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Annual Report 2021

Department of Nursing

Miho Kurihara, Kazue Hayasaka, Tamae Hiramatsu, Miki Kondo, Chiemi Saito, Megumi Yamagishi, Emiko Yasukawa, Mifumi Nakajima, Emiko Sasai, Aki Yaguchi, Makiko Suzuki, Nao Katagiri, Akiko Murayama, Wakana Kitazawa, Michiko Murata, Yoshiko Kaneda, Chisato Ichikawa, Kayoko Nakata, Yuta Hirano, Mayumi Hara

Introduction

 With its nursing philosophy of contributing as active members of the team responsible for state-of-the-art cancer treatment and participating in the development of cancer nursing at the core hospital providing cancer nursing care in Japan, the NCCE Nursing Division conducts activities according to the following key policies:

1.  To provide nursing care founded on trust and reassurance, respecting the patients' rights and their dignity regarding life,

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

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

4.  To promote the development of leadership skills.

 In addition, the Nursing Division is responsible for ensuring a balance between the provision of high-quality medical and nursing care and efficient management, and actively participates in and contributes to the management of the hospital.

Routine activities

1) Nursing activities

 To provide the best nursing that is safe and reliable, embraces the medical advances and meets the needs of patients and their families with an awareness and sense of responsibility as nurses of the NCCE, the Nursing Division actively engages in the following activities: participating in hospital management in a coordinated, cooperative and collaborative manner that goes beyond occupational boundaries; providing high-quality nursing while expanding the nursing specialty; and assigning personnel assignment appropriately in order to handle the yearly increasing number of patients and workload. We also promote decision-making and the division and transfer of operations in coordination and collaboration with doctors, nurses’ aides such as clerks and assistant nurses, and other co-medicals, and are establishing a system to provide high-quality, efficient and effective nursing services to improve operations, promote team medicine, promote medical cooperation within the region, and develop human resources.

 As a result of strengthening the centralization of the understanding of the bed situation in order to smoothly operate the bed through the head nurse, the bed occupancy rate increased by 103.6% (103.2% in 2020), contributing to hospital management.

 We opened Outpatient Cancer Chemotherapy Nursing Care, comprising two full-time nurses certified in cancer chemotherapy nursing in the Department of Cancer Chemotherapy, following the opening of Outpatient WOC (Wound Ostomy Continence), Outpatient Nursing Care for Women, and Outpatient Radiology Nursing Care. We established a system where we can continuously provide supplementary explanations on treatments, risk assessment, prevention and handling of adverse effects, etc., including before, during and after chemotherapy, so that patients can complete chemotherapy more safely and easily. For the future, we plan to continue expanding our services in areas where specialists including certified nurses and nurse specialists can fully demonstrate their respective strengths and play active roles.

 At the Hospitalization Preparation Center, which was established in the outpatient department, we are working to strengthen the hospitalization/discharge support system and PFM (patient flow management). It is now possible to provide multifaceted support, including ethical aspects, even before hospitalization.

2) Educational activities

 Conventionally, the in-hospital education program of our hospital was designed and operated to support career enhancement. Its main structure was an education system based on years of experience with the purpose of improving basic nursing skills, as well as knowledge and skills related to cancer.

 Since April 2019, we have been operating a career ladder system that evaluates the aptitude, fairness, and validity of career advancement according to the background and abilities of individual nurses.

 By using this career ladder, it is now possible for individual nurses to work on self-improvement and human resource development while assessing the extent of their own abilities, such as specialized nursing skills, practical nursing abilities and nursing management abilities. We expect that the career ladder system will also be an effective tool for human resource development.

3) Certified nurse specialists and certified nurses

 In FY 2021, the following nurses became newly certified: three certified nurses in cancer chemotherapy nursing and two certified nurses in wound, ostomy and continence nursing.

 There are now 11 certified nurse specialists in two areas, 48 certified nurses in 10 areas, and three certified nurse administrators. These staff serve as role models in nursing practice in their respective specialty fields and provide education, instruction, etc. to patients and staff in various nursing units and outpatient nursing care. They also work in cross-organizational roles as members of medical teams such as infection control, palliative care and nutrition support.

 Six people in six categories have completed the specific action training, contributing to the expansion of the role of nurses and the task shift in doctors' work.

 The in-hospital anticancer drug IV nurse curriculum, which was launched to improve the specialty of nurses and expand their operations, has entered its eighth year, and 134 in-hospital certified nurses in anticancer drug IV and 20 in-hospital certified nurses in radiotherapy intravenous injection are currently working actively in the hospital wards, Outpatient Treatment Center, Department of Radiological Diagnosis, etc.

 We provided online “Open Cancer Nursing Seminars” and “Communication Skills Training” sessions to help cultivate nurses outside our hospital. All of these training programs have been attended by many nurses from all over the country and have been highly acclaimed.

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

 Our hospital was accredited by the Japanese Nursing Association as an educational institution that is equipped to educate certified nurses. The association rated us highly for our excellent record of medical and nursing care, rich educational human resources, and the content of our education programs, establishing “certified nurse curriculums” within the hospital. We launched a “palliative care certified nurse curriculum” in 2015, “cancer chemotherapy certified nurse curriculum” in 2016, and “cancer radiation therapy certified nurse curriculum” in 2018.

 In 2021, 14 trainees completed the curriculum in cancer chemotherapy and are currently waiting for the qualification examination.

 Since the curriculums were established, 93 trainees have completed the curriculum in the palliative care field over five terms, 37 trainees have in the cancer chemotherapy field over four terms, and 23 have in the radiation nursing field over two terms. Of these, 91 in the palliative care field, 36 in the cancer chemotherapy field, and 23 in the cancer radiation nursing field passed the qualification examination of the Japanese Nursing Association. They are now actively working in their respective medical institutions as certified nurses, providing high levels of nursing using advanced nursing skills and helping to improve the care skills of nurses based on their three roles of practice, instruction and consultation.

Research activities

 In FY 2021, 29 presentations were made at academic conferences, with support from the NCCE clinical research support teams, the nursing research support team consisting of certified nurse specialists and certified nurses, and the nursing research committee. These support teams provided advice during the research process and inspired nurses to tackle challenges and issues that arise in clinical practice. In addition, one article was published in a journal.

 At the 36th Annual Conference of the Japanese Society of Cancer Nursing held in 2021, the Nursing Division of our hospital led the planning and management, bringing new knowledge to nurses involved in cancer nursing nationwide.

Future prospects

 As a core clinical research hospital, we are expected to make further progress and become a world-leading base for the development of new drugs and equipment, and to provide pioneering medical care and advanced treatment.

 As a member of team medicine, the NCCE Nursing Division will continue to secure, cultivate and appropriately assign nurses as the foundation for improving nursing quality and to adapt nursing to keep up with the evolution of medicine. We will also provide pioneering medical care fit for a core clinical research hospital and advanced treatment hospital, promote clinical research and trials, and strengthen the medical safety system.

 Recognizing that the philosophy and mission of a cancer research center cannot be achieved without stable management, we will keep improving our management in cooperation and collaboration with other departments.