The Structurization and Verification of Skills in Expert Midwife's Monitoring-Care during Labor and Delivery

在2004年期间，我们试图确定在分娩和分娩期间由专业护士-助产士进行“监测-护理”。经过文献回顾，包括我们之前的研究和我们之间的讨论，我们将“监护-护理”的目的编码为胎儿的健康，保证妇女的安全，掌握分娩过程，掌握妇女的控制感。2005年，我们利用上述研究成果和我们的讨论，尝试制定产程监护过程的方案。采用合作研究者Tsuru， S.提出的算法概念方法，制作产程监测护理过程临床流程图。为了复习和验证该临床流程图，我们将该程序应用于2006年1月1日至3月20日期间在2^<和1^< 2级产前产科病房分娩的60例临床病例。我们使用了41例处女分娩病例和19例紧急或预定剖腹产病例，这些病例的风险相对较低。结果表明，我们没有发现临床图表有任何偏差，但发现我们必须增加一些新的单元，如膜破裂、引产和/或胎儿保证等，并重新检查这些单元的标准。我们在制作临床流程图的同时，也进行了专家护生员在产程和分娩过程中监护和护理过程结构可视化的试验。可视化的思维过程和实践的专家护士和助产士，以前没有明确说明可以成为一个基础，更先进的护理整个行业。

During 2004, we tried to identify "monitoring-care" by expert nurse-midwife during labor and delivery. After literature review including our former researches and discussion among us, we coded the purpose of the "monitoring-care" as fetus's wellness, reassuring the woman's safety, grasping the progress of delivery, and grasping the woman's sense of control.During 2005, we use above research results and our discussion, and we tried to make the program of the monitoring and caring process during labor and delivery cared. Using algorithm notion method developed by Tsuru, S., our co-researcher, we made the clinical process chart of monitoring and caring process during labor and delivery. To brush up and verify that clinical process chart, we applied that program to 60 clinical cases delivered at 2^<nd> level prenatal obstetrical unit from Jan.1^<st> to Mar.20^<th> in 2006. We used virginal 41 delivery cases and 19 emergency or scheduled caesarian section cases, and these were relatively low-risk cases. As results, we couldn't find any deviations of that clinical chart, but found we must add some new units, for example rupture of membrane, induced labor and/or fetus assurance so on, and reexamine the criteria of these units.Our trial of making clinical process chart was at same time the trial of making structural visualization of the process of expert nurse-midwife's monitoring and caring during labor and delivery. Visualizing the thinking processes and the practice of expert nurses-midwives which have not been expressly stated previously can become a foundation for more advanced nursing care throughout the profession.