The nurse supporting system such as medical and nursing records used IT technique and medical care assistant staff, is essential matter for outpatient nurses in order to display their professionalism. We investigated situation of introduction of 10 nurse supporting systems in 65 general hospitals nationwide by questionnaire. Also, we conducted a survey of the relationship between situation of introduction of nurse supporting systems and quality of 592 members. The quality of nurse was measured by indexes of nursing work experience developed by Suzuki. Medical information system, medical care assistants, and centralization of ancillary medical tasks were introduced in more than 80% hospitals. Career ladder and performance evaluations of each nurse did not be used practically to nursing staff arrangement. Activities of certified nurse's specialist and certified nurses did not be used effectively in such hospital. Higher introduction rate of nurse supporting system were higher quality of nurse.

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With the reform of the health care system, the implementation of specific medical checkups and health guidance, and societal changes, public health nurses are now required to have more expertise and skills than ever before. In addition, the duration of education for public health nurses has doubled following revision of "The Act on Public Health Nurses, Midwives,and Nurses." The training of public health nurses in community-based activities and the implementation of "health guidance" unique to public health nurses must therefore be reconsidered. We have therefore proposed expansion of the range of public health nurse services and decision-making capacities: (1) expansion of the range of decision-making capacity with regard to performing specific physical checkups and specific health guidance; (2) expansion of the range of decision-making capacity with regard to performing home-visit preventive care services for specified elderly persons; and (3) expansion of the range of decision-making capacity with regard to performing influenza testing using a simple kit and vaccination. We have also suggested that training of public health nurses should be conducted in a 2-year master's course. Expansion of the range of public health nurses decision-making and training of public health nurses in a master's course will further increase their expertise and ability to discharge their social responsibilities as professionals.

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