Situated Clinical Decision Making Framework (SCDMF) - Answers Framework to support and
structure clinical decision making, and help identify contextual factors to provide a systematic
approach to informed decision making.
Macro Level - Answers HC system, scope, policies (e.g., time/budget constraints that influence
early discharge).
Meso Level - Answers Unit culture, relationships, workload, time demand.
Micro Level - Answers Patient condition, nurse-patient relationship, and ability to recognize
change.
Foundational Knowledge - Answers Knowing the profession (scope)
Knowing the self (confidence/strength/limitations)
Knowing the case (theoretical knowledge gained in education)
Knowing the patient (knowledge of specific patient)
Knowing the person (individual patient's experience and wishes)
Cues - Answers Data from observations, patient statements, labs/assessment data, atypical
responses/behaviours, intuition.
Judgement - Answers Interpreting meaning, using evidence, consult as needed.
Decision Making - Answers Reflected in internally - act, wait, or escalate.
PTSD - Answers Response to trauma, may lead to risky behaviours (e.g., substance use) that
affects the pregnancy and neonatal outcomes.
Trauma-Informed Care (TIC) - Answers Recognize effects of trauma across lifespan. Disclosure
of trauma is not necessary and is contraindicated. TIC fosters safety, trust, choice, and
collaboration.
Knowing the Profession - Answers Know scope of practice and core competencies for Perinatal
specialty areas of practice. Must meet BCCNM professional standards.
Historical Past of Childbirth - Answers A social, emotional life event, surrounded by community
and midwife. In indigenous communities, prenatal-postpartum period is sacred, and they are
surrounded by community, provided wisdom, and physical, mental, emotional, spiritual
dimensions celebrated.
20th Century Childbirth - Answers During industrialization/colonization, childbirth moved from
home/midwifery into hospital/medical model of care. Maternal and infant morbidity was high,