The Ministry of Health, Labour and Welfare promotes the use of the new bar code to ensure the traceability of pharmaceuticals and to prevent their drug-dispensing errors. This study was conducted to investigate what problems need to be resolved to realize the traceability of pharmaceuticals using the new bar code in health insurance pharmacies, and furthermore, how the new bar code might be effective in preventing the drug-dispensing errors, etc. While various tasks that needed to be resolved were identified, such as the addition of systems and modification of existing system functions, for realizing the traceability of pharmaceuticals in our health insurance pharmacy, we could construct an information management system that can trace each manufacturing number or code of prescription drugs to end consumers, i.e., patients. In addition, this new system reduced the monthly number of incident reports, such as the drug-dispensing errors, from 20.3 to 0.6 and was suggested to be effective in improving operations in health insurance pharmacies. The realization of pharmaceutical traceability makes it possible to provide safety information to end consumers, i.e., patients, as soon as drug-dispensing errors are found, and is expected to greatly contribute to the prevention of medical malpractice.

View full abstract

Pressure ulcers (PU) are chronic wounds that normally occur in bedridden elderly patients, caused by external force on bony prominences. Treatment of pressure ulcers usually takes a long time, therefore increasing both materials and labor costs as well as adversely affecting the patient's quality of life. The usefulness of PU treatment teams has not been demonstrated previously. Here, we performed cost-benefit analyses comparison of patients treated by Wound, Ostomy, and Continence Nurses (WOCN). Data were collected retrospectively,and compared for DESIGN-R score with regard to the materials and labor costs. The study patients were 295 patients treated by the PU team and the 80 patients treated by WOCN. The total cost-benefit score (yen/DESIGN points) was 6,709 (PU team) and 24,549 (WOCN). In conclusion, pressure ulcer treatment requires treatment by a team consisting of physicians, pharmacists, and nurses.

View full abstract

[Objectives] The aim of this study was to verify what kind of resources might influence the number of endoscopic screenings for gastric cancer when such screening is conducted at the level of a general clinic.
[Methods] We carried out a postal questionnaire survey by mailing questionnaires to subjects in Yonago city, Tottori prefecture and Niigata city, Niigata prefecture, where endoscopic screening for gastric cancer has been performed at the level of general clinics for about 10 years. Variables such as human resources, material resources, and characteristics of doctors were determined as the explanatory variables, and the Poisson regression analysis was performed using the numbers of screenings per week as the dependent variable. We also investigated the future intentions of general clinics for increasing the number of screenings.
[Results] Besides the presence/absence of medical specialists qualified by the Japanese Society of Gastroenterology and the ages of doctors, mainly material resources exerted a significant influence on the number of screenings. The material resources consisted of the number of endoscopes, possession/non-possession of fully automatic washing machines, and presence/absence of exclusive-use endoscopy rooms, all of which influenced the number of screenings.
[Conclusions] The findings of the study suggested that investment in material resources is effective for increasing the number of endoscopic screenings.

View full abstract

There have been several reports on the present state of in-hospital violence, but no reports on in-hospital violence exclusively in university hospitals providing highly advanced medical treatment. The Private University Hospital Liaison Council for Medical Safety Promotion conducted a questionnaire survey with all 29065 staff members of main hospitals of private universities in Tokyo in 2011 to improve the environment, so that the staff can work safely. As a result, the response rate was 78.6%, and 44.3% had received in-hospital violence within the last one year. Furthermore, it was revealed that although 3.7% (n=1,159) and 0.2% (n=58) thought “I want to retire” and “I want to die,” respectively, due to violence, their individual responses to in-hospital violence consisted mostly of restraining themselves or apologizing to the assailants. In addition, the support system of each facility was poorly recognized, with 71.7% answering “There is no support system” or “I do not know.” Anxiety about in-hospital violence was rated 2 or higher (feeling some anxiety) on a 5-point scale in 86.3% of the respondents, and this should be taken seriously. It is an urgent task to understand the present state of in-hospital violence and plan effective countermeasures, and it is essential to establish a trust relationship with patients and their families.

View full abstract