The purposes of this study were 1) to describe the perceptions of nurse directors regarding changes in administrative behaviors and the usefulness of knowledge and skills after completing the Japanese Nursing Association's certified nursing administration course and 2) to clarify the role of nurse administrators, and the knowledge and skills required for this position.

Subjects were 7 nurse directors who had completed the Japanese Nursing Association's certified nursing administration course. Data were collected by means of semi-structured personal interviews, with each interview being tape recorded after obtaining permission of subjects. Data were analyzed using content analysis techniques and a number of relevant categories were determined.

The following findings were obtained :

1. The motivation for learning nursing administration was as follows : ｢these skills were needed in order to fulfill the role and responsibilities of the position｣, ｢to gain support from superiors and the organization｣, ｢a desire to undertake continuing education｣, ｢these skills were required due to change and expansion of the organization｣.

2. Changes in skills or behavior after completion of the course were as follows : ｢becoming involved in the management of the organization ｣, ｢improved relationships with colleagues and members of the administrative team｣, ｢improvement and progress in negotiation skills｣, ｢implementing changes in the organization and starting the new ventures｣, ｢expansion of roles inside and outside the organization｣, ｢expansion of the network to include nurse administrators who work outside organization｣, ｢becoming involved in continuing education｣.

3. Required areas of competency for nurse directors were : business management, strategic planning, analysis and resolution of problems, negotiation, communication skills.

4. Knowledge and skills acquired from the course that were useful in nursing administration were related to : business management, medical economics, financial management, accounting, and marketing.

This study suggests the importance of providing opportunities for continuing education and showed that ongoing active learning for nurse administrators is essential.

The purpose of this study was to identify characteristics of clients' service utilization and cost, degree of care implementation and outcomes by type of home care agencies.

Subjects were 257 clients in 7 home care agencies. We assessed changes of outcomes including IADL, ADL, and willingness during a period of two months. In addition, we studied type, frequency and cost of services, and implemented services to promote independence of the clients for two months.

As a result, the independence level was higher in the clients of visiting care stations. Their spouses were primary caregivers, and also many clients lived alone by using mainly visiting care services. The independence level was lower in the clients of visiting nursing stations. They lived with their families, and were likely to use bathing and to visit rehabilitation centers. The clients in ambulatory rehabilitation centers were regarded as care level of J, B, and their daughters in law were primary caregivers. They also used significantly more day service and short-stay. Use of wheelchair and improvement of ADL were higher in the clients of visiting nursing stations. There was a tendency that improvement of willingness was higher in the clients of ambulatory rehabilitation centers while it was maintained in those of visiting nursing stations. It can be effective to implement a broad range of care including functional training, excretion care, fall prevention and encouraging socializing to improve ADL. Recreation, functional training and psychological support in ambulatory services are necessary to improve the willingness. It is worth for the clients to pay the costs for these services to promote their independence.

The aim of this study was to examine that the interdepartmental risk management system and the sections would have an effect on an acquirement of the risk manager's role. The reason we did it was that we could challenge and succeed some improvements of business under the new system, such as we could not challenge under the bureaucratic system.

In this study, the participants were 31 assistant head nurses that hold an additional post as a risk manager in her section. We have got the following results through the date analysis for K-J method :

The most had felt a dilemma on the time shortage or the capacity shortage toward the risk manager's role. However, the most had understood that it was very important and interesting and effective role. It promoted their motivations that they had held the positive responses of the staff nurses and the doctors and a head nurse against the practice of risk management. And a head nurse or a general risk manager supported their effective practices.

We supposed that in this way these positive cycles would bring about good results under the system correcting authority gradient, and so they could acquire the risk manager's role. We expect that the interdepartmental risk management system and the sections will reform the hospital organization.

The purpose of this study was to study care system and services in geriatric health services facility by analyzing care needs and risks in clients. Subjects were 77 clients in a geriatric health services facility. Nurses and professional caregivers used assessment sheets, and clients' needs were extracted. Three months later, it was evaluated whether their problems were solved or not.

As a result, "dementia and psychological symptoms" was the most common need, but it was maintained rather than improved in most cases. The highest solution rate was found in "meal". Clients who needed help in "meal" or "cleanness" tended to be lower in their care levels while those who were at risk in "re-infarction" or "re-fracture and fall" tended to be lower in their care levels. Care providers must assess risk factors of the clients, and incorporate preventative measures in their care plans. Also, care methods should be developed for promoting self-care in "excretion and cleanness" to meet their needs.

The purpose of this study is to analyze the practice of newly licensed registered nurses (RNs) and thus have daily nursing activities reflected in the knowledge required for the National Licensure Examination for Registered Nurses (NLERN). This study is also a preliminary stage before carrying out the main study, and is made in order to investigate areas relating to design of the study, including the subjects, items to be covered, and the format of the questions. The subjects of this study were newly licensed RNs and their preceptor nurses who worked at either the Special Function Hospitals or the general hospitals throughout Japan which were located in urban or suburban areas, and had more than 500 beds in their facilities. They were asked to fill out the questionnaires anonymously. "Important activities" were determined by analyzing seventy-three newly licensed RNs' and ninety-three preceptor RNs' activities. Important activities were "verification of safe practice," "identification and intervention of cardiopulmonary arrest," and "assessment and intervention of shock patient." This study suggests the importance of developing and improving questionnaires for analyzing the practice of newly licensed RNs in order to reflect their daily activities and required knowledge clearly on the NLERN.

The purpose of this study is to obtain basic information regarding the implementation of practice analysis for newly licensed registered nurses (PANLRN). Research questionnaires were mailed to the nursing administrators in all hospitals throughout Japan which have more than 300 beds in their facilities. The result shows that many hospitals use manuals and/or checklists, and adopt preceptor-ship systems for new graduates' education programs. Most of the hospitals allow them to start working evening and night shifts after 2 to 3 months of training in their hospitals. In order to improve the National Licensure Examination for Registered Nurses (NLERN) effectively, it is important to implement the PANLRN at least 3 months after of their hiring. Also, the activity items on the questionnaires for the practice analysis need to be established based on the currently used manuals and checklists in hospitals.