The purpose: We aimed to examine the relationship between emotional labor and basic communication skills, sympathy as aid communication skill for psychiatric nurses.

Methods: A questionnaire survey was conducted using nurse's emotional labor measurement scale (ELIN), communication skill scale ENDCOREs, multidimensional empathic scales (MES). Factor analysis of each scale was carried out and the factor structure was confirmed. Covariance structure analysis was performed to verify the association between each subscale. Covariance structure analysis set ENDCOREs and MES as independent variables, ELIN as dependent variable, and ENDCOREs as a parameter of MES.

Results: As a result of covariance structure analysis, ENDCOREs showed a significant positive direct effect on ELIN. MES "viewpoint acquisition" showed a significant positive direct effect on ELIN’s "exploratory understanding", "expression suppression", "representation of care". "Affected” showed a significant positive direct effect on ENDCOREs and showed a significant negative direct effect on ELIN. "Self-directed reaction" and "self belief" showed a significant negative direct effect to ENDCOREs and showed a significant positive direct effect on ELIN. "Other-oriented response" showed a significant positive direct effect on ENDCOREs "acceptance of others" and "deciphering ability", and showed a significant negative direct effect on ELIN "expression suppression".

Conclusion: It was suggested that development of a program to improve communication skills is essential for carrying out emotional labor.

View full abstract

Objective: The objective of this study was to investigate the usefulness of a method of referencing manuals using personal electronic devices by determination and comparison of the number of references to ward manuals and the number of incident reports.

Subjects and methods: The participants were 70 nurses who were using ward manuals. Three conditions were established: a control phase, in which only a Web version of the electronic manual was made available; an instruction phase, in which the nurses were instructed to perform tasks in compliance with the ward manual; and a device-use phase, in which the ward manuals could be viewed using personal electronic devices. The number of times the manuals were referenced and the number of incident reports during each phase were tabulated and analyzed using statistical methods.

Results: The median number of references to ward manuals per day (quartile deviation in parentheses) in each condition was as follows: 2 (0.75) in the control phase, 1.5 (1.13) in the instruction phase, and 3.5 (1.63) in the device-use phase. The number of references in the device-use phase was significantly greater than in the control and instruction phases (p < 0.05). The median number of incident reports per day (quartile deviation in parentheses) in each condition was as follows: 2 (1.25) in the control phase, 0.5 (1) in the instruction phase, and 1 (2) in the device-use phase. The number of incident reports in the instruction phase was significantly smaller than in the control phase (p = 0.02).

Conclusions: Improving accessibility increased the number of times ward manuals were referenced, and the findings suggested that the number of incident reports decreased with instruction to perform repeated tasks in compliance with the manuals.

View full abstract

Reports of the Cause Analysis Committee of the Japan Obstetric Compensation System for Cerebral Palsy were reviewed to determine whether due consideration was given to “non-punitiveness” and “confidentiality” as required by the World Health Organization (WHO) Draft Guidelines for Adverse Event Reporting System, and also whether consistent criteria were used in medical assessments of different cases. The review results indicated inadequate consideration of confidentiality, as the medical institutions could be identified from the summary versions of cause analysis reports available on the website of the Japan Council for Quality Health Care, coupled with the court's decision letters.

In addition, text indicating “low standard of medical care” was used in 330 of 442 reports (75%). Among them, regarding Caesarean decision, 53 reports (12%) contained wording indicating a possibility of avoiding predisclosure of possible negative outcome to the patient, which could be used in liability pursuit. Regarding the act of replacing a prolapsed umbilical cord, assessment of this same medical procedure varied across cases, indicating a possibility of impaired reliability. Since summary versions of cause analysis reports are open to the public, these issues of report descriptions will require discussion.

View full abstract

“The Work Environments and Management System from the Perspective of Quality and Safety in Healthcare Working Group” has been considering safe work environments since 2013. In FY 2017, we examined how the promotion of “work style reform” conducted by the government affected the way healthcare workers work. In March 2017, the government compiled “The Action Plan for the Realization of Work Style Reform” incorporating measures to rectify long work hours such as setting a penalized upper limit on working hours. Although physicians are subjected to the working hour regulation, a period of five years has been given until the application of regulation. However, doctors' long and continuous work hours have become a social problem lately. Therefore, hospitals that were handled exceptionally because of the specialty of contents of the operation are currently being actively investigated by the Labor Standards Inspection Office.
At the 12th annual congress of Japanese Society for Quality and Safety in Healthcare, we clarified the viewpoint of the inspection of the Labor Standards Inspection Office for hospitals, and cases of physicians, pharmacists, and nurses were reported. This report is the summary of the symposium WG-2 of the 12th annual congress of Japanese Society for Quality and Safety in Healthcare.

View full abstract