Purpose: To investigate the relationship of the patients' fall-risk and the interventions to prevent falls, the connection of the fall risk factors and the fall preventive cares, with the aim of evaluating those effects of fall prevention.
Methods: A literatures review was performed. We searched PubMed, CINAHL, Ichushi-Web from 2002-2011 to obtain the studies which implemented the multifaceted fall preventive interventions to the hospital inpatients, and 28 articles were identified.
Result: There were four types of combinations of the patients' fall-risk and the interventions to prevent falls. A)Evaluating the risks of falling by risk score calculation, and carrying out the interventions according to the scores. B) In addition to evaluating the risks of falling, provides the interventions to the specific risk factors. C) Performing the interventions with the fall risk assessment which investi-gates the cause of falls. D) Implementing the interventions corresponding to the specific fall risk factors which have been identified previously. There was no big difference in the fall preventive effect due to the type of those combinations. In addition, there were 5 classifications as specific risk factors: 1) cogni-tive problems, 2) movement problems, 3) mixed risks of 1) and 2), 4) medication use, 5) others. The connections of the fall preventive interventions and the risk factors were diverse. Falls might be reduced by care of exercises to the risk factor of movement problem. Other effects were not conclusive.
Conclusion: Further research should be conducted to clear the best method to tie the patients' fall-risk and the fall preventive interventions including cost side. It is also need to clarify the effect of the fall prevention cares for the fall risk factors.
The aim of this study was to analyze previous published literatures on resilience for nurses and to fur-ther explore study methods to improve resilience among nurses in Japan.
Using the PUBMED and Igaku Chuo Zasshi Database so that 24 literatures were selected, and 8resilience studies were conducted among nurses in Japan.
These studies were classified studies about factors which constitute resilience, about factors enhance the resilience in nurses, related to resilience of nurse, and relationship between factors of nurse and resilience in patients and their family. These studies have suggested factors that affect resilience and positive impact of resilience among nurses. It is important to identify the strongest factors to influence resilience for nurses in order to further explore method to improve resilience.
This study aimed to clarify the effects of joint nursing management training in ‘A' prefectural hospi-tal, and an originally prepared questionnaire survey was conducted before, during, and after the training involving 33 participants in basic and 28 participants in advanced courses. Survey items were "levels of concern about nursing management", "self-efficacy", and "career (manager or specialist) aspirations", and they were measured using a 10-cm VAS. Written reasons for their response to each question and the "recognition of nursing management" were asked for in free-form text. Regarding analysis, quanti-tative survey data were compared using a one-way analysis of variance. Regarding qualitative data, meaningful contexts were categorized based on the similarity.
As the results, a significant difference was observed in "levels of concern about nursing manage-ment" between during and after the training (p<.05), and "self-efficacy" between before and during (P<.05) and between before and after the training (p<.01) among the participants in the basic course, showing the highest mean scores for each item after the training. Before the training, 60% of the partici-pants considered that nursing management should be provided by nurse managers, but 70% of the total participants recognized that every staff member should be involved in nursing management in their own fields. Furthermore, although 80% of the participants had [no confidence in their own ability], many of them started to have a feeling that [there is something they can do] by obtaining awareness in the lec-ture and group work or experiencing a success in practical training. No significant difference was observed in the advanced course
In this study, the effects of the training structure, in which the participants not only received the lec-ture but also experienced an altered awareness during the practical training, were confirmed. The results indicate the importance of determining a training theme after understanding their readiness for nursing management, needs to make an approach to enable them to perceive nursing management as their own issues, and needs to strengthen support systems for the participants.
A trial stage is an important stage at which directionality is being established in the process of careerdevelopment. The objective of this study is to describe how the experience of intra-hospital ward rota-tion, considered as a means of career development, affects nurses during the trial stage. Semi-structured interviews were conducted with six nurses working in three different hospitals, and data were qualita-tively and inductively analyzed. Before the ward rotation the nurses at the trial stage were "seeking direction in their careers" and "interested in working in another ward because of the desire to improve themselves". After the ward rotation, they were "torn between the different value systems experienced among the former and present ward staff", "flustered due to the changes in the work environment", aware of "changes in their position", and experiencing "situations where they were not able to demon-strate what they could do as efficiently as in the former ward", despite all of this "they felt that they had become used to the new ward, three or four months after the ward rotation". The ward rotation is an important event for nurses at the trial stage of their career development because it is the experience of "discovering their preferences and aptitudes", and "discovering merits or demerits in their professional nursing expertise", and nurses will become aware of their "growth as professionals". It is also important because nurses will become aware of "the importance and educational benefits of the ward rotation". Findings also showed that for nurses at the trial stage, the ward rotation is an experience which can make them "reconsider their careers".
The expansion of nurses' work duties is currently being considered. It is therefore anticipated that giving supplementary explanations about pathology and other issues to patients and their families will become one of the principal responsibilities of nurses. To prepare for this likelihood, it is necessary for nurses to fully understand the process of obtaining informed consent undertaken by doctors. This study aimed to take basic information from contexts that were provided by doctors to patients and their fami-lies. The materials used for the analysis were on-site recordings of doctors gaining informed consent from patients and their families in hospital A. Text mining was used to analyze the data. Contents of the explanations were categorized into 9 items according to the criteria used at Hospital A. The results revealed that, as the cases were recorded prior to surgery, words such as "surgery", "anesthesia", and "blood transfusion" were ranked as important keywords and the frequency of these words was also found to be high. Content analysis showed that the doctors' explanations for obtaining informed con-sent mainly concerned pathology and prognosis. The frequency of items relating to patients' concrete requests or questions was found to be low. No explanations were provided concerning the items relat-ing to the procedures for patient withdrawal of consent for examinations or treatments. Overall, medical terminology was found to be used frequently in doctors' explanations. This indicates that patients might have had difficulty understanding these explanations. The results emphasize the need for nurses to have discussions with doctors and to provide any supplementary explanations about pathology and other issues using simpler terms so that patients and their families can fully understand them.