Although several previous studies have assessed the association between perioperative prophylactic pulmonary rehabilitation and postoperative pulmonary complications in lung cancer resection patients, these were generally single-center observational studies with no adjustment covariates.　There is therefore insufficient evidence to determine the efficacy of prophylactic pulmonary rehabilitation.　The aim of this study was to elucidate the association between prophylactic pulmonary rehabilitation in patients undergoing lung cancer resection and postoperative pneumonia using a multicenter inpatient database in Japan.　We defined perioperative prophylactic pulmonary rehabilitation as rehabilitation services provided during the preoperative period or from postoperative day 1.　Patients who received these services were designated the treatment group, and those who had not received these services were designated the control group.　We compared data from 8,014 eligible patients using propensity scores.　The overall incidence of postoperative pneumonia was 2.1%, and 48.2% of patients received prophylactic pulmonary rehabilitation.　The propensity score-matched analysis extracted 3,091 pairs, and showed that the treatment group was significantly associated with a lower incidence of postoperative pneumonia than the control group （1.6% vs 2.6%, respectively;p = 0.010）.　This study indicates that perioperative prophylactic pulmonary rehabilitation in lung cancer resection patients is potentially associated with a reduced incidence of postoperative pneumonia.

　　This study was aimed at clarifying the effect of workplace leaders’ （nurse managers） voluntary overtime work on their subordinates’ work-life balance satisfaction.　A questionnaire survey of 519 staff nurses and 30 nurse managers was conducted.　Analysis conducted using a multilevel structural equation model revealed that workplace leaders’ voluntary overtime work due to intrinsic motivation deteriorated the shared work-life balance satisfaction within the workplace through involuntary overtime work at the workplace.　On the other hand, workplace leader’s voluntary overtime work due to extrinsic motivation directly increased the work-life balance satisfaction at the workplace, although the overall effect could barely be appreciated.　It was indicated that to clarify the motivation for workplace leaders’ overtime work may contribute to the improvement of their subordinates’ satisfaction.

　　For proper administration of medications brought into the hospital by patients （hereafter, medications brought in）, several studies have proposed specialized operations for the medications brought in.　At present however, these studies have not yet discussed the integrated management of the medications brought in and the medications prescribed post-admission.　Therefore, we conducted this study to develop a standardized guide for internal medication management, taking into account the differences in nature between the medications brought in and the medications prescribed post-admission, to enable integrated management.

　　For internal medication management, we developed operational goals to realize integrated manage­ment:collections of information, directions （orders）, preparation, and medication （taking the medicine）.　We also developed a guide to standardize the aforementioned operations, taking into account the characteristics of the medications brought in.　In order to achieve integrated management, it is necessary to appropriately implement four procedures-“acceptance”, “stop”, “co-administration” and “switching”, taking into account the three characteristics defining of brought-in medications namely that （1） it is externally prescribed/dispensed, （2） its condition before hospital admission is variable for each patient, and that （3） it belongs to the patient.　We verified the validity of the operational goals and of the guide for standardization via a survey conducted at a hospital.

　　It is increasingly important to understand the cost of Diagnosis Procedure Combination （DPC） for hospitals which adopt DPC/PDPS （Diagnosis Procedure Combination / Per-Diem Payment System） in Japan.　Although 99.6% of hospitals have recognized the need for DPC cost accounting, this study revealed only 65.0% of hospitals have actually implemented.　This huge gap between recognition and implementation is the challenge for the future.　According to the result, public hospitals do not tend to implement the DPC cost accounting.　98.9% of hospitals address the DPC-by-DPC profitability improvement plans.　To evaluate the impact of improvement plans, periodical costing is required;however, only 17.9% of hospitals annually evaluate the DPC cost.　This study implies that implementation of cost accounting facilitate serious action for improvement plans.

　　The purpose of this study was to clarify the difficulties faced by nurses in administering pro re nata （PRN） psychotropic medications to delirious patients in acute care hospitals throughout the country.　The authors developed an original anonymous self-administered questionnaire containing 7 items designed to identify the difficulties faced by nurses in making the judgments required during the medication process.　The questionnaire was distributed to 3,848 nurses from 116 hospitals throughout the country who consented to participate in the study.　Responses to the questionnaire were collected by mail from 1,958 （50.8%） nurses;of these, 1,748 responses were rated as valid （representing a valid response rate of 45.4%）.　In regard to the nurses’ perceptions of difficulties in administering PRN psychotropic medications to delirious patients, “somewhat difficult” and “very difficult” accounted for 68.4% to 79.5% of the answers in response to questions about the specific judgments on the necessity for drug therapy, specific drug choice, and determination of the dose and dose rate.　The results of the study suggested that it is necessary to improve and disseminate the organizational activities to manage delirium, including education of nurses and other health professionals on psychotropic medications and improvement of instructions to administer PRN psychotropic medications safely and effectively to delirious patients.

　　A questionnaire survey was carried out of nurses and care staff working at long-term care health facilities to obtain their free comments on the need for improvement of the work environment at the facilities.　Content analysis allowed classification of 328 recording units of responses from 159 （12.5%） nurses into 28 subcategories, and 393 recording units of responses from 200 （15.7%） care staff into 25 subcategories, and all of these subcategories of responses from both the nurses and care staff were grouped into 7 categories.　In regard to improvement of the work environment, promotion of [institutional reform at the national level] allows [an allowance system making it possible to live with peace of mind] to be constructed and [recruitment and retention of staff] make it easier to take days off, leading to [the realization of work-life balance] and [intention to continue work].　Also, it is important to [secure career enhancement opportunities] and to [cooperate with various professionals and people] for further enhancing the expertise in each occupation, and it is required to take measures in which [no priority is given to facility profit], such as improving the staff’s practical care skills.　These various factors were suggested to enhance the [intention to continue work].