Nursing Division

Introduction
Our Division attained the 10th anniversary of founding the principle of "Nursing to meet the patients' desire". During the past 10 years, cancer treatment modalites have improved remarkably, and the expectation of people to the medical treatments has been changing. Considering the above, we have provided various nursing practices in which we concerned ourselves with improving the quality of life (QOL) of the patients fighting against their cancer or those requiring palliative care.
At the start of this fiscal year, we aimed to achieve the following four objectives of nursing.
1. To evolve the quality of nursing through;
i) Practicing nursing based on the available evidence
ii) Providing mental and social support to the patients based on a reliable relationship
2. To fulfill nursing responsibilities in;
i) Making patients' living environment more comfortable
ii) Conducting appropriate clinical paths
3. To promote more learning from the actual daily work
4. To have administrative point of view in our nursing practices

Routine Activities 
In this April, we had increase of 8 staff nurses, and a total of 258 nurses including 8 part-timer and 29 nurse's aides who cared for 512.9 outpatients per day and 383.8 inpatients per day during the year of 2002. The average hospital stay of inpatients was reduced from 20.8 to 19.9 days. As a result, nursing care in the ward has become much more pressing and intensive than before. The reduction of hospital stay has also increased the number of outpatients who need intravenous chemotherapy at the ambulatory treatment center, from 7, 510 to 7,630 cases in this year, although oral chemotherapy has been widely used recently.
The number of patients who underwent surgical operation under general anesthesia has increased from 1,965 in 2001 to 2,208 in 2002. Also, the number of patients who underwent chemotherapy and/or radiotherapy is increasing. In other words, all of the hospital functions are fully utilized, and recent nursing workload cannot be compared with that in the previous years. It is, therefore, necessary to take measures to avoid burnout syndrome in nursing staff.
In our division the educational team prepares compulsory subjects in postgraduate training courses for first-, second- and third-year nurses. In addition, for those having four years or more experience it also prepares the optional programs of units I (special lecture) and II (original research) for the specialist. As part of our overseas training program, we sent two nurses to Mayo Clinic in U.S. and one nurse to North London Hospice in U.K as four-week trainees this year.
As to the research activities, 15 papers were reported at the general meeting of The Cancer Nursing Society and some other meetings, and 8 articles were published in the nursing journals during the year of 2002.
We regularly accepted trainees from outside our hospital on the following programs.
1. At the palliative care unit: We prepare a specified course for the degree of Certified Expert Nurse (CEN) in palliative care given by Japan Nursing Association (JNA), or conventional one for nurses and visitors coming from various places in Japan.
2. At the general wards: We also prepare a specified course for the CEN in cancer chemotherapy or that of infectious disease, i.e., Infection Control Nurse (ICN) given by JNA.
3. We accepted the students of Chiba Prefectural Noda Nursing School for bedside training.

New Developments
1. Acceptance of trainees majoring ICN from the Postgraduate Educational Division of National Nursing College (January to February).
2. Introduction of nursing support programs in computerized hospital information system named 'MIRACLE'(February)
3. Increase of one more deputy director in the Nursing Division (April)
4. Reconfirmation of nursing activities and services for the coming inspection to assess Hospital Accreditation Standards (April to December)
5. Start of the infection control team (ICT) including ICN, and link nurses in the wards (June)
6. Receiving the full time instructors for teaching postgraduate nurses of National Nursing College, according to the project of unifying the field of education and clinical practice with a support of advisory committee consisting of supervisors in our hospital (July)
7. Establishment of nursing teams attached to the bedsore-care committee (August)
8. Appointment of a risk management specialist for stepping up the prevention of medical accident or incident (October)
9. Holding the Extension Seminar of Cancer Nursing as 10th anniversary of founding of the hospital (October)
10. Conduction of critical paths for cancer nursing (December)

F. ADACHI

Number of nurses that visited the NCCHE

	1995	1996	1997	1998	1999	2000	2001	2002	Total
Palliative care unit	23	32	21	18	14	13	11	18	150
		(3)	(2)	(2)
General facilities	7	25			1	7	14	6	60
Total	30	57	21	18	15	20	25	24	210

( ) : those from foreign countries

Table of Contents