The purpose of this study was to clarify the relationships among experiential learning, work beliefs, work environment and nursing competencies of new graduate nurses. A questionnaire survey was conducted on 1,858 new graduate nurses who worked in 49 hospitals with more than 500 beds, at 4 and 12 months of employment. We analyzed 135 surveys (7.3% valid response rate) that could be compared between 4 and 12 months of employment and had no missing scale responses. Experiential learning was composed of two factors: reflection on experience and positive challenges. Work beliefs were composed of three factors: patient-oriented, business management-oriented, and self-management-oriented. Workplace support was composed of three factors: support for providing consultation and comfort, support for action, and support for thinking. The nursing competencies at 12 months of employment were significantly correlated with all eight factors of experiential learning, work beliefs, and workplace support. Multiple regression analysis with nursing competencies as the dependent variable showed that reflection on experience, positive challenges, and patient orientation had positive effects, while the presence of rotation training, a factor of the work environment, had a negative effect. In covariance structure analysis, two factors of workplace support, support for action and support for thinking, were significantly correlated with work beliefs. Work beliefs significantly affected experiential learning, and experiential learning significantly affected nursing competencies. Therefore, in order for new graduate nurses to have a high level of nursing competencies, it is important to have work beliefs, and to be aware of the support for action and thinking from seniors in the workplace through repeated positive challenges and reflection on experiences.

Objectives: To elucidate the work engagement and competency of middle-to-older-aged nurses in non-managerial positions, the relationship thereof, and relevant influential factors.

Methods: A self-recorded questionnaire survey was performed by ward nurses aged ≥40 years. Their work engagement and competency were evaluated by the "Japanese version of the short Utrecht Work Engagement Scale (UWES-J)" and the "Nursing Excellence Scale in Clinical Practice –ward nurses–(NES)," respectively. Furthermore, influential factors were set based on previous research.

Results: A total of 39 hospitals cooperated in this survey nationwide. We distributed questionnaires to 1,691 nurses, and obtained responses from 892 nurses (response rate: 52.7%), with valid responses from 869 nurses (valid response rate: 97.4%). The mean "UWES-J" score was 2.61 points (SD=1.2) for non-managerial positions and 3.11 (SD=1.1) for managerial positions, whereas the mean "NES" was 120.6 (SD=19.9) points for non-managerial positions and 127.0 (SD=19.8) for managerial positions. The "UWES-J" and "NES" scores were significantly lower for non-managerial positions than those for managerial positions (p<0.01). Furthermore, a relatively strong relationship was observed between "UWES-J" and "NES" (non-managerial: r=0.466, p<0.01; managerial positions: r=0.400, p<0.01). The "UWES-J" and "NES" of non-managerial positions were affected by the "sense of growth."

Discussion: The result suggested that improved support to enable a sense of growth might improve the work engagement of middle-to-older-aged nurses in non-managerial positions and lead to a display of greater nursing competency.

Objectives: As the concept of community medicine is being formulated, restructuring of maternal-fetal medicine with declining birth rate is an issue that cannot be avoided. This study aimed to clarify the transition experience of midwives who faced organizational transition.

Methods: We used a qualitative descriptive study method to conduct a semi-structured interview with eight midwives who continued to work at a new hospital after organizational changes on choices and future outlooks associated with maternal-fetal medicine restructuring. Subsequently, the data of meaningful narratives was classified and coded to identify topics.

Results and discussion: The transition experience of midwives who experienced maternal-fetal medicine restructuring consisted of 4 topics, 11 categories, and 34 subcategories. The four topics indicated the following processes: "awareness of the end," "conflicting thoughts regarding a new system," "confusion about the difference between expectations and reality," and "awareness of responsibility to build the foundation."

The transition experience of midwives initiated with experiencing distress from the lack of reality and sense of satisfaction while being aware of the old system's culmination. Without adequate reintegration of the identity, the midwives were determined to terminate the old system and build a new system. They felt unexpected emotions toward the system after the restructuring and experienced confusion with the lack of preparation and knowledge. However, they earnestly took on the challenge of fulfilling their responsibility in establishing the new system and promoting the potential transition process from awareness of the sense of solidarity with staff and patients.

This study aims to develop a competency measurement scale for assessment of ward nursing managers from a nursing standpoint in order to facilitate collaboration between nurses and care workers in wards containing long-term care beds (medical and nursing care beds). First, we clarified the concept of measurement through a preliminary survey and prepared question items for a provisional scale. Next, using standard deviation and the item-total correlation test, 34 items were identified for a prototype "Manager Competency Measurement Scale." We then asked nurses to cooperate in a survey regarding this prototype and received responses from 853 nurses (64.6% acceptable response rate). The responses were subjected to descriptive statistics, factor analysis, test-retest reliability and internal consistency (Cronbach's alpha) analyses, and a criterion-related validity analysis against related scales. As a result, reliability, validity, and temporal stability were confirmed for the entire scale and for 5 subscales extracted from the 34 question items: "conflict management," "communication in the ward," "development of trust," "understanding of expertise," and "efforts to share goals." The Cronbach's alpha values ranged from 0.72 to 0.82 (p<0.01), and similar results were produced in test–retest reliability. Based on these results, the developed scale can be used for self-assessment by ward nursing managers striving to ensure that nurses and care workers collaborate in a ward that contains long-term care beds and features a complicated personnel structure, as well as in fact-finding related to the state of collaboration in the ward.

Objective: Nursing managers conducted activities designed to improve nursing management regarding human resource development at their facilities based on a regional nursing network. The objectives of this study were as follows: 1) to elucidate changes in awareness and words/actions of nursing managers that resulted from this process through the interactive activities in the regional nursing network and 2) to investigate the factors that caused these changes in the nursing managers.

Methods: We utilized action research as the study method. Nursing managers at hospitals, health care facilities for the elderly, and visiting nurse stations participated in 15 activities (reviews). Certified nursing administrators, public health nurses, and researchers participated as "supporters" in reviews.

Results: We identified that the awareness and behavior of the nursing managers changed through the following six stages: [start a review based on a sense of crisis], [share concerns and search for evidence-based problems], [learn through discussion to notice problems in human resource development], [assess the first year of reviews and develop plans for the second year], [utilize what was discovered to work toward improving human resource development], and [notice changes in personnel on the job and plan the next series of improvements].

Discussion: The factors that led to changes in nursing managers were as follows: 1) nursing managers having a sense of crisis and enthusiasm regarding human resource development, 2) mutual support among nursing managers, and 3) the emergence of changes in nursing managers' awareness as a result of discussion.

Conclusion: The results suggest that improvements in nursing management can occur when nursing managers work toward improving human resource development based on networks.

This study aims to reveal the components of key competencies for nursing managers and the process of acquiring them to examine effective measures for developing organizational human resources meant to improve the management skills of nursing managers. An interview survey was conducted among twenty nursing managers who worked at four acute care facilities in a regional core city with at least 300 beds. The semi-structured interview lasted about 60 minutes per person. The interview content was recorded and compiled as verbatim. The survey was conducted from July to December 2016. Our analysis identified the following five components as the key competencies for nursing managers: Situational Awareness, Decision-making, Self-management, Meta-cognitive Behavior, and Career Support. The acquisition of these key competencies was shown to relate to internal factors including "Problem Awareness and Willingness to Challenge" and "Quality of Reflection", as well as external factors such as "Feedback" and "Provision of Opportunity" by colleagues and superiors. To improve the management skills of nursing managers, it is necessary to focus on the acquisition of five key competencies and provide training that allows nursing managers to enhance their awareness of problems and quality of reflection.

Objective: To clarify what kind of community surrounds potential nurses raising children, how that community contributes to their return to work, and obtain suggestions on what support they need in their return to work.

Methods: We conducted a semi-structured interview of 14 nurses currently raising children up to the sixth grade of elementary school. These nurses were returning to work after 1-6 years of leave of absence at a hospital with more than 200 beds that provides support for child-rearing in Tokyo.

Results: The potential nurses raising children had a community comprising of nurses raising children, mothers other than nurses raising children, and families and relatives. During their leave of absence from their jobs, they were worried about returning to work and their work style. However, they were encouraged to do so by the support from their community and motivation from their colleagues. They acquired specific information regarding work style while raising children and the expected changes in lifestyle after returning to work. Furthermore, it became clear that having a community contributed to their desire to continue working after returning to work.

Discussion: There was encouragement from the other mothers raising children and motivation from their efforts in encouraging them to return to work. By listening to experiences of others who actually returned to work as nurses, the anxiety about their work style may have reduced. Moreover, the participants intrigued about the possibility of working while raising children mostly likely took the step toward returning to work by receiving specific information regarding changes in lifestyle after returning to work and balancing work and childcare.

Aim: This study explored the relationship between nurse manager competency and emotional intelligence.

Methods: We conducted survey research by administering questionnaires to 248 nurse managers from Eastern Japan; of these, 122 completed questionnaires were valid for analysis. We performed the analysis using the Kruskal-Wallis test and multiple regression.

Results: A moderate correlation (r=0.453) was found between nurse manager's level of competency and their emotional intelligence. The group with higher level of competency also had higher emotional intelligence. In addition, there were two explanatory variables -emotional intelligence variable (situation response), master's degree- for competencies.

Discussion: Nurse managers are required to respond flexibly to various situations and efficiently administer the team of nurses. Therefore, it is thought that "situational response" influences the competence of nurse managers. It was also suggested that the competence of nurse managers may be influenced by individual attributes such as the presence or absence of a degree (master's degree in nursing) and certification as a Certified Nurse Administrator. These influential factors and their background require additional study.

The study's purpose was to determine the relationship between professional nursing organizations for certified nurses (CN) and staff nurses' work motivation in Small- and Medium-Sized Hospitals. Three hundred and thirty seven CNs and 1685 staff nurses working in hospitals nationwide with 400 beds or fewer were targeted. CNs were asked about their individual demographics (such as length of time as a CN) and about forming specialized CN nursing organizations; staff nurses were asked about their work motivation. A covariance structure analysis was used to examine the relational model between CN's demographic attributes, forming specialized CN nursing organizations, and staff nurses' work motivation. Researchers collected 286 replies from CNs and 1266 from staff nurses. The relational model showed that the demographic attribute, "10 years or more of experience as a certified nurse" led to "positive communication" via the "problem solving behaviors" aspect of forming specialized nursing organizations, which then led to staff nurses' "self-actualization through work." The model also showed that the demographic attribute "participation in off-site activities" led to the staff nurses' "self-actualization through work" via the "positive communication" aspect of forming specialized nursing organizations. This suggests that CNs may improve their counseling skills and their communication skills via off-site activities. Additionally, by providing staff nurses with positive feedback about success stories and personal growth, specialized nursing organizations may help them increase their sense of work accomplishment and satisfaction.

The purpose of this study is to clarify the difficulty that the assistant head nurses of a university hospital feel in maintaining ethical behavior. That purpose is to consider the education/support system to improve ethical behavior as well. The subjects were fifty assistant head nurses belonging to University A Hospital. The content of the survey is a free statement asking clinical experience, educational experience of nursing ethics, and specific cases and one's behavior in line with the framework of J. Rest's ethical behavior's four elements [(1) moral sensitivity, (2) moral reasoning, (3) commitment, and (4) implementation]. In the analysis, we use descriptive statistics for option items. We further conducted a content analysis by extracting the context that expresses difficulty in a free statement. As a result of a free statement's content analysis, we extracted eight categories indicating difficulty. Those categories are (a) unable to protect the patient's dignity, (b) insufficient informed consent, (c) support for decision-making of patients who cannot make self-determination, (d) communication with doctors, (e) difference in medical value, (f) deficiency of opportunities to learn ethics, (g) no confidence in the leadership position, and (h) placement of nurses leading to lack of care.

For the assistant head nurses to have ethical behavior, it is necessary not only to have knowledge in the form of educational support but also to strengthen their ability to clarify ethical issues and verbalize them to convey them to others. Furthermore, it is required to have practical support from an administrator and a specialist.

Objectives: The purpose of this study was to obtain concrete suggestions for the development of a head nurse's action manual for ward management in the acute phase of disaster in the event of a great earthquake.

Methods: The participants were 20 head nurses who worked at disaster base hospitals in the disaster area during the Great East Japan Earthquake and The 2016 Kumamoto Earthquake and had experience in operating wards during the acute phase of disaster. Semi-structured interview methods were used to collect data, which were analyzed qualitatively and inductively.

Results: As the actions of the head nurse who was responsible for the management of the ward during the acute phase of disaster in the event of a great earthquake, [Ensuring safety to protect lives], [Confirmation of survival of related parties], [Collaborating with the Disaster Countermeasures Headquarters], [Providing a place of medical treatment for many victims], [Support for patients, families and staff who are anxious due to the disaster], [Creating a provisional work system], and [Physical and mental health management of nurses] were identified. [Ensuring safety to protect lives] in the acute phase of disaster when a great earthquake occurs is understood from the two perspectives of avoiding danger immediately after a violent shaking and responding to changes in the situation as aftershocks continue. The importance of [Physical and mental health management of nurses] was shown in order to manage the ward by [Creating a provisional work system].

This study aimed to verify the reliability and validity of the Self-Help Strategies Scale (SHS) that can be applied to nurses. A self-administered questionnaire was distributed to 779 staff working in three hospitals, and included items on demographic data, such as completion of mental health training, the SHS item pool, the 13-item Sense of Coherence Questionnaire (SOC), the Kessler Psychological Distress Scale K6 (K6) and the Brief Coping Orientation to Problems Experienced Inventory (B-COPE). From all responses received, the responses of 248 nurses were analyzed. Based on exploratory factor analysis, two factors, [1^st factor: Ingenuity to care for oneself] and [2^nd factor: Examination and application of knowledge and information], consisting of 15 items were extracted for the SHS. The structural validity was confirmed by the goodness of fit based on confirmatory factor analysis using the two extracted factors. The convergent validity was confirmed by the correlation coefficient between SHS and SOC scores (r=.24; p<.01). The difference in SHS scores between the K6 positive/negative groups (p=.036) and those with/without mental health training (p=.003) confirmed the known-groups validity. The SHS and the six B-COPE subscale scores showed an approximately moderate correlation coefficient of r=.39 to .56 (p<.01), confirming the concurrent validity. Cronbach's α coefficient was .76 to .85 for each SHS factor, and internal consistency was confirmed. Therefore, the reliability and validity of the SHS were confirmed.

The purpose of this study was to analyze sleep, fatigue, and physical activity intensity in 16-hour shift nurses during pregnancy using subjective and objective indicators, and to clarify the actual situation. The subjects of this study were 11 pregnant 16-hour shift nurses working in hospitals with 160 beds or more. We investigated the actual conditions of fatigue, sleep, and physical activity intensity during day shift, night shift, and holiday work using questionnaires, physical activity meters, and wearable heart rate monitors. As a result, the average age of the subjects was 29.5 years and the average length of service was 7.2 years. There were 8 prenatal and 3 multiparous women, and they were not depressed because the EPDS averaged 4.7 points. Their sleep quality scores averaged 6.9 points for PSQI-J. Shift-working nurses during pregnancy increased fatigue before and after day shift and before and after night shift, but recovered by sleeping at night. They also spent their holidays at low physical activity intensity without feeling tired. They had an hour and a half nap during the night shift, but it became clear that they were more sympathetic and stressed than when they slept after the day shift. In addition, the sleep quality of 16-hour shift nurses during pregnancy tended to be worse than that of non-pregnant female nurses.

The purpose of this study was to develop a discharge support planning sheet for patients who have been admitted to the emergency ward and their families. The proposed discharge planning sheet would assist in the extraction and structuring of items that pertain to risks that would hinder discharge, along with items that can be implemented across multiple disciplines. We further clarified the details of discharge support using a time axis so as to enable early responses to risks that might potentially impede discharge. These risks are: "a decline in ADLs after discharge compared to before hospitalization," "intermittent delirium and cognitive decline," "a lack of understanding of the changing needs of patients and families regarding discharge," "a patient's need for new social resources," and "restrictions imposed by the transfer destination due to medical classification." We also identified discharge support items that can be implemented by a multidisciplinary team: "information collection and sharing across multiple disciplines"; "sharing discharge goals with patients and families, and among multiple disciplines"; and "addressing the discharge needs of patients and families across multiple disciplines." The components of the discharge support planning sheet clarified the risk of discharge difficulties and multidisciplinary support items on a time axis (at admission, on the third day after admission, and during the first week). The result was the development of a tool that allows patient- and family-centered discharge support that can be practiced without influence from the environment of the emergency ward or the competence of attending nurses. In addition, it is thought that collaboration among multiple disciplines in the early stages of hospitalization can reduce the length of hospitalization and promote functional differentiation of hospital beds, such as efficient use of hospital beds.

The purpose of this study was to review nursing management literature on reducing physical restraint in acute hospitals and clarify recent trends and issues in the future. The databases, which were searched on January 5, 2020, include; PubMed, CINAHL with Full Text, the Cochrane library, and Japan Medical Abstracts Society. A total of 190 studies were identified in the search, although only 15 studies (seven in Japanese and eight in English), published between 2000 and 2019, that met the inclusion criteria were selected. Intention of nursing management practice under factors of physical restraint included ethics, older people, falls, delirium, quality of cure and care, short of manpower, dementia. The main contents of nursing management practice were: 1) setting goals and judge criteria; 2) clarification of issues; 3) sharing problem recognition; 4) reviewing and constructing system; 5) security assurance; 6) providing educational opportunities; 7) launching and operating teams; 8) promoting cooperation; 9) motivation; and, 10) evaluating trial. The non-randomized controlled trial was found to reduce time and the rate of physical restraint while improving knowledge and attitude. Future studies need to indicate common nursing management evaluation items or indicator to consider reducing physical restraint for any acute hospital in spite of difference in hospital size.

Job characteristics theory proposes that five job characteristics of skill variety, task significance, task identity, autonomy, and feedback are associated with internal motivation and these affect work-related outcomes. This study developed a Japanese version of the Job Characteristics Scale based on the modified scale (Idaszak & Drasgow, 1987) of the Job Diagnostic Survey (Hackman & Oldham, 1975), which includes a scale for measuring the five job characteristics, and verified its reliability and validity in nurses. Permission from the original author was obtained beforehand. In June 2017, anonymous self-administered questionnaires were distributed to 308 nurses working in an acute care hospital, and 297 responses were collected. The responses of 240 with no missing values in the developed scale were analyzed. All Cronbach's alphas for the subscales were over 0.7, the item-total correlation coefficients were 0.46–0.67, and the intraclass correlation coefficients by a retest method were 0.62–0.71. Four factors were extracted by exploratory factor analysis. However, the results of the confirmatory factor analysis showed higher goodness of fit for the five-factor model based on the theory than the four-factor model identified by exploratory factor analysis. To confirm criterion validity, correlation coefficients of each subscale of the developed scale with job satisfaction and psychological empowerment were calculated. Significant correlations were found as assumed (coefficients were 0.23–0.53 for job satisfaction and 0.16–0.73 for psychological empowerment). Internal consistency, reproducibility, factorial validity, and criterion validity were confirmed, demonstrating acceptable reliability and validity of the developed scales for use by nurses.

Working hours and environment must be improved to increase Work-Life Balance for nurses, thus increasing the number of the medium- to long-term nurses. This study aimed to identify specific issues and strategies for medical facilities to implement, using the perspectives of nursing managers, to improve nurses' working hours and environments. From November 2019 to March 2020, we conducted interviews with the nursing managers of five medical facilities in Japan, including acute and chronic care hospitals, who consented to participate in this study. The data were qualitatively analyzed for each facility regarding their workplace issues and specific strategies utilized, as well as changes in staff and organizational structures in accordance with each facility's background and resources, with the commonalities between each one being extracted. Common issues were identified, such as the increasing number of workers in specific shifts, taking days off and overtime work, employees raising children while continuing to work, and the increasing number of nursing assistants aimed at reducing nurses' overall workload. Based on the results of our study, specific strategies such as changing the number of staff assigned to each work shift, reviewing each organization's recruitment plans, appropriately managing personnel based on the available data, actively operating the Work-Life Balance system, providing a workplace that encourages employee motivation, promoting nursing managers' attitudes, and fostering an organizational culture that seeks to improve the workplace environment are all crucial for improving issues related to nurses' working hours and their environments.

Purpose: Lean work cell nursing implementation is reported to enhance time spent with patients. In this study, we investigated patient perceptions of this nursing style.

Methods: From November 1 to December 1, 2018, we performed a questionnaire survey. A 5-point Likert scale of 4 to 0 was used for scaling responses to 7 questions about topics including Q1: the presence of nurses, Q2: feelings of security, Q3: nurse awareness, Q4: working attitudes, Q5: loudness of nurse's voice, Q6: a feeling of being watched and Q7: privacy protection.

Results: The number of responses received from 537 patients at discharge varied depending on the question item, ranging from 472 to 519 (valid response rate, 87.9% to 96.6%). The median of the scores was 4 in Q3, Q6, Q7, and 3 in Q1, Q2, Q4, Q5. There were statistically significant age-related relationships with patient perceptions in Q1, Q2, Q4 and Q5 (p<0.05). Sex and the ward structures did not show a significant relationship in any of the 7 questions. None of the patients in a private room ward chose score 1, positive denial, in any of the 7 questions.

Discussion: These results may indicate that more care for older patients and a generalization of the care services in private room wards may advance patient-centered care and improve patient perceptions in all wards.

Conclusion: Lean work cell nursing implementation can keep patient perceptions high including that of privacy protection despite the enhanced time spent in proximity.

This study conducted an intervention for nursing managers of non-designated disaster hospitals to promote hospital disaster response plans and raise the awareness of disaster preparedness by providing disaster management information. A randomized controlled trial was performed to identify the effect of the intervention.

Participants who had expressed consent to the study participation were randomly divided into an intervention group (n = 17) and a control group (n = 18). Information was provided to the intervention group once every two weeks for three months (January 2020 to March 2020), a total of six times. The information was excerpted from the "Gensai" Calendar supported by Hiroo Disaster Management Group (HDMG), which is a small group training tool on disaster risk reduction and management.

The information topics in ascending order were as follows: "How to assemble staff in the event of a disaster?", "Thinking about how to contact the families of staff", "Accommodating a large number of injured! How to divide the facility into sections?", "Studying the manual!", "Encouraging staff to participate in desktop exercises in the event of an earthquake", and "Thinking about the kind of training that is necessary!".

As a result, "providing education on patient care in the event of a disaster (including doing triage and life-saving measures)" in the intervention group was the most statistically significant difference in the responses between before and after the information provision. This suggests that providing information may be effective in making nursing managers aware of the importance of providing educational material on nursing care in the event of a disaster.

To elucidate the factors affecting the ethical behavior of middle manager of nursing in Prefecture A, Japan, a questionnaire survey was conducted with 655 such managers from 57 institutions. The questionnaire gathered information on participant age, gender, duration of experience as a nursing manager and a nurse, experience in nursing management and ethics training, and nursing ethics conferences, and recognition of situations where ethical issues are involved based on Matsumoto's 18 ethical problems and Ode's ethical behavior scale. Responses were collected from 347 participants (recovery rate: 53%), of which 307 responses were analyzed (valid response rate: 89%). Results showed that 223 (72.6%) had attended the training for middle managers of nursing, while 263 (85.7%) and 213 (69.4%) attended a nursing ethics training and conference, respectively. Many participants indicated recognizing ethical issues in the following settings: patient's family making a decision on treatment without confirming the patient's intentions, and physical restrictions being used that would not be necessary if sufficient nursing staff were available. Those who attended nursing ethics training and nursing ethics conferences achieved high scores for ethical behavior under the headings: respect for autonomy, justice, and nonmaleficence/beneficence. Scores for ethical behavior were lower in those who indicated that they recognized ethical issues in 13 settings compared to those who indicated they did not. The results suggested that nursing ethics training and conferences are factors that facilitate ethical behavior in nurses. However, recognition of ethical issues does not necessarily lead to ethical behavior.

Purpose: This study aims to clarify nursing practice by years of experience to obtain suggestions for education and support according to the growth and stage of operating room nurses.

Method: An anonymous self-administered questionnaire survey was conducted nationwide operating room nurses nat. The survey contained 39 items of nursing practice- with responses using the four-step ordinal scale. The years of experience were categorized into five groups(<1, 2–3, 4–5, 6–7, and 8 years). Calculation of descriptive statistics and Kruskal -Wallis tests were performed for the analysis. The significance level was 5%.

Results: The number of questionnaires collected was and the number of valid responses were 560 (collection rate 58.0%) and 549 (98.0%), respectively. The average number of years of surgical nursing experience was 4.9 years (SD=7.1). A significant difference between each group within 1 -year (p=0.00–0.03) was observed because of the Kruskal-Wallis test. The average value of nursing practice was low for <1 year (2.0–3.7) but high for 2–3 years (2.3–3.8). No change was found between 4–5 and 2–3 years. 6 years more was practiced patient-centered with an emphasis on patient safety and collaborate with teams.

Conclusion: The average value of many practices increased in 2–3 years, and the value of the patient-centered was equivalent to that of 8 years more.4–5 years remained unchanged at 2–3 years, and the frequency of practice of being close to the patient was low. 6 years more was patient-centered with an emphasis on patient safety.

This study aimed to examine the construct validity of the Essentials of Magnetism II (EOM II) in Japan.

We administered a questionnaire-based survey participated in 9 nurse managers/experienced nurse managers and 1315 registered nurses (RNs). To confirm the construct validity of EOM II, we analyzed the collected data according to four components: content, structural, generality, and external components.

Based on the content component analysis, 78.0% of the average scores for each item were positive (strongly agree and agree). To confirm the structural component, we used a confirmatory factor analysis (CFA) on the identified structure of five factors (33 items), and the CFA results met the fitness level (CFI=.932, RMSEA=.056). Regarding the generality component, the internal consistency coefficients were adequate, accounting for .74–.92 of the total score and the subscales in the five factors (33 items). Meanwhile, the five factors (33 items) in the external component were related to nurses' job satisfaction statistically.

It is confirmed that the Japanese version of EOM II (J-EOM II) with 5 factors (33 items) had three components in terms of construct validity besides content validity. Four out of the five identified factors were "collaborative RN/MD relationships," "supportive nurse manager relationships," "perceived adequacy of staffing," and "culture in which concern for the patient is paramount." These findings are supported by previous studies, and the last factor, that is, "autonomous control over nursing practice," reflected the characteristics of Japanese medical backgrounds.

Objectives: To conceptually analyze and define the career plateau experienced by mid-career nurses.

Methods: Six databases were searched, and 14 articles published between 2000 and 2020 were analyzed using the Rodgers' concept analysis method.

Results: The analysis identified five attributes: [decreased sense of self-affirmation], [sense of reaching a dead end], [mental and physical unwellness], [anxiety about promotion], and [recurrence]; four antecedents: [monotonous daily life], [sense of burden], [decreased opportunities to receive education], and [career stagnation]; and three consequences: [departure from the status quo], [maintenance of the status quo], and [escape from reality].

Discussion/Conclusion: The career plateauing experienced by mid-career nurses was defined as "a state in mid-career nurses characterized by a decreased sense of self-affirmation, a sense of having reached a dead end, mental and physical unwellness, and anxiety about promotion, which is elicited by monotonous daily life, sense of burden, decreased opportunities to receive education, and career stagnation, and which recurs in an unpredictable manner." The results also indicate that career plateauing is an important opportunity leading to the pursuit of nursing and new challenges and has different effects on future career development as a nurse depending on how it is undergone. Future tasks based on the results of this concept analysis include the development of a scale for early detection of career plateauing in mid-career nurses and the establishment of support and education systems to help mid-career nurses exit the career plateau quickly.

This study aimed to assess the reliability and validity of the "Competency Rating Scale for Head Nurses in the Realization of work-life balance (WLB) among Nurses," which was advanced from the existing scale developed in a previous study. A questionnaire survey was conducted with 2,285 head nurses working for 431 hospitals across the country. The study items included the attributes and 41 previously constructed items of the Competency Rating Scale. Of the 1,924 questionnaires returned (response rate: 66.4%), 1,743 were analyzed. An exploratory factor analysis (principal factor method, promax rotation) and a confirmatory factor analysis identified eight factors and 33 items in the scale. The eight factors were: sharing of vision, career support, promotion of the understanding of the WLB support system, transparency and fairness in taking holidays, problem-solving activities in nursing practice, flexibility underlying the development of interpersonal relationships, responsible behavior as middle managers, and staff deployment leveraging individual competency. The overall Cronbach's α was .940, and coefficients for each factor ranged from .784 to .887. Convergent validity was assessed through correlations between the scale and their attributes ("received training as certified nurse administrators," "experience of planning/conducting workshops in the hospital," "presence of promotion system for managers based on clear criteria," "years of head nurse experience," and "presence of WLB promotion committee"), and discriminant validity was evaluated using age and sex. Future studies should look at examining the reproducibility, criterion-related validity, and utility of the scale.

The purpose of this study was to describe the evaluation of a competency-based management program for nurse managers. We interviewed 5 participants of the program regarding their effective work as nurse managers and developed a structure of competency clusters of their practice. Further, we discussed strategies that could make the program more efficient.

Usually, when nurse managers faced problems, they first analyzed the current situation and conceptualized problems to identify their essence by demonstrating the "Cognitive" (competency) aspect. Once the crux of a problem was clarified, appropriate goals were established for problem solving and problem fulfillment. Subsequently, the "Achievement and Action" (competency) was consistently demonstrated through the process of task achievement. Meanwhile, demonstrating the "Personal Effectiveness" (competency) through the process of achieving tasks supported the progress toward achievement. Moreover, the "Helping and Human Services" (competency), the "Impact and Influence" (competency), and the "Managerial" (competency) were demonstrated in accordance with the situation throughout the process.

It was suggested that the efficacy of this program could be enhanced by developing it in accordance with the structure of competency clusters. Furthermore, this program would also improve practical skills of not only new nurse managers but also of those who are not confident in their practice.

This study aimed to clarify factors related to nursing record time. Using the electronic medical record and human resources data of the hospital, data of 2 days were collected regarding nursing record time during daytime and night-time work shifts, nurse and patient attributes and nursing record attributes. Fundamental statistics for each variable and Spearman's rank correlation coefficients for nursing record time and each attribute were calculated. Logistic regression analysis was performed using nursing record time and each attribute as dependent and independent variables, respectively. Mean nursing record times were 93.8±47.8 and 102.9±80.2 min for daytime and night-time work shifts, respectively. No significant correlation was observed between nursing record time and nurse attributes in daytime or night-time work shifts. In daytime work shifts, following factors significantly correlated with the length of nursing record time: score of ≥1 in Item A (severity and medical/nursing requirements) of their patients (OR=1.86, p=.042), score of ≤3.8 in Item B (OR=0.50, p=.041), ≤80% nursing records taken within 60 min after occurrence of an event (OR=0.39, p=.002) and ≤40% patients eligible for a clinical pathway (OR=0.39, p=.002). In night-time work shifts, only the number of nursing records showed significant positive correlation (r=.551, p=.010). These results suggest the importance of using severity and medical/nursing requirements as an index for allocating patients, especially in daytime work shifts; increasing record terminals for taking nursing records timely and using simplified recording formats like clinical pathways.

Purpose: This study aimed to clarify the reality of nursing administration curriculum in nursing college and learn suggestions to improve it.

Method: The subjects were 230 teaching staff of nursing administration in nursing college.

Questionnaire consisted of the nature and content of nursing administration curriculum, teaching staff background etc. Out of them, 58 (25.2%) teaching staff were analyzed.

Results: The college opening the nursing administration subject accounted for 84.5%, the others, although not opening it, have conducted the education of nursing administration. Of the nursing administration subject, one credit accounted for 70.8%, two credits for 29.2%. The nursing administration subject, in 68.8% college, was registered in 4^th year. Of 28 education items in the college opening the nursing administration subject, 【The concept of the cooperative medical care】 【An evaluation of the nursing quality】 and 【Infection preventive measures】 showed the significant difference between amount of credits and education content. As background of teaching staff in the nursing administration, managers in medical facilities accounted for 46.9%.

Conclusion: Nursing administration curriculum was carried out in all nursing colleges, while curriculum contents varied among nursing colleges. This result suggests that it should be necessary to standardize nursing administration curriculum connected with novice registered nurse training.