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Abstract Background: Expanding nursing workload is a worldwide problem. However, any nursing workload assessment (NWA) tool requires complicated analyses of the nursing job profile. To determine the imbalance in time assignments across all nursing operations and to reduce nursing workload, a nursing job survey was conducted. Methods: A total of 25 major job categories, common to all hospital wards, were identified, and an NWA tool was developed for efficient analyses to feature easy/flexible entry of the time spent for each job category and real-time visual profiling of job time allocation. The profile could be divided by job categories, wards, shifts, and years. Results: From the preliminary analyses, undesirable time allocation was revealed in several job categories, especially the time for recording and other nonessential nursing operations. Using the analytical functions of the NWA tool between 2014 and 2016, a series of corrective measures were successfully taken to many job categories, and they were found to be effective. Consequently, excessive overtime workload was reduced from 125 min/day/nurse in 2014 to 100 and 100 min/day/ nurse in 2015 and 2016, respectively. Conclusion: Notable improvements in nursing workload and time allocation for attentive patient care could be achieved employing the novel user-aimed NWA tool.
Creators : Shimizu Yumi Satou Kazutaka Manago Noriko Itou Masako Ichihara Kiyoshi Maekawa Tsuyoshi Publishers : Yamaguchi University School of Medicine
Abstract Background: Recently, the importance of nutritional management in pressure ulcer control has been pointed out. In this study, we analyzed the relationship between nutritional indicators and the presence or absence of pressure ulcers in order to reveal the importance of nutritional management in pressure ulcer control. Method: We investigated 407 inpatients for blood tests, height, weight, BMI, the Ohura-Hotta (OH) scale, nutrition method, living independence, and the presence or absence of pressure ulcers. Results: In the comparison of patients with and without pressure ulcer, significant differences were found in gender, nutrition method, serum total protein, serum albumin, hemoglobin concentration, and the OH scales. Multiple logistic regression analysis showed that gender, intravenous nutrition, serum albumin levels, and the OH scale were associated with the presence or absence of pressure ulcers. The results suggest that not only the OH scale, but the nutritional support was also important in the prediction of the pressure ulcer. It was suggested that shifting from intravenous feeding to tube feeding or oral feeding is important. Conclusion: we found that pressure ulcer was related to gender, intravenous nutrition, serum albumin level and the OH scale. The importance of nutritional management for pressure ulcer prevention was confirmed.
Creators : Tanabe Nobuka Kodama Etsuko Matsui Mayumi Wakuda Kayoko Fujiwara Kazuyo Tsutsumi Masae Yamamoto Takeshi Publishers : Yamaguchi University School of Medicine
Yamaguchi medical journal Volume 71 Issue 1 pp. 15 - 23
published_at 2022-02-22
We have developed ACTce‑CCM̶ Analysis and Coordination Tools of Clinical Ethics in Critical Care Medicine. The preparation process was carried out in four stages:construct setting and prototype creation, application of prototype version to fictitious cases, clarification of the construct based on focus group interviews, and a fact-finding survey on ethical issues and ethical adjustment. The completed version of ACTce-CCM consists of information organization and assessment frameworks, problem analysis and integration, problem lists, goals, care practices, and ethical adjustment. There are six frameworks for information organization and assessment:pathology and treatment, QOL and QOD, patient intention, family psychosocial situation, medical team situation, and the surrounding situation. The problem lists include those related to the patient, the family, and the medical staff. Goals include those of the medical team and the expected outcomes for the patient/family. Care practices and ethical adjustment consist of three aspects: direct patient care, direct family care, and medical team adjustment.
Creators : Yamase Hiroaki Tado Asami Yamamoto Konami Tatsuno Junko Suda Kaho Saeki Kyoko Publishers : Yamaguchi University medical association
Yamaguchi medical journal Volume 71 Issue 1 pp. 5 - 14
published_at 2022-02-22
This study aimed to clarify outcome of the public health nursing practice conducted under the influence of COVID-19. A self-administered anonymous questionnaire survey was performed for 4th grader students at University from 2018 through 2020. The investigation items consisted of basic attributes, impression of public health nurse activity, learning motivation and learning target items. We compared shortened clinical practice and online practice enforced in 2020 and before. For 217 effective answers,"A public health nurse was involved in practice sufficiently" was significantly low. In top learning achievement scores of 2020 included many of the items from the the learning target"Process of public health nursing activity" and "Role and function of public health center and municipalities. In 2018 and 2019, learning achievement degrees were over 80% in 94.3% of 53 items while on the other hand it was only 32.1% in 2020. Learning achievement degrees were less than 60% in no items in 2018 and 2019 while it was 15.1% in 2020. For the techniques of health service and health practice for which the learning achievement degree were low in 2020, it is necessary to support students so that they can acquire them as a public health nursing practice ability.
Creators : Isomura Satoko Morita Takae Saito Miyako Murakami Yurika Publishers : Yamaguchi University medical association
published_at 2021
Creators : 宇都宮 利彰
山口医学 Volume 70 Issue 1 pp. 5 - 16
published_at 2021-03-04
Creators : Kanamori Yumie Morita Takae Publishers : 山口大学医学会
published_at 2020
Creators : 中島 千代
山口医学 Volume 69 Issue 3 pp. 113 - 123
published_at 2020-09-25
Creators : Kawamura Atsuko Tsutsumi Masae Nagata Chizuru Nogaki Hiroshi Yonemura Reiko Publishers : 山口大学医学会
山口医学 Volume 69 Issue 3 pp. 125 - 133
published_at 2020-09-25
Creators : Kijima Ayano Morita Takae Publishers : 山口大学医学会
山口医学 Volume 69 Issue 1 pp. 57 - 66
published_at 2020-02-28
Creators : Isomura Satoko Morita Takae Saito Miyako Kijima Ayano Publishers : 山口大学医学会
published_at 2019
Creators : 天尾 優希