The purpose of this research is to clarify the structure of the quality of life of the ostomate and to clarify the factors that influence the structure. Knowledge the structure of the quality of life will help nurses to enhance ostomates's attitudes about themselve after discharge from the hospital.
Causal relations of ten factors are clarified by accepting significant path coefficients using the Covariance Structure Analysis in 159 ostomates. The ten factors are (1) discouragement with having a stoma, (2) relief due to effectiveness of stoma surgery,(3) positive attitude toward life,(4) subjective attitudes about life,(5) personal assessment of health,(6) difficulties with living,(7) burden of having a stoma,(8) satisfaction with diet,(9) self-esteem, and (10) social support. The structure of the ostomate's quality of life is gained by displaying each causal relationship.
The factors that influence the structure are (1) marital status,(2) Independence in changing of a stoma appliance, and (3) sexual satisfaction. These factors are related to the family.

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The purpose of this study was to examine how the hospital characteristics relate to the proportion of high-acuity patients who require critical and/or intensive care. A survey on hospital nursing was conducted in September of 1991. A 20 pecent random sample, by size of hospital measured in terms of the number of beds, type of ownership and proportion of psychiatric beds, was drawn for all hospitals in Japan for the survey. The survey collected a wide range of information about hospital characteristics as well as characteristics of each ward such as number of beds, case mix and nurse staffing. Usable questionnaires were received from 642 hospitals (34.0%) included in the survey sample, and from 1,281 wards of which the total number of 70,144 beds accouts for 4.2% of all the hospital beds in Japan.
Out of 39,178 patients in 927 general wards, the total number of high-acuity patients were 2,111 patients (5.4%). By the size of hospital, the percentage of high-acuity patients was 3.0% in the category of hospitals with fewer than 100 beds, whereas it was 7.8% in the category of hospitals with 500 or more beds. The percentage of high-acuity patients of university hospitals was the highest (9.9%) among all categories of type of ownership. Generally, non-public hospitals had lower proportion of high-acuity patients than the others; 3.6% of patients of private hospitals and 4.1% of patients of medical care juridical corporation hospitals were high-acuity.
By the patient classification system commonly used in Japan, the patients who are bedridden and require continuous observation by nurses are classified into the group with the greatest nursing needs (so called “A-I” patient). The distribution of “A-I” patients, however, suffered a slippage from the distribution of high-acuity patients in some categories of hospitals classified by their characteristics. It is apprehended that the patient classification system above-mentioned does not reflect nursing care as practiced in the hospitals.

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The purpose of this paper is to identify any potentially hazardous errors that may occur in the nurses working environment and to develop a system that can protect against any such occurrences. For this purpose, the author examined characteristics and dosage of medicines used in each ward, and also interviewed nurses regarding their experiences with such problems in the work place.
The research was conducted at a 600-bed hospital which employed approximately 300 nurses. Questionnaires were distributed to 230 nurses, who were working in various wards, on September 1st through 7th and again on October first through 7th, in 1994. The author asked nurses to identify medication errors that they had personally been involved in during their working day.
This paper is concerned with 10 general wards in the hospital and the questionnaire response rate was 90.4%. 2,157 questionnaires were returned with 1,324 having been written on work days and the remaining information having been provided by head nurses. This information also included unit sizes, case mixes, staff lists and staff schedules.
In the course of the two weeks the research revealed a total of 61 medication errors, 118 near misses, 88 prescription errors which nurses identified, and 141 medication errors made by others which nurses actually dealt with. Results show that the nurses had not made any medication errors on 95.6% of their entire work days (1,324) and that on 12.4% of 1,324 work days nurses dealt with errors made by others.
The number of patients in serious conditions along with the amount of oral medication consumed had a direct influence on the number of medication errors. There is also a correlation between the Care-need-score divided by the number of nurses on duty (especially the evening-shift) and the number of error occurrence.
Several limitations of this study dictate that the results be applied with caution. However, the results might also be helpful in determining factors which can lead to the occurrence of various errors which put patient safety at risk.

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To evaluate the effectiveness of support surfaces and massage as management for prevention of pressure ulcers, we measured the transcutaneous oxygen tension (TcPO₂) at sacral resion in healthy subjects. The ratio of TcPO₂ values taken during pressure application for 60 minutes to TcPO₂ values before pressure application was compared between treatment of three support surfaces (ring cushion (donut-type), air-mattress, urethane foam-mattress) and treatment of futon, mattresses pad as control. The significant difference of TcPO₂ ratio had been demonstrated among each support surfaces. The decreases of TcPO₂ ratio were less in the subjects treated with, in order of significance, ring cushion, air-mattress, urethane foam-mattress, futon, mattress pad. The recovery time of TcPO₂ after relief of pressure that returns to the same level prior to application of pressure was analyzed in the subjects with or without treatment of massage prior to for 5 minutes pressure application. There was no significant differences between recovery time of subject treated with massage and that without treatment. These results suggest that air-mattress is most effective for prevention of pressure ulcer development as support surface and it will be necessary to re-evaluate the significance of massage treatment in prevention of pressure ulcers

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