Optimizing care for patients with cancer require careful monitoring. This review aimed to identify facilitators and inhibitors for nurses in the implementation of patient-reported outcome (PRO) into clinical practice. The database search, such as PubMed, was conducted from January 17, 2017 to January 18, 2023 for English-language articles that described nurses’ perception of implementation of PRO. Selected factors were categorized into the Consolidated Framework for Implementation Research. In total, 24 articles were identified. It was found that it is necessary to provide individualized care for each patient (e.g., write in the free text box that consultation with a health care professional is needed), to ensure that patients and healthcare professionals share a common understanding of PRO, to have an open dialogue between facilitators and staff, and to provide a trial period to ensure that staff are confident in conducting PRO.

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The authors have conducted some conceptual analysis of the term “Fuon” applied by nurses in Japan to clarify its use.
The results revealed that nurses in Japan assess a patient to be in a state of “Fuon” when he is hyperactive and exhibits incomprehensible behavior to them， as well as when the nurses’ intentions are not being conveyed to a patient.
The results also show that nurses in Japan attempt to catch subtle signs in nursing care by using the term “Fuon” operationally to an extent instead of strictly applying it based on a rigid definition.
Accordingly， based on these findings， we surveyed nurses in each department where they provide care to patients who are amid “Fuon” to analyze the actual use of the term.
The findings showed wide variations about when and how to apply the term “Fuon“ based on their experiences and the departments they belong in.
Therefore， it is natural to assume that it can potentially harm patients when they receive treatments based on how the term “Fuon” was applied.
To avoid the risk， it is crucial not to overuse the term “Fuon，” which is vague and indicates a variety of different conditions. Alternatively， we should consider introducing terms based on the Richmond Agitation-Sedation Scale（RASS).

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Introduction: Dispensing errors involving drug preparation and inspection can lead to severe incidents, so pharmacists should develop strategies to prevent errors for patient safety.
Despite our efforts to improve dispensing procedures and develop strategies for dispensing errors, these errors were challenging to reduce in our facility.
For this reason, we introduced an information technology (IT)-based dispensing inspection support system to address these dispensing errors and verified the efficacy of introducing the system in reducing dispensing errors and improving patient safety.
Method: We introduced a system for assisting drug preparation (F-WAVE®, TOSHO) and inspection support system (C-correct II®, TOSHO). To verify the IT system’s efficacy, we analyzed the number of incidents, including near-misses, during the 12 months before and after March 2022, when we introduced the IT system to our facility. To confirm the contribution to patient safety, we analyzed the typical incident reports before introducing the IT system (January 2018 - February 2022).
Result: The average number of incidents significantly decreased before the introducing the IT system. Also, the number of near-miss incidents related to “Incorrect drug” and “Incorrect strength/dosage form” significantly decreased. On the other hand, the number of detected near-misses related to “Incorrect quantity” significantly increased after introducing the IT system. Dispensing errors that could have led to serious incidents reported before introducing the IT system but not after.
Discussion: The IT-based dispensing inspection support system was adequate to prevent errors in “Incorrect drug”, “Incorrect strength/dosage form”, “Incorrect quantity”, and improves patient safety.

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Many medical professionals are victims of disruptive clinician behavior (DCB), which interferes with team care and makes other staff uncomfortable. In the U.S., measures to eradicate DCB have been actively implemented, but measures in Japan have lagged. Therefore, this study conducted a questionnaire survey of comprehensive hospital staff (N=493) to quantitatively examine the reality of DCB victimization. The results showed that the majority of the staff who responded to the survey had experienced DCB victimization, and the majority of them had been victimized in the past year. Although DCBs were mainly committed by the same job group, DCBs from physicians to other job groups were also reported. Although downward DCBs by supervisors and senior staff accounted for 70% of the cases, upward DCBs by staff subordinate to them in occasional groups and positions were also observed in some cases. Increased victimization was concentrated among novices and soon after becoming proficient. Based on the above, we discussed how to detect and deal with the various DCBs that frequently occur in hospital organizations.

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Health insurance pharmacies face various near-misses, such as drug dispensing errors every day. The growing trend of pharmacy automation is fueled by innovation in robotics that increases medical safety and productivity of pharmacy operations to address these near misses. The main objective of this study is to evaluate the impact to medical safety and advantages in overall pharmacy operations from installing an automated robotic dispensing system in a health insurance pharmacy. The impact of the introduction of automation is measuring by tracking key indicators such as the number of picking errors of medications and demonstrating improvements before and after installation of the dispensing system. In addition, the study also surveyed pharmacist satisfaction to measure their response towards reduced burden relating to better dispensing operations and decreased mental burden from lesser picking errors of medications. Improvement of dispensing inspection time and patient waiting time were also shown. The introduction of the device not only improved medical safety, but also improved both the pharmacy operation environment and operation efficiency.

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The tasks of the patient safety training were a heavy workload for the general patient safety officers. We tried to improve the work related to training by introducing information and communication technology (ICT) in FY2019. We studied the total number of staff, the total working hours and the total number of work processes related to the training tasks, the training format and the attendance rate of FY2018, 2019 and 2020 respectively. The total number of staff in charge of the training decreased from 566 (FY2018) to 272 (FY2020). The total working hours decreased from 452.6 (FY2018) to 158 (FY2020). The total number of work processes decreased from 167 (FY2018) to 95 (FY2020). The training format changed from 100% on-site in FY2018 to 17% on-site, 17% web-based and 42% e-learning in FY2020. In terms of attendance, the percentage of those who completed two training sessions increased from 92.2%(FY2018) to 98.6%(FY2020). Furthermore, the number of those who did not attend any training decreased from 80 to 2. We concluded that the implementation of ICT has led to a reduction in training-related work and improved the status of training attendance.

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Aim: This study aimed to analyze and identify the related factors of the incident report of hemodialysis devices using the open access cases from the Japan Quality Council National Database.
Methods: We obtained the medical devices-related data during the financial year 2012 to 2021 from the open access data of the Japan Quality Council National Database. The data were analyzed using descriptive statistics. Quantitative data were categorized into related factors by content analysis by three researchers, nurses, and a clinical engineer. This study secondarily uses the data published by the Japan Quality Council after completing anonymization.
Results: Accident cases were more likely to occur during night/early morning than near-miss cases (38.5% vs 12.2%, p<0.001), required additional medical care (92.3% vs 52.6%, p<0.001), and multiple parties involved (34.6% vs 8.1%, p<0.001). By Hawkins’s SHELL model, the software has "no rules for managing before, during, or after device-use (17 cases, 65.4%)," hardware is "transparency of operations [3 cases, 11.5%])," and liveware has "low attentiveness" and "lack of awareness of risk or falsely low perception of risk” (19 cases, 73.1%).
Conclusion: To prevent incidents of hemodialysis, we believe it is necessary to collect medical device-related incident reports regularly and improve the quality of medical devices.

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