The purpose of this study is to understand the seamless care provision systems for hospitalized patients. This study attempted to determine the trends in and content of the cooperation system in continuous care through Japanese literature.

From the original papers published by the Japan Medical Abstracts Society, papers that included terms such as “continued nursing,” “nurse,” and “cooperation” were identified. In an overview of the abstracts selected, studies on cooperation between nurses in the hospital were excluded. Subsequently, the cooperation system in continuing nursing, cooperation between partners of the hospital, survey content, and results of the studies were examined.

The keyword search identified 174 papers, which were narrowed down based on whether the studies dealt with the introduction of a system for continued nursing. Finally, 15 papers were analyzed. Cooperation with visiting nurses was the most common topic covered in the papers. The main cooperation methods were patient referral documentation and conferences before discharge. Cooperation in the care of patients after discharge was rarely reported. Most studies examined the effects of cooperation via questionnaire surveys of nurses of the hospital and the cooperating facility, and patients' anxiety was studied through interviews.

Few studies report the introduction of a system for cooperation for post-discharge care. Few case studies have examined the effect on patients, through interviews. In the future, it is desirable to conduct intervention studies on a cooperation system for care after discharge, as well as large-scale studies to measure the effects of the same on patients.

By using infrared transmitters (beacons) and infrared sensors (sensors), nursing staff's workload can be measured, but few studies demonstrated its effectiveness. This study aimed to demonstrate the effectiveness and possible application of time-study using beacons and sensors in clinical practice. Items used for patient's severity and needs for nursing care (nursing demands) were evaluated as for their validity and simplification of items was examined.

In a surgical ward of an acute-care hospital, bed-side sojourn time of healthcare workers was measured automatically by beacons and sensors from December 14 to 27 in 2015. The relationship between the bed-side sojourn time and the items of nursing demands was analyzed after adjusting for confounders by multivariate analysis.

A total of 687 in-patient's data was obtained. Healthcare worker's average bed-side sojourn time per one patient in a day was 44 minutes. As for nursing demands, there were some items and its options which showed no significant difference for bed-side sojourn time of nurses and nursing aids. According to multivariate analysis, 6 items；wound treatment, respiratory care, management of syringe pump, roll over, feeding and clothing change, were related to the bed-side sojourn time.

This study demonstrated that the time-study using beacons and sensors can be used effectively in clinical practice.

Social care corporation Keiwakai Oitaoka hospital is an acute care hospital of secondary emergency designation located on the east side of Oita City, Oita Prefecture. Due to its location, damages caused by a tsunami or a direct hit caused by earthquake of the Nankai Trough seismic activity is assumed. We have formulated a business continuity plan for such an emergency event. There is a problem about the use and conservancy of electronic medical record data in the event of a disaster. We are considering using the cloud service to solve the problem. We have constructed an environment to browse medical care information in the event of a disaster.

We applied to the Ministry of Health, Labour and Welfare for a system that allowed all the clinical training hospital of Iwate Prefecture as co-operative facilities since 2010. As a result, residents were then able to select educating programs of all training hospitals. Due to this change, quality assurance of clinical training hospitals was required, and we began a peer evaluation of all training hospitals in Iwate Prefecture from 2013. Iwate Ihatov working group by doctors and administrative staff in charge of the clinical training hospitals were paired up to perform the peer evaluations. Clinical (Japan Council Evaluation of Postgraduate Clinical Training) training program manager and administrative staff of other hospitals and JCEP Surveyors conducted a visit investigation of peer evaluation. JCEP self-assessment questionnaire was used and, in accordance with the procedure of JCEP, one-day site visit was carried out. Several good efforts of each training hospital were shared, and improvement items were listed in the survey report. After investigation, the auditee license of the Governor was awarded to the auditee hospital. Clinical training evaluation by visiting investigation and confirmation of the standards of training hospitals will improve the quality of training hospitals in Iwate Prefecture. We introduce the background and content of the peer evaluation.

Reports of accidents involving residents, such as misidentification of patients and needle-stick injury, increase around six months after they are employed. To address this problem, we provide a complementary training program for residents. This program consists of seminars on cases of accidents involving residents and exercises of techniques, such as blood collection, infusion, and blood transfusion. Two to three residents were assigned to a mentor selected from members of the medical safety committee or the infection prevention committee. The residents practiced through role-playing exercises in which each resident alternately acted as a patient and a doctor. The questionnaire survey on the training program showed that the residents were satisfied with the timing, contents, and other aspects of the program and supported its continuation. Since reports of accidents and needle-stick injury after the training program have decreased, the program appears to have been effective to a certain extent.

The objective of this study was to clarify the support for newly graduated nurses from preceptors and the support for preceptors from the other nurses in order to suggest the effective support for preceptors. A questionnaire survey was conducted on 110 preceptor nurses in our hospital from April 2013 to March 2014. For statistical analyses, simple tabulation and Mann-Whitney U test was conducted using a software program SPSS Ver.(20) for Windows, with a level of significance of 5%. Twenty-nine items regarding the support for newly graduated nurses received positive evaluation (over 80 percent), for example the item of [Show the nursing skills model] was 97.6%. And five items regarding the support for preceptors from the other nurses were evaluated positively (over 80 percent). Among preceptor nurses, 95.3% had an opinion that [To be a preceptor can lead to own professional growth], on the other hand, 68.2% answered [Get stressed from the role of preceptors]. There were significant higher percentage in 3 items such as [motivation as preceptor] among participants of preceptor training program. Preceptor nurses have higher motivation to support newly graduated nurses but are also stressed from this role. These finding suggest that mental support for preceptor nurses is important.

Numerous reports are published on the contribution to the general condition and physical functions with an early rehabilitation intervention for aspiration pneumonia (AP), but only a few reports to its relation to the patients' return home. We examined 221 patients admitted to our hospital with AP diagnosis who were prescribed rehabilitation intervention. After excluding cases of death and total ADL assistance before admission, a retrospective study was conducted on 107 cases.

Study items are：age, sex, length of stay, Barthel Index, the average number of units of rehabilitation provided, the presence or absence of dementia, serum albumin level, Body Mass Index, nutrition method, and ability to move. Cases were divided into two groups-in-home care and hospital care. Logistic regression analysis was conducted on a) the presence or absence of dementia, b) nutrition method, c) number of units provided, and d) ability to move, which showed significant difference between the groups.

These four items were shown to be important in achieving patients' return to in-home care, and a higher number in provided rehabilitation units resulted in better outcome.

The purpose of this study was to identify how nurse's skills should be effectively exploited. 229 nurses nearing retirement age (55 to 60 years) and 401 nurses in their 30s to 40s who were working at a hospital were surveyed. The researchers examined the type of hospitals where the nurses were working, their position, and their intention to continue working. The researchers also examined their desired employment status. The answers to the survey questions were then compared against each other.

40% of the nurses nearing retirement age expressed their intention to continue working. The reasons that were given by the nurses were, “financial reason”, “Capable to work over the age of 60”. The nurses nearing retirement age wanted to continue work in the same department, but only wanted to work during the day shift. These results suggest that when considering how to utilize nurses nearing retirement age, employers should ensure that the nurses' experience and knowledge match their desired employment status. We also need to consider more systematic method and share information within their community.

These days a digital information system is widely used to inform a large number of public in the amenity areas such as waiting room and lobby. Also in Tosa City Hospital, there is an information display in the main reception hall, but not in the waiting room of each clinic where patients must wait for a long period. To show patients some features of skin diseases while waiting for my examination, I put up a digital signage using a liquid crystal display television in the waiting room for outpatients. I created contents using Keynote and saved the file on iCloud to synchronize with iPad which is placed in the examining room. Then I played the Keynote file on iPad to display it on the television via Apple TV using AirPlay. It is so easy to change the contents by just updating the Keynote file on Mac. A digital signage such as this would help patients understand some skin conditions. If the waiting rooms of other clinics are likewise installed with digital signage, the patients' complaints about long waiting time will be mitigated and the hospital reputation will improve.