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Annual Report 2018

Department of Nursing

Chie Asanuma

Introduction

 With its nursing philosophy of serving as a member of the team responsible for cuttingedge medicine in cancer and developing cancer nursing as a core hospital for cancer nursing in Japan, the NCCE Nursing Division has carried out activities based on the following key policies:

1. To respect the dignity and rights of patients regarding life and to provide comforting nursing focusing on the relationship of trust,

2. To pursue the essence of nursing and practice scientific and creative nursing,

3. To promote clinical research and transmit new information on cancer nursing, and

4. To nurture human resources who can be successful leaders.

 The Nursing Division also plays a role in ensuring a balance between the provision of highquality medical and nursing care and efficient management, and actively participates and contributes to hospital management.

Routine activities

1) Nursing activities

 To provide the best nursing that is safe and reliable, incorporate the progress in medicine, and meet the needs of patients and their families with an awareness and responsibility as nurses of the NCCE, the Nursing Division has provided nursing of higher quality by participating actively in hospital management through collaboration, cooperation and coordination beyond occupational boundaries and expanding the specialty of nursing; assigned personnel appropriately in order to handle the yearly increasing number of patients and amount of work; promoted work sharing and delegation in collaboration and coordination with doctors, administrators, nurse's aids such as nursing assistants and other co-medical personnel; and worked on system establishment, operation improvement, promotion of team medicine, promotion of community medicine partnerships, and human resource development to ensure highquality, efficient and effective nursing services.

 In FY 2018, the Admission Preparation Center was newly opened for all patients scheduled to be admitted to the hospital, including surgery patients. We established an environment where patients can comfortably receive inpatient care by taking measures including gathering information on the patient's background, living conditions, medical history and so forth; assessing risk and providing early intervention by a special medical team of diverse specialists according to the risk; and improving the safety and quality of inpatient life. We also established a system to ensure continuous support for patients after discharge while predicting the life after discharge based on inpatient care, in coordination with the Admission Preparation Center, Outpatient and Inpatient Wards and MSWs.

2) Educational activities

 The NCCE has constructed a system to assist career development, which is structured with an education system based on years of experience, in order to improve basic nursing practice capabilities, knowledge and skills related to cancer. However, recognizing that this support system was insufficient for evaluating the aptitude for career development, fairness, validity and so forth depending on individual backgrounds and capabilities, in FY 2017 we started a review on the current education program in cooperation with the NCC and the construction of a new career ladder system. This was completed in FY 2018 and is scheduled to start operation in FY 2019. We expect each nurse to be able to engage in self-improvement and development while assessing the level of their own capabilities, including the level of development in their specialty as a nurse, the level of capabilities for nursing practice and nursing administration, and the level as a specialist such as certified nurse specialist and certified nurse, by using this career ladder, and that it will be an effective tool in human resource development.

3) Certified nurse specialists and certified nurses

 In FY 2018, one nurse was certified as a certified nurse specialist in cancer nursing, one as a certified nurse in cancer chemotherapy, four as certified nurses in palliative care, and one as a certified nurse administrator, bringing the total to 11 certified nurse specialists in two fields, 40 certified nurses in eight fields, and certified nurse administrators. These staff are actively involved in each nursing unit as nursing practice models in specialty fields, and also in a cross-organizational manner as medical team members for infection control, palliative care, nutritional support teams and so forth.

 The in-hospital anti-cancer drug IV certified nurse curriculum, which was launched to improve the specialty of nurses and expand their operations, has entered its 5th year, with 117 inhospital anti-cancer drug IV certified nurses and four in-hospital certified nurses in radiation intravenous injection actively working in the clinical setting.

4) Management of certified nurse curriculum and training of certified nurses

 Our hospital has been highly evaluated for excellent medical care, nursing results, diverse range of instructors, and educational contents. We were authorized by the Japanese Nursing Association as a certified nurse educational institution with appropriate conditions for the education of certified nurses. The "Certified Nurse Curriculum Division" was established within the hospital to launch a "palliative care certified nurse curriculum" in 2015, "cancer chemotherapy nursing certified nurse curriculum" in 2016, and "cancer radiation nursing certified nurse curriculum" in 2018 to provide courses every year in 9-month curriculums so that the nurses can learn as they work.

 In 2018, eight nurses completed the curriculum in the cancer chemotherapy nursing field and 13 in the cancer radiation nursing field, and all of them passed the qualification examination.

 Since the curriculums were established, 93 nurses have completed the curriculum in the palliative care field over five terms, 29 in the cancer chemotherapy nursing field over three terms, and 13 in the cancer radiation nursing field over one term. Of these, 91 in the palliative care field, 29 in the cancer chemotherapy nursing field, and 12 in the cancer radiation nursing field passed the qualification examination of the Japanese Nursing Association. They are providing high-standard nursing by applying the nursing skills they have acquired, and are actively working in various medical institutions as certified nurses, helping to improve the care skills of nurses based on their three roles of practice, instruction and consultation.

Research activities

 In FY 2018, 35 presentations were made at academic conferences, including two overseas, with support from the NCCE clinical research support teams, nursing research support team comprised of certified nurse specialists and certified nurses, and nursing research committee.

 These support teams inspire the spirit of inquiry in nurses who are willing to bravely address questions in clinical practice, and provide support in research including advice during the research process.

 There were 20 publications in journals.

 We hope to continue improving the quality of nursing research in order to develop and publicize new and well-grounded cancer nursing from the NCCE.

Future prospects

 Our hospital is expected to make further progress as a core clinical research hospital aiming to be a base for developing new drugs and equipment at the highest level in the world and as an advanced treatment hospital which provides sophisticated, pioneering medical care.

 The NCCE Nursing Division will continue to secure and maintain a sufficient number of nurses and appropriate assignments, which will be the foundation for improving nursing quality and creating new nursing to support ever-evolving medical care, while providing sophisticated, pioneering medical care appropriate for a core research hospital and advanced treatment hospital, promoting clinical research and trials, and strengthening the medical safety system as a team medicine member.

 We will also strive to improve management in cooperation and collaboration with other divisions, recognizing that the philosophy and missions of the NCC cannot be achieved without stable management.