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Shaping the future of care - ANMF priorities 2025: Nursing and midwifery workforce reform

2025-02-11 - 2025-02

The Australian Nursing and Midwifery Federation (ANMF) is focused on driving meaningful change in 2025 to ensure better conditions for nurses, midwives, careers, students and to meet the health and aged care needs of the community
Recognizing the critical milestones we have already achieved like wage increases and mandated care minutes, we know progress is possible.
The ANMF's vision is to priorities reforms that support recruitment and retention, empower nurses and midwives to work to their full scope of practice to ensure accessible and affordable healthcare, and deliver improved outcomes for women.
The ANMF remains committed to the development of strategies to: enhance the recruitment of nurses and midwives, especially new graduates; reduce undergraduate attrition; and address workforce retention.
Unsustainable workloads are a key driver of the workforce crisis. The ANMF is advocating for a range of strategies to improve retention, including: increasing nurse practitioner positions, boosting the nursing and midwifery workforce through scholarships, increasing support for continuity of care models, improving clinical placements, and increasing support for RUSON and RUSOM models of care, and exploring financial incentives like allowances.
After years of lobbying by the ANMF, recent introduction of Commonwealth Prac Payments for nursing and midwifery students from 1 July 2025, may help stem undergraduate nursing and midwifery student attrition. The $319.50 a week (means-tested) provides some financial support for students while undertaking their 800 hours unpaid mandatory clinical placement.
The much-awaited National Nursing Workforce Strategy is due to release its report in 2025. The strategy will provide a national approach to shape the future of nurse workforce planning, investment and reform in Australia. The strategy has come out of the Nursing Supply and Demand (2023-2025) study which found unsurprisingly that our supply of nurses will not meet future demand.
Similarly, the Midwifery Futures report, commissioned by the Nursing and Midwifery Board of Australia (NMBA), exposes widespread staffing shortfalls, especially in non-metropolitan areas. The report makes 32 recommendations including in the scale-up of midwifery models of care. This includes to attract, educate, and retain the Aboriginal and Torres Strait Islander midwifery workforce and maintain ongoing initiatives such as Birthing on Country programs.
Both complement other government blueprints including the Nurse Practitioner Workforce Plan, Independent Review of Overseas Health Practitioner Regulatory Settings, and Unleashing the Potential of our Health Workforce (Scope of Practice) Review in how to tackle our critical workforce challenges.

Air pollution exposure late in pregnancy increases NICU admission risk

2025-02-14 - 2025-02

The researchers focused on common pollutants, such as nitrogen dioxide (NO2), which is caused primarily by the burning of fossil fuels in vehicles, industrial processes and power plants, and PM2.5, which refers to fine inhalable particles with diameters that are generally 2.5 micrometers and smaller. They also studied ozone (O3), which is a secondary pollutant that is formed from oxygen and other gases in the presence of sunlight.
The findings, published in January in the Nature journal Scientific Reports, show that newborns exposed in the last month of pregnancy to higher levels of NO2 have a 30-35% higher risk of NICU admission and an 11-22% increased risk associated with PM2.5.
"Our findings highlight the critical impact of air pollution during the final weeks of pregnancy, a time of heightened fetal vulnerability, and emphasize the significance of addressing air pollution exposure, even at lower levels," says the study's first author, Yohane V.A. Phiri, PhD, a postdoctoral research associate in the Department of Epidemiology and Environmental Health in UB's School of Public Health and Health Professions.
Exposure to air pollution during pregnancy has been linked to several adverse neonatal outcomes including birth defects, preterm delivery and altered fetal growth, according to Phiri.
"While our findings are not causal, limiting direct inference, they support local and national initiatives aimed at further reducing air pollution and improving air quality," he said. "Such efforts could ultimately benefit pregnant women by minimizing exposure to harmful pollutants and reducing associated neonatal health risks."
Despite advancements in maternal and child health care, NICU admissions remain high in the U.S., with 8.1% of infants admitted in 2018, the year on which the study is focused. And while the U.S. has relatively low air pollution levels compared to other countries, air pollution's impact on NICU admissions remains an understudied area, according to Phiri.
The study, he adds, was designed to assess the impact of air pollution exposure on NICU admissions across the United States using satellite-derived data, which allows for more comprehensive coverage that can also include areas that lack ground-based monitoring, such as rural parts of the country.
The research team grouped data by regions of the U.S. For example, the Great Plains area saw a lower risk of NICU admissions, a finding that could be attributed to the fact that the risk is underestimated given that infants in more rural parts of the country are transferred to a NICU only for severe complications due to limited access of such units in these areas.Findings varied by pollutants and geographic region.
"We saw the strongest risks with NO2 and intermediate risks with PM2.5," Phiri said, adding that ozone results showed either a protective effect or no difference among groups, except for during the summer.
Geographically, the Midwest and Mid-Atlantic regions had the highest odds of NICU admission due to NO2 exposure. For PM2.5, seasonal variations were noted, with persistent risks along the West Coast and in the Southeast. Summer saw widespread risks, while winter risks were highest in the Northeast, Phiri said.
The research team included senior author Pauline Mendola, PhD, chair and professor, and Jing Nie, PhD, research assistant professor and research scientist, both of the Department of Epidemiology and Environmental Health at UB; and researchers from the University of Maryland and the University of Massachusetts Amherst.

New blood test accurately predicts preeclampsia

2025-02-12 - 2025-02

"The placenta is not something we can biopsy during pregnancy, but we believe it is integral to developing preeclampsia," said Dr. Swati Shree, a UW Medicine OB-GYN and co-corresponding author of the paper. "Doctors do look at clinical risk factors, which can work reasonably well, but it still misses a fair amount of people."
Preeclampsia is a pregnancy complication characterized by high blood pressure (hypertension) or organ dysfunction. It typically occurs in the third trimester. The condition's exact cause is unknown, but doctors suspect it is related to an abnormal interaction between the placenta and the mother's blood vessels.
Traditionally, doctors tried to discern a pregnant woman's risk based on her patient history. Risk factors for preeclampsia include first pregnancy, history of preeclampsia, history of hypertension or chronic kidney disease or both. Sometimes, however, preeclampsia develops in the absence of any of these pre-existing conditions.
Researchers have known for at least two decades that the placenta sheds DNA into maternal blood. Labs have been able to extract cell-free DNA, sequence it and use the sample to screen for fetal abnormalities such as Down syndrome.
Earlier, this testing was shipped to outside labs for processing, but in 2017, UW Medicine started doing these tests in house, one of the first healthcare systems to do so, Shree added. UW Medicine and Fred Hutch Cancer Center teams collaborated in developing the idea to use cell-free DNA sequence data to screen for pre-eclampsia, Shree said.
Over the past two years, the investigators, led by Shree and co-corresponding author Gavin Ha, a computational biologist at Fred Hutch, used this data, which functions as a liquid biopsy, from the first trimester of pregnancy for over 1,000 pregnant individuals to develop and then validate their test.
"The innovation in this tool reinforces how important it is. Liquid biopsy tests were pioneered in pregnancy health research and is now an emerging research area in oncology," said Ha. "There are similarities in the genes we're looking at in both areas of research, which makes this study a collaboration which bridges both fields."
The samples were collected between 2017-2023. The researchers found that their approach, which uses signals stored within circulating cell-free DNA sequence data, had 80% sensitivity at predicting whether a pregnant individual would experience preterm preeclampsia or not.
Shree said that the next steps would be to improve the training model with more samples, and ultimately to conduct a trial that includes thousands of patients. The researchers hope a test like this could become an early preeclampsia prediction tool that seamlessly integrates into routine early pregnancy screening.
"Although using liquid biopsies for human diseases is largely used in the cancer area, given the frequency at which cell-free DNA screening is performed, prenatal biology truly has incredible opportunities for the discovery and application of innovative tools," she said.

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Shaping the future of care - ANMF priorities 2025: Nursing and midwifery workforce reform

Air pollution exposure late in pregnancy increases NICU admission risk

New blood test accurately predicts preeclampsia