Local QI Teams: Midwife/Nurse:
BACKGROUND:
Rwandan Paediatric Association is working in partnership with The Royal College of Paediatrics and Child Health since 2012 in perinatal care. Providing training, mentoring on quality improvement and health system strengthening strategies to improve clinical skills and care practices. Based on that we have received a fund from James Percy Foundation to implement a 3-year programme. Therefore, we are looking for 3 midwives and 3 neonatal nurses (or nurses with neonatal experience) to join our new programme ‘Rwanda Perinatal System Strengthening’.
Reporting to: Program Manager
Job Title: Midwife / Neonatal Nurse
Contract: 2 years
Location: Karongi, Kamembe, or Musanze (Must live in one of these areas as work will be based in provincial hospitals)
Terms of Reference
The Quality Improvement Team will be seconded to support three cluster hospital facilities (one central Provincial hospital, with several geographically adjacent district hospitals). Each team will include nurse and midwifery expertise. They will be supported by a team of international volunteer clinicians working across all hubs (see below).
LOCAL QI TEAMS: This team of two members (Neonatal Nurse, Midwife) will be focused on the Provincial hospital and dedicated to the support and development of the Neonatal Intensive Care Unit and perinatal improvement.
INTERNATIONAL SUPPORT QI TEAM: This team of three international members (Paediatrician, Obstetrician, and Neonatal Nurse) will be dedicated to supporting the local QI teams with light outreach support at the District Hospital level with a specific focus on perinatal care improvement across all cluster hospitals.
PROVINCIAL QI TEAM OBJECTIVE
- Support the hospital in developing and strengthening its ability to provide neonatal intensive care – primarily through the operationalisation or improvement in existing NICU facilities.
- Work with local counterparts to strengthen general neonatal care quality focusing on the core indicator list set out in the Programme Manual. The focus will be on improving basic routine and emergency care functions associated with improving newborn conditions and outcomes in low-resource settings – temperature regulation, infection control, feeding, and KMC.
- Work simultaneously with local counterparts in maternity and delivery to strengthen general intrapartum care quality, focusing on the indicators set out in the Programme Manual. As with NNU, the strategic focus will be on improving the basic skills of midwives in identifying high-risk pregnancies early on arrival at hospital, basic fetal monitoring, appropriate identification of emergency labour conditions, and timely communication and decision-making in the case of decision to c-section. Whilst there will be a focus on improving the skills of General Practitioners to manage process around c-section, much of the focus of QI will be on midwives’ knowledge and skills and their consequent ability to manage an efficient ‘flow’ from triage through to postpartum care, minimising avoidable systemic causes of delay which are associated with poor maternal and neonatal outcomes.
- Strengthen the communication and working relationship between delivery and neonatal care – with a clear focus on enhancing the skills of both midwives and nurses in delivering high-quality immediate and follow-on routine new-born care (from the ‘golden minute’ to the 28th day and discharge), as well as efficient and effective resuscitation where required.
Principal responsibilities of the Provincial QI Team Nurse/Midwife will include:
- Reviewing assigned hospital’s facility assessment data and engaging with hospital administrators and Champions to agree a 2-year plan for delivering neonatal care training modules, as well as agreeing schedule and/or opportunities (daily/weekly/monthly) for refresher training, on-job mentoring, and other relevant training/mentoring activities.
- Agreeing with hospital administration consultation and planning process for facility improvement projects (as relevant and necessary) and periodic review of equipment/medicines supply/quality/functionality.
- Agreeing with hospital administrators/Champions indicators, data, and data collection methods for a 2-year period in line with programme objectives and hospital improvement plans.
- Engaging with administrators/Champions to give feedback of data collected and agree on improvements to add to the hospital improvement plans on return of data.
- Engaging with Neonatal & Maternity Champions and RPA Mentor to agree 2-year schedule of training and mentoring activities, and agreeing Champion, Provincial QI Team, and RPA Mentor roles and responsibilities within training/mentoring schedule.
- Agreeing with Neonatal & Maternity Champions and RPA Mentors the consequent schedule of training/mentoring support for 12-month follow-on period (after initial 2 years, following departure of Provincial QI Team).
- In partnership with Neonatal & Maternity Champions and RPA Mentor, planning and implementing quality improvement projects and related periodic audits.
- Contributing with hospital clinical colleagues in the provision of care for neonates (as directed by the hospital administrator/Neonatal Champion, to a maximum of 40% of time weekly, over a 5-day week).
- In consultation with Neonatal Champion and RPA Mentor, to review post-discharge follow-up practice with small/preterm new-borns; agree and implement strategy to strengthen follow-up system.
- Agree with Champions/clinical directors/director generals to introduce and implement introductory work-based training in coordination with RPA.
Tasks of the Local QI Team (Nurse/Midwife) will include:
Mentoring and Coaching colleagues
- Maintain communication links with the Hospital Directors.
- Update hospital staff on the progress of the program
- Consider introducing MDT meetings within the hospital
- Being present at the hospital for the UK Quality Assurance visits
- Be a role model at work – support, encourage and communicate with the MDT and your colleagues
- Work closely with the international support team
- Support the facilitation of 3 monthly hospital coordination workshops
Data collection
- Develop and maintain communication links with the data manager
- Complete data collection referring to M and E tools and submit it as required
- Support Champions to complete short monthly/3monthly data collection, of all indicators on the Kobo Toolbox. Complete monthly reports and upload onto SharePoint
- Complete excel teaching log and upload onto SharePoint
- Complete the NICU/NNU mortality data collection monthly (this is the Champions role but will need directing to do this)
- Feedback data was collected to hospital staff to inform HIP
Development and support implementation of Hospital Improvement Plan (HIP)
- Support Champions with the hospital improvement plan, assisting with assigning roles and responsibilities to hospital staff
- Support Champions in reviewing and updating hospital improvement plans on a monthly basis
- Identify gaps in training, equipment, and infrastructure and address them when possible and report them to the RPA administration.
- Support champions in the engagement from hospital staff with quality improvement plans and share them across departments and senior hospital staff
Training
- Run training sessions on maternal and neonatal care as and where necessary
- Conduct bedside teaching/mentoring to colleagues
- Support Champions in taking on training sessions and bedside training
Knowledge management
- Document best practice examples (e.g., innovative approaches to teaching, or quality improvement approaches) and share them with the RCPCH technical advisor and RPA
- Collate and share posters, and other materials that could be used by other hospitals and health centers
Hospital visits
- Please ensure that a representative from the Local QI Team is present during supervision visits to the hospital by the funder and other relevant organisations
REPORTING:
Monthly:
- Ensure data collection is completed by Champions and submitted via the KOBO toolbox
- Your monthly report. Template on SharePoint. Only one per team is required.
- Excel teaching log. Template on SharePoint
- Supporting champions in updating and reviewing the hospital improvement plan. Upload updated HIPs onto SharePoint.
Requirements/Competencies
Degree: A0 with a minimum of 3 years experience/A1 with a minimum of 7 years experience
You must have a Rwandan nursing or midwifery licence to practice
Having experience in training or mentoring in a clinical capacity is an added value
Having previous experience working in remote areas in Rwanda or similar settings is added value
Application Guidelines
Please send us your most recent CV and a cover letter of how you fit the criteria of the role and the preferred location to pediatric.rwanda@gmail.com and copy charlotte.mann@rcpch.ac.uk
Application deadline: 21st September (Interviews will be scheduled the following week)
