J Midwifery Womens Health. 2010 Mar-Apr;55(2):107-16. doi: 10.1016/j.jmwh.2009.11.002.
The documentation of pain in the labor and delivery setting is one of the essential tasks of all health care providers who care for women in labor. The Joint Commission standards mandate regular pain assessments, but compliance with this mandate in the highly unique patient population of laboring woman is problematic when using the standard 0 to 10 Numeric Rating Scale. Labor pain is always unique given the various contributing physiologic, emotional, social, and cultural components. This article describes the work of a process improvement group to create an alternative pain assessment tool named the Coping With Labor Algorithm. The group, consisting of nurses and nurse-midwives, used the FOCUS format and Deming's "Plan, Do, Check, and Act" cycle to create a formalized assessment tool for use with laboring women. The Coping With Labor Algorithm is currently in use in the labor unit of a large tertiary care facility, which successfully passed a Joint Commission inspection while using the coping algorithm. The value of the coping algorithm is two-fold: it provides a mechanism for pain documentation, and it provides nursing care suggestions for the laboring woman. This article reports nurses' perceptions of the tool.
在分娩环境中记录疼痛是所有照顾分娩妇女的医疗保健提供者的基本任务之一。联合委员会的标准要求定期进行疼痛评估，但在使用标准的 0 到 10 数字评分量表时，对于分娩妇女这一高度独特的患者群体，遵守这一规定存在问题。由于生理、情感、社会和文化因素的不同，分娩疼痛总是独一无二的。本文介绍了一个流程改进小组的工作，该小组创建了一种替代疼痛评估工具，名为“应对分娩算法”。该小组由护士和助产士组成，使用 FOCUS 格式和戴明的“计划、执行、检查和行动”循环创建了一个用于分娩妇女的规范化评估工具。应对分娩算法目前正在一家大型三级保健机构的分娩单位使用，该单位在使用应对算法时成功通过了联合委员会的检查。应对算法的价值有两方面：它为疼痛记录提供了一种机制，并为分娩妇女提供了护理建议。本文报告了护士对该工具的看法。
