“Nursing Need Degree （NND）” are recorded every day in patient charts.　In this study, we developed a model to identify patients at high risk for falls and also developed a risk score based on NND, and evaluated their usefulness.　The study involved patients who were admitted to our hospital in fiscal year 2016.　Factor analysis was conducted to use NND evaluation items in the development of the risk score.　Logistic regression analysis to determine the influence of falls was performed using independent variables, including NND evaluation items and patient characteristics, to create a risk score.　The risk score was compared between “patients with falls” and “patients without falls”.　Two hundred fifty-four （2.5%） patients had falls, and 9,894 （97.5%） patients had no fall.　Fifteen evaluation items could identify patients at high risk for falls with high accuracy （area under the curve ［AUC］ = 0.75, p<0.01）.　Furthermore, there was a significant difference in the risk score between the two groups （3.7 vs 1.4, p<0.05）.　Identification of patients at high risk with NND, whose data are recorded on a daily basis, will lead to efficient fall prevention measures in hospital care, which is becoming increasingly more relevant with the aging of the population.

This study was a questionnaire survey conducted of 1,075 nurses working in hospitals, to elucidate the reason for their overtime work and to identify factors affecting their mental health.　Multilevel structural equation modeling analysis was conducted on nurses nested within wards, and multiple group analysis was performed to test differences among hospitals.　The results revealed that overtime work due to workload affected the increase in overtime hours at both the ward and individual levels.　At the ward level, overtime work due to workload significantly worsened mental health, while overtime hours had no significant effect on the mental health.　At the individual level, the number of overtime hours, and overtime work due to conformity, overtime work due to workload, overtime work for money and reputation, and overtime work for fun of work affected the mental health.　The degrees of influence of these factors differed among hospitals.　It is important to recognize that not only a reduction in overtime hours improves the mental health, and to promote measures against long working hours in such a way as to reduce excessive workload.　In addition, the findings of the survey suggested that measures need to be taken after understanding the influence of the reasons for overtime work on the mental health at each hospital.

　Purpose:The purpose of this study was to describe the competencies of head nurses whose excellent achievements are recognized by directors of nursing, and present an outline of the achievements.
　Method:Semi-structured interviews were conducted with 5 directors of nursing in advanced treatment hospitals in the Kanto area, and the results were analyzed qualitatively and inductively.
　Results:The directors of nursing recognized the excellent achievements of head nurses from the viewpoint of the ［quality of nursing received by patients］, ［maintenance of the quality and quantity of staff］ and ［contribution to hospital management］.　To realize these achievements, the directors thought that the head nurses had the following competencies:［competency to follow through on transformation of the site］, ［competency to assess the site］, ［competency to involve the people around］, and ［competency to unlock and use the staff’s potential］.　They thought that the following competencies were important for the head nurses to exercise their above competencies:［competency to improve themselves as managers］ and ［competency to be positively confident in themselves and others］.