Diffusion of new evidence-based nursing techniques is an urgent issue for nursing. Although the term “innovation” is often used in relation to this issue, its meaning remains unclear. The objective of this research is to clarify what “innovation in nursing in Japan” actually means at present so that a strategic model for diffusion of new evidence-based nursing techniques can be established. Rodgers’ concept analysis method was used as the research approach to analyze 15 Japanese articles from the literature containing the terms “innovation” and “nursing” . The results showed that the antecedent to innovation in nursing in Japan was the process of noticing the presence of problems and adopting new techniques to resolve them, and there were factors that acted on the process. The attributes were the details of evidence-based techniques that would replace existing nursing techniques and practice patterns. The primary consequence was incorporating the techniques into an organization and the secondary consequence was the outcome resulting from implementing the incorporated techniques. Innovation in nursing, from the antecedent through to the consequences, showed the process of diffusing new nursing techniques and included factors that affected that diffusion.

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 This study aimed to clarify characteristics of observations and procedures followed by expert nurses for the selection of intravenous insertion site, focusing on the veins identified. We performed the study on 11 competent (control group) and 13 expert nurses. The nurses were recorded while selecting the site for intravenous infusion on the forearm of a mock patient. We performed an interview after the recording, including questions that aimed to clarify the purpose of procedures and characteristics of observations. During the interview, we watched the video of the procedure and examined each process followed during the procedure.
　Subsequently, we identified 12 procedures of palpation, including 9 for competent nurses and 11 for expert nurses. Analysis of the average time, number of observation points, variations of procedures etc., showed no significant difference between the 2 groups. The average time for site selection by expert nurses was 147.4±83.2 seconds, control group was 111.8±37.2 seconds. Regarding site selection, control group tended to select from multiple areas, including the dorsal venous network of left hand and basilic vein of right forearm. On the other hand, expert nurses tended to select from limited areas, and 61.5% of them selected the cephalic vein as the insertion site.

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 An educational sphygmomanometer that could visualize pressure reduction speed and measurement values was developed to allow nursing students to acquire blood pressure measurement skills. Although Device No. 3, which was successively modified from the original Device No. 1, showed effectiveness in the technical acquisition of skills associated with depression speed, it was not effective in the acquisition of skills for listening to Korotkoff sounds, thereby suggesting low measurement value detection precision. Therefore, Device No. 4 was developed with enhanced measurement value detection precision and its educational effects were investigated. The subjects were first-year nursing students；Device No. 3 was used by 58 students (hereinafter, Device No. 3 group) , and Device No. 4 was used by 54 students (hereinafter, Device No. 4 group) . Similar to the Device No. 3 group, effects were observed for depression speed measurement in the Device No. 4 group. The Device No. 4 group could listen to Korotkoff sounds more precisely than the Device No. 3 group (P＜0.05) . The increased measurement value detection accuracy with the educational sphygmomanometer Device No. 4 enabled students to accurately review their skills, leading to effective training.

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 The objective of this study was to clarify the liquid temperatures used and the warming status with regard to glycerin enemas administered by 93 nurses through constitutive participation observation. A total of 64 nurses were found to warm glycerin enemas before administering them. The average surface temperature of the glycerin enema container just before the administration of the enema was 31.6±4.9℃. In detail, 32 nurses had an average surface temperature of ＜28.8℃, 38 had an average surface temperature of 28.8 to ＜35.2℃, 18 had an average surface temperature of 35.2 to ＜38.9℃, 1 had an average surface temperature of 38.9 to ＜40.7℃, and 4 had an average surface temperature of ＞40.7℃. Future studies should evaluate the relationship among such factors as the autonomic nervous system, hemodynamics and intestinum peristalsis while also clarifying the optimal temperature to safely perform glycerin enemas.

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 The aim of this study was to investigate the physiological and psychological effectiveness of hand massages on female university students. We compared the difference in effectiveness of hand massages of short durations, such as 5 and 10 minutes. We randomly assigned 23 students each to receive a 5-minute and 10-minute massage, respectively.
　Additionally, we investigated the participants’ basic characteristics, and the physiological effects were measured by taking into account body temperature, pulse rate, blood pressure, α-amylase activity, high-frequency power (HF) , and ratio of low-frequency power to high-frequency power (LF/HF) both before and after the massage. Bodily and mental fatigue, stress, and relaxation were assessed using visual analog scales (VAS) , and mood was assessed using the Profile of Mood States (POMS) -Short Form.
　After the massage, there was a significant decrease in pulse and systolic blood pressure in the 5-minute group and in pulse and diastolic blood pressure in the 10-minute group. However, all changes in numerical value were minimal.
　In addition, bodily and mental fatigue and stress levels decreased significantly. Relaxation levels increased significantly in the 5-minute massage group. POMS scores revealed significantly lower “Tension-Anxiety” , “Depression” , “Anger-Hostility” , “Fatigue” , and “Confusion” following the 5-minute hand massage. “Tension-Anxiety” , “Vitality” and “Fatigue” were significantly lower following the 10-minute hand massage.
　This study indicated that only the 5-minute hand massage had significant psychological effects. Thus, short hand massages of 5 minutes may be clinically useful in nursing.

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 This study examined the production of phlebitis by anticancer drugs in a rabbit model, and observed the histopathology of phlebitis in greater detail, including the histological effects of poultice application on phlebitis. Macroscopically, after 24 h of grouting, in every 6 rabbits has extended auricular veins and perivascular, and after 72 h grouting, and after 72 h grouting, strong auricle redness was present, but no differences were found between all groups. Histologically, after 24 h, loss of venous endothelial cells and presence of perivascular edema and thrombus were identified. After 72 h, these findings were more severe. Comparing pathology after 72 h, rabbits that underwent grouting alone showed the most severe findings, followed by rabbits that received a hot poultice after grouting, and rabbits that received a cold poultice after grouting as the mildest. These findings suggest that application of a cold poultice is the most effective method and hot poultice is contraindicated when phlebitis is caused by anticancer drugs.

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 The present study aimed to determine the effects of skin surface pH, amounts of sebum, adenosine triphosphate (ATP) , skin surface temperature and subjective evaluations on various types of bed baths, using a crossover design. Fifteen healthy adult volunteers participated in this study. Skin surface temperature increased and ATP levels declined regardless of the nature of the bed bath. Rates of ATP reductions were lower after bed baths using baking soda compared with those using hot towels and soap. The skin surface pH was ＜6.0, indicating an antibacterial effect of bed baths using hot towels, soap, and a skin cleanser. These pH findings were the same as those of bathing. Subjective evaluations found that all of the bed baths were refreshing and comfortable. Based on these findings, we recommend bed baths using hot towels or soap according to dirty of skin, and skin care after bed baths.

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 This study sought to clarify the relationship between foot angle and postural stability when nurses stand with their feet placed behind and forward to aid patient’s standing and sitting.
 Participants were 28 healthy females and six healthy males with an average age of 29.3 years. I first determined participants foot placement at three foot angles：0°, 45° and 90° (right-angle standing), and measured the support base area. In addition, I determined a foot placement (triangle standing) with foot angle of 90°, similar to a base of support of 0°. I measured the Index of Postural Stability (IPS) and perceived postural stability for four kinds of foot placement.　
 The results revealed that the area of the base of support was greatest when the standing angle was 45°, followed by right-angle standing, and triangle standing, which was similar to 0°. In contrast, IPS scores were highest with triangle standing, followed by right-angle standing, 45°, and 0°. Perceived postural stability was highest with triangle standing, followed by 45°, right-angle standing, and 0°.　
 These results indicate that a foot angle of 90° provided the greatest postural stability among foot angles of 0°, 45°, and 90°, when participants stood with their feet placed behind and forward. Furthermore, my findings suggest that foot angle is a factor in increasing postural stability, in addition to the area of the base of support.

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 The aim of this study was to clarify the effect of sensory stimulation of the feet by different temperatures on cerebral blood flow in the prefrontal cortex. The feet of 25 healthy adults were stimulated for 180 sec in foot baths set at temperatures of 40℃, 16℃ and 30℃. Changes in cerebral blood flow in the left and right prefrontal cortex were measured using near-infrared spectroscopy, and the feeling experienced at each temperature and the pleasantness of the temperature were subjectively evaluated. In intragroup comparisons, cerebral blood flow in the left prefrontal cortex increased 120 sec from the start of immersing the feet in the 40℃ water bath as compared with baseline levels (P＜0.05). Intergroup comparisons also showed that cerebral blood flow in the left prefrontal cortex was greater at 60 sec and 120 sec from the start of immersion of the feet in the 40℃ water bath than in the 16℃ water bath (P＜0.05). However, no change was seen in cerebral blood flow in the right prefrontal cortex. In the subjective evaluation, 40℃ was considered a “warm” sensory stimulus with a “pleasant feeling,” while 16℃ was considered a “cold” sensory stimulus with an “unpleasant feeling.” These results demonstrate that the “pleasant feeling” resulting from “warm” sensory stimulation of the feet causes cerebral blood flow in the left prefrontal cortex to increase more than the “unpleasant feeling” resulting from “cold” sensory stimulation. These results also show that sensory stimulation of the feet do not produce any changes in cerebral blood flow to the right prefrontal cortex.

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 The purpose of this study was to verify the relaxation effects of hand massage combined with a hot compress (hot compress massage), which can be used in home care. The subjects were 6 local residents (mean age, 50.2±3.3 years, and hot compress massage was applied by 6 nurses who had previously received training in this technique. Measurements were made using an acceleration pulse wave measuring device (TAS9VIEW), and the indices of autonomic nervous system activity were the high frequency component (HF), the low frequency component (LF), and the ratio of the two (LF/HF) obtained from analysis of heart rate variability. Mood was evaluated using the Profile of Mood States Brief Form Japanese Version (POMS). The results showed that HF exceeded 100% immediately after the start of hot compress massage, and a 138.4% increase persisted from care after the start. LF/HF decreased immediately after the start until approximately 5 min after the start 69.5% (P＜0.05), after which the decrease persisted. There were no significant differences in POMS before and after hot compress massage, but Tension-Anxiety showed a slight decrease and Vigor showed a tendency to increase. Hot compress massage takes about 8 min to administer, and the results of this study suggest that it is a form of care in which parasympathetic nervous activity functions significantly.

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 This study examined the correlation between cardiac load indicators and the time taken for a self-bed bath in order to develop a safer self-bed bath method and familiarize cardiac-disease patients with self-care. The subjects were 10 healthy adult males, who performed a self-bed bath of both the upper extremities and the thoracic-abdominal part while sitting on a bed vertically inclined at 60°. Pulse, blood pressure, and oxygen intake (VO₂) were measured before, during, and after the self-bed bath to calculate myocardial oxygen consumption (DP). The reciprocating self-bed bath motion was repeated five or ten times at 50 times/min. The results showed that the values for pulse, DP, and VO₂ (with time) significantly increased, suggesting that cardiac load might increase even with light motion. Cardiorespiratory dynamics and metabolism increased during the motion. Thus, to enable cardiac-disease patients to take a self-bed bath safely, a caregiver should observe the cardiac load on the patient based on the measured pulse and should consider the time taken for self-care.

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[in Japanese]

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 Patients have their body position changed every two hours to prevent bedsores. Much remains unclear about the pain patients endure when they maintain reclining position with dorsal elevation. Therefore, in this study, we aimed to clarify time-dependent pain experienced by patients in reclining position with dorsal elevation. The subjects were 32 healthy adult male and female volunteers assigned randomly to 4 groups of dorsal elevation angle：0° (control), 30°, 45°, and 60°. While maintaining a reclining position, they were measured in terms of subjective aspects (visual analog scale (VAS) scores, complaints of physical symptoms) and objective aspects (changes in body position, LF/HF ratio, body pressure, and muscular activity) for 120 min. We found that the VAS score significantly increased over time. Changes in body position, LF/HF ratio, body pressure, and muscular activity were significantly affected by time. Our findings suggest that maintaining a consistent reclining position with dorsal elevation for two hours is not comfortable, because over time pain increases, posture deteriorates, and sympathetic nervous system activity rises.

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 NICU healthcare workers have high knowledge of and belief in the usefulness of gloves to prevent the spread of infection. Although infection control measures are positively implemented, it is reported that the healthcare-associated infection rate in NICUs is high. This study aimed to clarify obstacles to the use of gloves and behavior related to the use of gloves to prevent infections, in order to obtain suggestions for new infection control measures concerning glove use in NICUs. Group interviews on glove use were conducted with physicians and nurses working at NICUs in four medical facilities in Japan, using Discovery and Action Dialogues (DADs). The qualitative data were extracted and categorized according to the following themes : obstacles to wearing gloves, a person who helps them overcome the obstacles to wearing gloves, and good practices for glove use. The DADs yielded eight categories on practices for the appropriate use of gloves, including hand hygiene from the fingertips through the elbow, methods to touch the buttons of medical devices, methods to access gloves and hand disinfectants, and environmental improvement to foster hand hygiene. To overcome the obstacles to using gloves, various measures regarding the way to use gloves and to maintain hand hygiene were exhibited at the individual level. However, further analysis is necessary to clarify the effectiveness of these measures. It was also found that infection control was supported by the involvement of the surrounding people in the NICU, indicating the importance of building a favorable relationship with others.

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 This study was performed to identify problems related to the method of exchange of needles during preparation of injections and to obtain suggestions for establishment of safer injection techniques. Data were collected through a questionnaire survey for hospital nurses that was conducted nationwide. The subjects were 729 nurses with a median of experience of clinical nursing of 15 years. For needle exchange, recapping with both hands, recapping with scooping in the tray, removing with a needle disposal box, and removing with hand. Furthermore, 61.3% of nurses who had experience of needle recognized that their method for exchange of needles during preparation of injections could be problematic. These findings suggest that a clean and safe method should be developed for exchange of needles without use of recapping.

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 In a clinical situation, the behavior of wiping off water drops on a wash basin counter with a paper towel, which was used to dry hands after washing them, is routinely observed. There are various bacteria on the wash basin counter. So, the purpose of this study was to examine the possibility that fingers can be contaminated by the behavior of wiping off water drops, by measuring adenosine triphosphate (ATP) values. The ATP values are used as the indicator of bacterial contamination. This study consisted of 13 participants who were nursing students and teachers. The ATP values were measured on the surfaces of germfree gloves (palm, fingertip, between fingers), before and after wiping off water drops on a wash basin counter with a paper towel, after washing hands with running water, with the gloves on. We measured the difference between the ATP values before and after wiping and the relationship between the ATP values after wiping and the ATP values of the experimental environment and the number of paper towels used. The results revealed significant increase in the ATP values after wiping, on all parts of palm, fingertips, and between fingers, which indicated the possibility of contamination on the fingers caused by the behavior of wiping off water drops on a washbasin counter. No correlation was observed between the glove surface, the ATP values of the experimental environment, and the number of paper towels used. Furthermore, it was suggested that the behavior of wiping off water drops after washing hands can cause the risk of finger contamination.

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