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.

Abstract Purpose: The purpose of this study was to investigate the effects of two different postures (sitting and standing) and three different ambient temperatures (10℃, 20℃, and 30℃) on heart rate variability (HRV) among healthy young adults. Methods: Twelve young adult volunteers (males 6, females 6) were recruited. Following acclimatization to any the room temperature (10℃, 20℃ or 30℃), 5-min measurements of HRV were conducted in sitting and standing postures of the subjects. Results: Compared to the sitting posture, measurements obtained in the standing posture revealed a significant decrease in high-frequency power/HF, root mean square of successive differences between RR intervals, standard deviation of Poincaré plot perpendicular to the line-of-identity or SD1 and SD1/standard deviation of Poincaré plot along the line-of-identity or SD2, and a significant increase in lowfrequency power/LF and LF/HF under all experimental conditions (p<0.05 to 0.005). Majority of HRV parameters showed significant differences while the values obtained under 10℃ were compared with 20℃ and 30℃ conditions, respectively (p<0.05 to 0.001). Conclusions: Our findings suggest the predominance of sympathetic tone in the standing compared with sitting posture. Furthermore, colder conditions caused a predominance of the parasympathetic activity in both sitting and standing postures, and such effects of ambient temperature on the sympathovagal balance were stronger in the latter posture.

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.