What to look for when credentialing midwives

Any health care institution giving nurse midwives privileges should require them to undergo the same credentialing process
that other professional staff do, says Deanne Williams, CNM, MS, director of professional services and support for the American College of Nurse Midwives in Washington, DC.

Types of documentation that can be used to show the education and experience of a nurse midwife in support of credential determinations include:

* educational program transcripts;

* evidence of certification by the American College of Nurse Midwives;

* evidence of state licensure as a nurse midwife, registered nurse, advanced nurse practitioner, and/or nurse practitioner;

* evidence of Drug Enforcement Admin-istration (DEA) registration;

* evidence of a current professional liability insurance policy;

* letters of recommendation from people who have worked with and who can comment on the ability and character of the applicant;

* evidence of physical and mental capacity to perform duties (if required of other professional staff).

The National Practitioner Databank in Washington, DC, does not require that nurse midwives report results of peer review activities that suggest substandard care, Williams says. But other information regarding nurse midwives, including liability settlements, adverse actions against the license to practice, and actions against DEA settlements, appears to be handled the same way by the databank
as it is for physicians and dentists. This means everything other than peer review cases become public information.

In addition, the hospital may want to require the nurse midwife to demonstrate basic life support skills for adults and infants, suggests Karen Fernandes, RN, BSN, CPHQ, senior quality/risk specialist for Tenet Healthcare System in Dallas. Because nurse midwives may be involved in procedures where such skills will be required, it is useful for them to be able to begin life-saving skills until a physician in brought into the case. *