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

在2004年，我们试图确定“监测护理”的专家护士助产士在劳动和交付。本研究经过文献回顾，结合本研究所先前的研究与讨论，将产程监护的目的编码为胎儿健康、产妇安全、掌握产程进度、产妇控制感，并于2005年期间，利用上述研究成果与讨论，尝试将产程监护的程序化。使用Tsuru，S.开发的算法概念方法，我们的合作研究者，我们制定了临床流程图的监测和护理过程中的分娩和分娩。为了对临床流程图进行复习和验证，我们对2006年1月1日至3月20日在二级妇产科分娩的60例临床病例进行了应用<nd><st><th>。我们使用了41例处女分娩病例和19例急诊或计划剖腹产病例，这些病例的风险相对较低。结果未发现临床流程图有任何偏差，但发现必须增加破膜、引产、保胎等新的单元，并重新审视这些单元的标准，我们制作临床流程图的尝试，同时也是将专业助产士在产程中的监护过程进行结构化可视化的尝试。可视化的思维过程和专家护士助产士的做法，以前没有明确说明可以成为整个行业更先进的护理的基础。

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.