At the 2007 AWHONN Convention, attended a presentation entitled “Assessing Pain in Labor” by Brenda Gulliver RN L&D, University Hospital University of Utah and Leissa Roberts, MS, CNM Associate Professor University of Utah College of Nursing. The presentation was an Algorithm they developed for evaluation of Labor Pain using “Coping/Not Coping” clues and actions to help the patient cope with labor. Permission was obtained to bring this Coping/Not Coping Algorithm to Baylor Health Care System with Copyright@ University of Utah Hospital and Clinics be placed at the bottom of the Algorithm. A project was designed to implement this Algorithm in Labor and Delivery Units of Baylor Health Care System.

Proposed change:

The need for an improved method to evaluate and chart labor pain was a driving force for bringing Coping/Not Coping to the bedside at Baylor Health Care System. The proposed change was to enable nurses to evaluate labor pain in the Baylor Health Care System thru evaluation rather than assigning a number of 0-10 to labor pain.

Implementation, outcomes and evaluation:

After obtaining permission to bring the tool to the Baylor Health Care System, the process of modifying the Algorithm to Baylor Health Care System was started including how the Algorithm fits the Joint Commission standards for pain. It was agreed by all who reviewed the Algorithm that a pilot needed to be done in order for the nurses to evaluate the tool prior to implementation.  A pilot was designed and implemented in order to trial the tool. At end of the pilot, many positive responses were obtained with no recommendations for change in the Algorithm, only to place the charting information on the pain and contraction tabs of the computer charting system. A booklet for Patients was also written explaining the terminology of Coping/Not Coping to labor patients.  Education of nurses in Baylor Labor and Delivery Units was done and the Algorithm was implemented. The nurses have positively stated that the tool is an effective tool in the evaluation of labor pain thru observation of behaviors.   

Implications for nursing practice:

The use of Coping/Not Coping Algorithm gives Labor and Delivery Nurses tools to evaluate a patient’s labor pain thru evaluation of labor clues.  It also gives the patient control over perception of her labor pain by not assigning a number of 0-10.

Keywords: Coping/Not Coping Algorithm, Labor Pain Tool, implementation, evaluation