Development of a Patient Safety Model for Independent Midwifery Practice Implementation

Abstract

Introduction: Patient safety is a key concern in independent midwifery practices in Indonesia, especially in regions like Tangerang that face contextual and systemic limitations. These include decentralized governance, limited infrastructure, and professional isolation, which collectively compromise the quality of maternal and newborn care. The purpose of this research is to analyze the available patient safety models and frameworks in the practice of midwifery as well as ascertain the critical matters to patient safety to assist in forming a tailored model of separate midwifery practices for Indonesian midwives. Method: This study applied a Systematic Literature Review (SLR) using PRISMA 2020 guidelines. From 24,342 initial records retrieved from Scopus, 25 studies were selected based on their relevance to patient safety models in midwifery, following a structured screening and eligibility assessment process. Result: Findings revealed persistent and interrelated challenges such as high psychological burden among midwives, non-adherence to clinical protocols, limited access to evidence-based practice (EBP) resources, inadequate interprofessional communication, cultural insensitivity, and fragmented care. While existing models, such as resilience frameworks, continuity of care approaches, and structured communication tools, have demonstrated effectiveness in high-resource settings, their applicability in Indonesia is limited by contextual misalignment, resource constraints, and regulatory fragmentation. Conclusion: The study emphasizes the urgent need for a regionally adapted patient safety model that integrates culturally sensitive, community-based approaches with enhanced access to EBP, structured collaboration across healthcare actors, and resilience-building strategies for midwives. By aligning global best practices with local realities, this model offers a practical framework for improving safety outcomes in independent midwifery care and ensuring maternal and neonatal well-being in decentralized healthcare systems.