Purpose: Shared decision-making (SDM) with patients is important to provide patient-centered care. This study aimed to determine the extent to which the consultation system is used for SDM among female patients with breast cancer, and to investigate the relationship between patient age, stage, treatment, facility type, and consultation.

Methods: Health service utilization data linked to hospital-based cancer registries from 591 hospitals were used. Hospitals that used this system in at least one case and provided first-course treatment for breast cancer were selected. Female patients aged 18 years and older who were diagnosed with breast cancer and notified of their cancer in 2019 were included in the analysis. A multilevel mixed-effects logistic regression analysis was conducted to estimate the consultations associated with patient characteristics and hospital type after a descriptive analysis of the consultation.

Results: Overall, 18,132 patients (29.5%) from 528 hospitals received consultations, 95.0% of which were in the outpatient setting. The odds ratio (OR) was 0.75 (95% confidence interval (CI), 0.66-0.84%) for those in their 40s and 0.70 (95%CI, 0.61-0.79%) for those in their 50s compared with those under 40 years of age, and the OR were negatively associated with age. Stage III (OR, 1.98, 95%CI, 0.28~0.37%) and treatment type of radiotherapy (OR, 1.68, 95%CI, 1.59~1.77%) were positively associated with consultations.

Conclusion: These results suggest the importance of establishing a system in which physicians and nurses can provide support in an outpatient setting.

Objective: To clarify the specific causes of medication errors that occurred in nursing homes in Japan, focusing on the detail of the errors, the number of times they occurred, and the most frequently occurring word in accident reports ("confirmation)" in the process of taking medication. Based on the results, we made recommendations for medication error prevention.

Methods: We created a co-occurrence network and conducted content analyses of sentences containing the word "confirmation" in 156 accident reports related to medication errors in the two nursing homes.

Results: Details of the medication errors were divided into 14 categories, with "omission" being the most common detail (109 cases). In the co-occurrence network, "confirmation" was at the center, with "omission," "wrong resident," and "wrong time" as connections. Sentences containing "confirmation" were extracted for content analysis; 70 sentences described insufficient confirmation and 74 described factors that may have influenced confirmation. Those with insufficient confirmation were classified into four categories: [Drugs] (22 cases), [Medication information on the package] (21 cases), [Finish taking the medicine] (14 cases) and [Medication instructions] (13 cases). Factors that may have influenced "confirmation" included "lack of compliance with confirmation rules" (21 cases) and "assumptions"(13 cases).

Conclusion: There is a link between "confirmation" and medication errors, and our results suggest insufficient confirmation leads to medication errors. To prevent insufficient confirmation, it is necessary to review the methods and timing of confirmation, change the color of the medicine packets, and consider introducing computer systems.

Aim: This study aimed to identify the birth years of the largest cohort of practicing registered nurses using longitudinal data from the Report on Public Health Administration and Services (RPHAS) in Japan.

Methods: Data on the number of practicing registered nurses using five-year age groups spanning 1992–2022 were extracted from the RPHAS. The analysis encompassed eight categories, ranging from "under 25" to "55–59." The number of practicing registered nurses by age group and reporting year was displayed in a line graph to observe changes. The birth years and count of practicing registered nurses in the age group with the highest frequency in each reporting year were aggregated in a table to identify the most prevalent birth year.

Results: The distribution of practicing registered nurses of five-year age groups revealed that the group with the highest count moved to older age ranges over time: "30–34" in 2008, "35–39" in 2012, "40–44" in 2016, and "45–49" in 2022. Tracking the birth years within these age groups, the count of practicing registered nurses at the end of the decade increased for the following birth years: "1973–1977," "1974–1978," "1975–1979," and "1976–1980." The occurrences of birth years in the age groups with the highest counts indicated that practicing registered nurses born in 1976 and 1977 are likely to outnumber those from other years.

Objective: This study aimed to describe the actual clinical competencies of nurses with 3 to 5 years of clinical experience and to determine whether differences exist in these clinical nursing competencies depending on the content of instruction received from certified nurses.

Method: A self-administered questionnaire was administered to 1,241 nurses with 3 to 5 years of clinical experience. The Clinical Nursing Competence Self-Assessment Scale (CNCSS) was used to evaluate clinical nursing competence. Scores for the 13 competencies of the CNCSS were calculated, and U-tests were used to compare competencies based on the content of instruction.

Results: The response rate was 34.2%, with 364 nurses included in the analysis. Of the 13 competencies, "Basic responsibilities" and "Ethical practice" were rated highly. Among the respondents, 261 (71.7%) had received instruction from certified nurses. Upon examination, nurses who " were provided with a role model at the bedside" had significantly higher scores in "Supportive relationship" and "Clinical judgment" compared with those who did not. In addition, nurses who "received help with clinical reasoning," had significantly higher scores in "Basic responsibility" and "Continuous learning," while those who "received specific advice at conferences" scored higher in " Continuous learning."

Conclusion: The results suggest that the creation of a system where certified nurses provide bedside guidance and advice at conferences may enhance clinical nursing competencies.

【Purpose】 This study empirically analyzed the impact of nurse staffing on the profitability of acute care hospitals, considering departmental staffing status.

【Methods】We used a 2017 report on bed functions and the financial statements of public acute care hospitals. We performed a multiple regression analysis of the data from these with medical profit margins as the explained variable.

【Results】 The medical profit margin, numbers of ward nurses, HHI, length of hospital stay, and care mix dummy were significantly negatively correlated, whereas the medical profit margin, numbers of other nurses, bed occupancy rate, and 7:1 dummy were significantly positively correlated.

【Discussion】 The negative correlation between the medical profit margin, number of ward nurses per 100 beds, and length of hospital stay suggests that the minimum number of nurses required, such as 7:1, for the medical revenue obtained will improve the profit margin. In reality, however, a large number of nurses are required to maintain high bed occupancy rates.

Objective: To verify recovery experiences and related factors among shift-working nurses.

Method: Study included 1335 nurses in six hospitals, each with 300 or more beds. Participants, selected using opportunity sampling, included shift-working nurses not holding the positions of head nurse /chief nurse. The survey measured16 basic attributes, 7 items from the Brief Job Stress Questionnaire plus the average monthly overtime hours as job demands, totaling 8 items. Additionally,16 items from the Japanese version of the Recovery Experience Questionnaire were included. Multiple regression analysis was conducted with attributes and job demands as independent variables, and recovery experience as a dependent variable.

Results: A total of 441 valid responses were included in the analysis. Participants' recovery experience scores: psychological distance mean score, 3.09 (SD 0.92); relaxed 3.66 (SD 0.91), proficient 2.64 (SD 0.92), control 3.9 (SD 0.86). Multiple regression analysis revealed the following as significantly associated with recovery experience: having preschool children (B: partial regression coefficient = -8.44, p<0.01), three-shift vs. two-shift systems with night shifts 16+ hours (B = -0.804, p<0.01), psychological workload (B = -2.35, p<0.01).

Conclusion: Recovery experiences of shift-working nurses were currently less favorable compared to those in general occupations, particularly in terms of psychological detachment and mastery. Factors such as having preschool-aged children, working three shifts, and psychological workload were identified as contributors to the diminished recovery experience among shift-working nurses.

The study aimed to clarify the current situation of securing nursing staff during the COVID-19 outbreak in Japan (hereafter referred to as "the outbreak"), as well as the measures implemented to secure such staff both in ordinary times and during the outbreak. A self-administered questionnaire was distributed to one respondent from each of 47 prefectures, 110 cities, and 47 prefectural nursing associations. A total of 110 responses were collected (response rate: 53.6%). Key strategies for securing nursing staff included requests for staff dispatch between medical institutions, consultation coordination by certified and specialized nurses in infectious disease nursing, and the referral of inactive nurses. Efforts that were effective during the pandemic and originated from normal times included the provision of training on the latest nursing knowledge and skills, as well as identifying employment conditions for unemployed or retired nurses. The responses indicated that the measures considered most effective during the pandemic included staff dispatch coordination between medical institutions and consultation coordination by certified and specialized nurses in infectious disease nursing. To prepare for potential unknown infectious diseases in the future, it is necessary to establish a system that can manage nursing personnel recruitment more efficiently and effectively. This includes identifying latent and retired nurses, building networks for nursing personnel, organizing training on nursing knowledge and skills, creating databases of nursing personnel, and developing efficient coordination systems utilizing technology.

This study aimed to elucidate nurses' needs for nursing research and challenges faced while promoting research. We developed a research support system in collaboration with the nursing department and university research department. Using a questionnaire survey, we investigated nursing managers' perceptions of research before and after using the research support system. We facilitated and organized projects on nursing research, and the research needs of hospital nursing departments, university Faculty members who belong to the research department of the university, certified nurse specialists, and certified nurses were shared and matched. The research support system reduced the number of respondents who deemed "lack of support for conducting research" as the most common reason for their "motivation and difficulties in conducting nursing research." More-over, items such as "time available to spend on research," "training research supervisors," "supporting staff in research," and "nursing managers' own feelings" showed no significant changes. Furthermore, no changes in the environment for conducting research were observed. However, collaboration between the nursing department and research Divisions influenced the nursing managers' thinking and be-havior toward research. Thus, in the future, the nursing managers should collaborate with the university research divisions to learn the process of research and create a research system to support their research.

Purpose: This study aims to determine whether clinical coaches can contribute to improving clinical judgment skills of learners when providing learning support in the clinical judgment process while communicating what the clinical coaches are thinking in nursing practices using a "think-aloud method."

Methods: Participants (learners) were 16 nurses with 2–3 years of clinical nursing experience who were provided learning support with the "think-aloud" method by clinical coaches during one-year on-the-job training. The learners assessed their clinical judgment skills before and after the one-year learning support, using a clinical judgement skill assessment scale developed by the researcher based on Tanners Clinical Judgement Model (2006). Scores of clinical judgement skills before and after the one-year learning support were compared using the Wilcoxon signed-rank test.

Results: Scores in clinical judgement skills were 118.0 before the learning support and 120.5 one year later, showing improvements after the support. Of the aspects of clinical judgement skills, there was a significant improvement in "Interpreting" with a score of 23.0 before and 23.5 one year later. There were also improvements in the other aspects, but no statistically significant differences (p<.05). Learners stated that learning some parts of thinking processes from expert nurses enables understanding of key points.

Conclusions: The findings suggest that learning support where clinical coaches verbalize their thinking process may enable learners to understand cognitive thinking processes to conduct meaning-making and interpret information, and so contribute to improving the clinical judgment skills of learners.

Purpose: This study aimed to identify details of work engagement (WE) of mid-career nurses and factors related to WE.

Method: A web-based survey was conducted with full-time nurses, five to 25 years of nursing experience without holding any specific managerial position in hospitals with 200 or more beds in Prefecture A in the Kanto region of Japan. Depending on the scores of a Japanese version of the Utrecht Work Engagement Scale (UWES-J), respondents were classified into two: high-score and low-score groups. Factors of these groups were compared, and logistic regression analysis was performed.

Results: A web-based survey invitation letter was distributed to 710 nurses in 15 facilities, 208 responses (29.3%) were collected, and 194 (93.3%) were determined as valid and included in the analysis. The WE of mid-career nurses was related to "Enjoyment of work," "Innate resilience," and "Instructing/training junior nurses and students".

Discussion: The reasons these elements were related to WE may be that "Instructing/training junior nurses and students" served as opportunities for reflection on the own nursing and having such roles could lead to personal growth, and that "Enjoyment of work" may lead to a more effective work performance.

Conclusions: "Enjoyment of work," "Innate resilience," and "Instructing/training junior nurses and students" were related to the WE of mid-career nurses.

Objective: To examine trends in the goals set by novice nurses at 3 and 6 months after beginning employment.

Method: A quantitative text analysis was conducted on those goals during off-job training by 29 novice nurses hired in 2022 at a regional hospital department.

Results: In the 3rd month, the goals included "improving my current situation," "developing an effective nursing process," "improving my communication skills," "fulfilling my societal role," "strengthening interdepartmental cooperation," "Sustaining commitment to work," and "developing my personal skills." By the 6th month, the goals shifted to "acting based on decisions about priorities," "providing patient-focused care," "Improving collaboration within the nursing team" "increasing work efficiency," and "achieving independence in my role."

Discussion: In the 3rd month of employment, novice nurses primarily set goals centered on "action,"—completing immediate tasks to build a stable professional foundation. However, by the sixth month, their goals shifted, with more frequent emphasis on "thinking"—focusing on reflective nursing practice and work-related insights. The results suggest the importance of supporting novice nurses changing goals throughout their initial 6 months in the workplace.