
NMC (2011) The PREP handbook
NMC(2012) Midwives rules and standards, Rule 5; Scope of practice
NMC (2013) Raising concerns: Guidelines for nurses and midwives.
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NB Competencies listed are to be modified or removed in light of the outcomes of the supervisory investigation.
Clinical Proficiency Assessment Criteria used is (Benner, P. (1984). From novice to expert, excellence and power in clinical nursing practice.
Menlo Park, CA: Addison-Wesley Publishing Company, 307 pp.
Evidence Verifier/ signature can be:
No Benchmark Statements
1
As a practising midwife is responsible for
providing midwifery care to a woman and
baby during the antenatal, intra-natal and
postnatal periods, you must be able to
demonstrate that you are familiar with the
necessity to:

Promote normal birth

Facilitate women’s choice

Act as an advocate
Verifier signature/designation :
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Lead investigating Supervisor of Midwives, Academic Assessor, Risk/Governance
midwife or Sign off mentor
1.1.
1.2
Documented discussion and structured questioning to demonstrate in-depth of
physiology of labour and how this may be enhanced during birth.
Demonstrate insight by writing a reflective essay which identifies and applies key
principles and evidence to promoting normal and normalising complex birth and the
outcomes of the supervisory investigation.
Evidence of achievement
Evidence Verifier/ signature can be:
No Benchmark Statements
2
Lead investigating Supervisor of Midwives, Academic Assessor, Risk/Governance
midwife or Sign off mentor
Date
Pass/Fail
Assessment of maternal wellbeing,
interpreting findings accurately and
shares information with women,
discussing any further
action/consequences as necessary to
include:
2.1 Assessment of clinical competence in an area relevant to supervisory investigation
recommendations and related identified practice gap.




Monitoring maternal well being
Follow evidenced based care
pathways, justifying any
deviations
Identification and management of
risk
Timely action and referral to
appropriate professionals.
Verifier signature/designation :
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2.2 Documented discussion and structured questioning
2.3 Critically appraise own practice demonstrating insight in reflective essay.
2.4 Attendance at a ‘normal birth’ workshop/MLU clinical practice and relate practice to the
relevant physiology to facilitate low risk birth
Evidence of achievement
Evidence Verifier/ signature can be:
No Benchmark Statements
3
Lead investigating Supervisor of Midwives, Academic Assessor, Risk/Governance
midwife or Sign off mentor
Date
Pass/Fail
Assessment of fetal wellbeing.
3.1.
Assessment of clinical competence in an area relevant to supervisory investigation
recommendations.
3.2.
Successfully complete CTG training package.
3.3.
Complete ‘fresh eyes’ reviews with delivery suite/DAU coordinators and review
findings and follow up action.



Care for, monitor and support
women during labour and monitor
the condition of the fetus,
supporting spontaneous birth.
Participates in monitoring fetal
wellbeing using appropriate use of 3.4.
Pinard, intermittent auscultation or
by technical means.
3.5.
Documented discussion and structured questioning
Critically appraise own practice demonstrating insight in reflective essay.
Recognises deviation from the
normal wellbeing of the fetus

Take appropriate action in
response including appropriate
referral
Verifier signature/designation :
AKJuly2105
Evidence of achievement
Evidence Verifier/ signature can be:
No Benchmark Statements
4
Lead investigating Supervisor of Midwives, Academic Assessor, Risk/Governance
midwife or Sign off mentor
Date
Pass/Fail
Support the creation and maintenance of
environments that promote health, safety
and wellbeing of women, babies and
others, including;
4.4.
Undertake mandatory training and apply learning to the identified practice gaps
4.2.
Documented discussion and structured questioning in relation to effectively
promoting healthy lifestyle choices and ‘Making every contact Count’
http://www.nhslocal.nhs.uk/story/every-contact-counts




Prevention and control of infection
Promoting health
Safety and security in the
environment in which they work
whether within the home,
community, clinic or hospital.
Appropriate use of
equipment/technology
Verifier signature/designation :
AKJuly2105
Evidence of achievement
Evidence Verifier/ signature can be:
No Benchmark Statements
5
Lead investigating Supervisor of Midwives, Academic Assessor, Risk/Governance
midwife or Sign off mentor
Date
Pass/Fail
Measure, assess and facilitate wellbeing
during antenatal/postnatal periods.
5.1.
Assessment of clinical competence in an area relevant to supervisory investigation
recommendations.
5.2.
Documented discussion and structured questioning
5.3.
Critically appraise own practice demonstrating insight in reflective essay with
application of relevant physiology and evidenced based guidelines.
5.4.
Review with their clinical mentor 5 – 10 sets of their own records demonstrating
evidence of justification of actions taken.



Follow evidenced based care
pathways, justifying any
deviations.
Assessment and interpretation of
progress to include; observation,
screening, abdominal, vaginal
examinations as required;
providing feedback to women.
Social needs and assessment
vulnerability.

Timely referral to appropriate
professionals
Verifier signature/designation :
AKJuly2105
Evidence of achievement
Evidence Verifier/ signature can be:
No Benchmark Statements
6
Lead investigating Supervisor of Midwives, Academic Assessor, Risk/Governance
midwife or Sign off mentor
Date
Pass/Fail
Measure, assess and facilitate the
progress of labour.
6.1.
Assessment of clinical competence in an area relevant to supervisory investigation
recommendations and identified practice gaps.
6.2.
Undertake the review of an existing guideline and benchmark against National
guidance and if necessary update applying new research findings relevant to the
guideline.

Critically appraise and justify the
use of any intervention, in order to
facilitate birth
 Seeks informed consent prior to
undertaking any procedure.
 Recognises deviation from the
normal progress of labour or the
well-being of the woman and fetus
and discuss any further
action/consequences as
necessary.
Verifier signature/designation :
Evidence of achievement
AKJuly2105
Evidence Verifier/ signature can be:
No Benchmark Statements
7
Lead investigating Supervisor of Midwives, Academic Assessor, Risk/Governance
midwife or Sign off mentor
Date
Pass/Fail
Assesses accurately the health and
wellbeing of the mother and baby at birth
7.1.Assessment of clinical competence in an area relevant to supervisory investigation
recommendations and identified practice gaps

Initiates and maintains emergency 7.2.Attend and pass NALS training/update
measures if required
7.3.Attend and pass BLS training/update
7.4 Attend and pass Skills/drills training/update
Add amend/add as required
Verifier signature/designation :
AKJuly2105
Evidence of achievement
Evidence Verifier/ signature can be:
No Benchmark Statements
8
Lead investigating Supervisor of Midwives, Academic Assessor, Risk/Governance
midwife or Sign off mentor
Date
Pass/Fail
The midwife must demonstrate
accountability by demonstrating on-going
development, education and practice
experience to maintain registration.
8.1.
Identify learning needs through the development of a professional portfolio.
8.2.
Discussion regarding PREP/Revalidation requirements.
8.3.
Present an individual learning plan to detailing learning needs and SMART goals to
plans for how these will be achieved for the next year.
Verifier signature/designation :
Evidence of achievement
Date
Pass/Fail
If Evidence, for example a study day, or attendance at a particular activity has not yet happened by either the 150 or 300 hour review please enter NYF (Not Yet Facilitated).
At each of these reviews, if particular activities have not yet been facilitated , reassurance will be sought that, for example dates, times, venues, etc,, have been arranged to
ensure evidence is completed and in place for the final 450 hour end review. At the final 450 hour review, if level 3 is not achieved, reasons for the failure must be clearly
evidenced to justify the failure of the supervised practice programme.
Named mentor must meet the sign off mentor requirements (NMC (2008) Standards to support learning and assessment in practice)
The named supervisor can provide all the information in one document if appropriate.
You may use the same five to ten sets of records if they provide all the evidence required
You are only expected to prepare one presentation for student midwives ensuring that all areas identified are covered
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