The first purpose of this study was to observe superior gluteal nerve, artery, and vein of intramuscular injection sites in 24 buttocks of 14 cadavers. As intramuscular injection sites in the buttocks “right and/or left upper quadrant of the buttocks” and “the site of Clark” were taken in this study. When the injection needle prick the top of gluteus minimus muscle, 20 buttocks (83.3％) were observed damage to the backward branch of the superior gluteal nerve on “right and/or left upper quadrant of the buttocks.” And “right and/or left upper quadrant of the buttocks” had 2.6 times higher risk of damaging to the superior gluteal nerve than “the site of Clark.” Therefore “right and/or left upper quadrant of the buttocks” had high risk of damaging to the superior gluteal nerve, artery, and vein. The second purpose of this study was to measure sebaceous and muscular thickness of intramuscular injection sites in 76 buttocks of 43 cadavers. The sebaceous thickness of “the site of Clark” had a significantly thinner than “right and/or left upper quadrant of the buttocks” (p＜0.01). The gluteus medius muscular thickness of “the site of Clark” was thicker than “right and/or left upper quadrant of the buttocks (p＜0.01)”. These results were suggested that in comparison with “right and/or left upper quadrant of the buttocks,” “the site of Clark” is a safety site of intramuscular injection in the buttocks, because it has lower damages to the superior gluteal nerve, thinner sebaceous thickness, and thicker gluteus mediusmuscular thickness than “right and/or left upper quadrant of the buttocks.”

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　Heat application in the lumbar region using hot moist compresses is clinically used for the induction of bowel movement and flatulence. In this study, we developed a heat- and steam-generating sheet, which provides heat and steam more simply, safely, and stably than hot moist compresses, and examined the effects of the sheet applied to the abdominal region on bowel movement. The sheet is applied to the abdominal region using a holder, and maintains a temperature of 38-40℃ on the surface of the skin in contact with the sheet for more than 5 hours.
　The subjects were 59 middle-aged and elderly females with irregular defecation, with a mean age of 54.5. The sheet was applied to the abdominal region once per day during the examination period of 3 weeks. As a result, the number of subjects with constipation decreased from 26 to 9, and those with flatulence from 23 to 8. In 59 subjects, defecation increased from 4.1 days/week to 5.1 days/week on average (p＜0.01). These findings indicated that the heat- and steam-generating sheet produced parasympathetic predominance, enhanced gastric motility, and improved defecation, suggesting its usefulness for the improvement of constipation, flatulence, and defecation in particular.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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　In order to clarify what nursing techniques are used to administer glycerin enemas, nursing professionals were questioned about methods currently followed in clinical settings. Basic nursing curriculum textbooks were also surveyed on content for administering glycerin enemas.
　A written questionnaire was distributed to nursing professionals at the 5th Annual Meeting of the Japanese Society of Nursing Art and Science and a review was conducted of commercially available nursing texts containing information on administering glycerin enemas.
　Ethical considerations for the questionnaire included explaining its aims and providing appropriate assurances on voluntary participation and complete anonymity. As for the textbook analysis, the most recently published textbooks were selected without bias.
　The study covered types of lubricating liquid used, catheter lengths, insertion methods, postures at the time of insertion and main items to observe before, during and after administration. The textbook survey also included information on glycerin concentration and whether printed materials included references.
　Few textbooks cited references when describing techniques for administering glycerin enemas. Although most textbooks did not specifically address lubricants or proper direction for catheter insertion, nursing professionals indicated various methods were practiced in clinical settings. The recommended catheter length was 6-10 cm and key items to observe included a patient' s abdominal condition and vital signs. The rate of administration by nursing professionals was high and it can be inferred that much of their common knowledge about nursing techniques in this area is based on textbook content.
　Positions used in clinical settings including standing and crouching, however, were not covered in textbooks although nursing professionals indicated such positions were often utilized in actual practice.
　These results clearly indicate the necessity for a uniform means by which nursing professionals can judge the safety and suitability of administering glycerin enemas ; one that reflects the latest knowledge on the subject and takes the reality of the clinical situation fully into consideration.

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