Factors affecting the future employment of new graduate nurses as home-visiting nurses: a cross-sectional study in Japan.

Objective: In Japan, home-visiting nurse (HVN) stations are at the frontline of providing home-based medical care and end-of-life care. The nursing authorities aim to establish an education program that allows new graduate nurses to become home-visiting nurses. However, previous studies have indicated gaps in education between new graduates recently employed as HVNs and experienced home-visiting nurses. The present study further investigates the factors influencing the recruitment of new graduates as home-visiting nurses. Methods: Self-administered questionnaires were sent to 2,000 HVN stations randomly selected from the 5,565 registered home-visiting nurse stations throughout Japan. The survey covered three main areas, namely, those concerning the respondent (6 items), the home-visiting nurse station (8 items), and the nursing services provided (12 items). Results: Four of the 26 items were statistically significant, and only one of these was determined by multivariate logistic regression analysis to be an independent factor for accepting new graduates as home-visiting nurses. This factor was undergraduate home-visiting nurse training for student nurses (OR=1.916, CI=1.124-3.267). Conclusion: To increase the recruitment of new graduates as home-visiting nurses, these findings suggest that nursing schools nationwide and home-visiting nurse stations should further cooperate with the specific aim of increasing the provision of practical training at home-visiting nurse stations for pre-graduation student nurses.

Factors influencing decision-making ability of the patient receiving home medical care.

BACKGROUND: Patients' decision-making ability is a substantial barrier to end-of-life conversations with doctors. This study aimed to examine factors influencing this ability. METHODS: Altogether, 914 doctors from Japanese home care supporting clinics providing home medical care as of February 2019 participated in this study. Data were collected through an anonymous mailed survey between April and May 2019. RESULTS: Stepwise multiple linear regression analysis of factors influencing patients' decision-making ability revealed the following significant factors: (a) independence level in the daily life of older adults with dementia (B: -0.52), (b) disease name (B: 0.20), and (c) family structure (B: 0.12). CONCLUSIONS: Patients' decision-making ability regarding conducting end-of-life conversations with doctors was characterized; thus, (a) they did not have cognitive impairment, (b) they had cancer, and (c) they lived with a spouse.

Qualities required for new graduate visiting nurses: A qualitative study.

BACKGROUND: The qualities required for new graduates to become visiting nurses remain unclear. The present study aimed to clarify the qualities required for new graduate visiting nurses. METHODS: Semi-structured interviews were conducted with nine home-visiting nurses. Content analysis was conducted by the transcribed data collected from visiting nurses. RESULTS: Years of nursing experience were ranged from 16 to 50. In total, 23 attributes were extracted and categorized. CONCLUSION: Our findings indicated that the qualities required for new graduate visiting nurses were as follows: basic knowledge and skills required as professionals and appropriate attitudes as members of society.

Proposal of a Model of Disaster Medical Education for Practical Risk Management and Disaster Nursing: The SINCHI Education Model.

Education in disaster nursing and risk management is important, and developing the human resources of medical staff who participate in disaster response is also necessary. However, a practical educational model for risk management and disaster nursing has not yet been established in Japan. In the present study, a model of disaster medical education for practical risk management and disaster nursing was proposed. Seventeen expert nurses with experience in practical international disaster response (IDR) participated in this study. They were recruited from among past members of Japan disaster response medical teams. They were asked an open-ended question through a questionnaire survey: "What kind of nursing education is necessary for risk management and practical activities in disaster response?" The responses were analyzed qualitatively and an educational model was developed.Sixty-five codes were obtained from the answers to the open-ended question, and they were categorized into 19 sub-categories and three categories. Subsequently, the "SINCHI education model" was proposed for practical disaster nursing education; it comprises six elements: (1) Simulation exercise and small-group work; (2) International nursing knowledge; (3) Nursing skills and knowledge, including disaster nursing; (4) Communication ability promotion; (5) Humanity, responsibility, and flexibility; and (6) Infection prevention and control. A sample of this education exercise model is the following: (1) preparing the list of medical staff members (2) information-gathering simulation (3) preparing the list of medical instruments, and (4) developing the plan for risk management and operation, including infection prevention and control. Disaster nursing education could be made more instructive and practical by including simulation exercises.

[Medical Home-Care Support Activities by Clinics in Japan: Developments Since 2008].

The purpose of this study is to investigate the comparative changes over time of the home care supporting clinics(HCSCs) in each of the 4 Secondary Medical Areas within Mie Prefecture. There were 129 HCSCs activity reports in 2008, and 170 in 2014. The number of patients and the number of deceased patients have increased in Mie Prefecture. These findings suggest that improvements in the home-care staff recruitment system should be further expanded throughout Mie Prefecture and, in particular, the quality improved in the Higashi-Kishu area.

Process and contents of telephone consultations between registered nurses and clients with HIV/AIDS in Japan.

Antiviral therapy is essential for HIV/AIDS patients, but many variables impede patients' adherence to therapy. To facilitate adherence, trained registered nurses in Japan provided consultation by phone at the AIDS Clinical Center. This study describes the process and content of this intervention and explores the predictors for length of time of phone consultations. The study was completed over 1 month using a time study, checklist, and medical record inquiry. A total of 175 consultations were described. Mean time was 4.8 +/- 3.8 min, and longer for patients with complications or comorbidity. Although the contents of conversations differed according to the phase of highly active antiretroviral therapy, major identified themes included need for medical consultation, symptom control, provision of information, and active listening. The results are useful for those trying to find ways to use telephone consultation effectively to reinforce adherence.