Full implementation of a computerized nursing records system at Kochi Medical School Hospital in Japan.

A project to fully implement a novel computerized nursing records system resulted in the standardization of nursing records, reduced the administrative workload for staff, enabled medical staff to know a patient's status at any given time, and improved the quality of nursing care provided to patients. The development process of the computerized nursing records system involved three main steps: 1) the establishment of a new nursing assessment form and introduction of nursing diagnosis into routine work, 2) computerized system design and construction, and 3) the usability check of the computerized nursing records system in a clinical setting for 1 year. The successful development of the computerized nursing records system was based on the following points: 1) the assessment form for nursing diagnosis was improved and the nursing diagnosis was introduced before the computerized system was designed and constructed; 2) full, rather than partial, implementation of the computerized system occurred; 3) existing knowledge of nursing assessments and standard care planning were fully used; 4) registered data were optimally reused upon summarization and readmission to reduce the nurses' workload; and 5) portable computers were introduced to enable simple and quick recording of bedside findings. The routine use of the computerized nursing records system was started in April 2000. More comprehensive investigations during the next 2 to 3 years are necessary to determine how the contents of nursing records can be improved and how much the computerized nursing records system affects the quality of nursing.

[Characteristics of psychosocial nursing care--the dimensions of psychosocial nursing care to promote empowerment among patients].

UNLABELLED: Nurses provide the psychosocial nursing care to promote the patients' empowerment. In spite of recognizing the importance of psychosocial nursing. The research reported here is part of a large study designed to explore the psychosocial nursing intervention strategies. This part of the study is focused on characteristics of psychosocial nursing care as identified by nurses. Research design was descriptive and qualitative. Subjects were a convenient sample of nurses who have more than 5 years experience and agreed to participate in this research. Data was collected through semistructured interviews. Data was recorded on a tape and transcribed, then analyzed based on Grounded Theory Approach. SUBJECTS: The number of subjects consisted of 39 nurses. The average age and duration of clinical experience was 36.6 years old and 12.6 years. RESULT: Sixteen of the characteristics of psychosocial nursing to promote the empowerment among the patients were identified; 1) respect the patients' decision making, 2) clinical judgment from multiple perspectives, 3) predictability, 4) flexibility, 5) classification of the patients by comparison, 6) monitoring, 7) relief from reality, 8) relief from pain and suffering, 9) enhancement of the patients' ego strength, 10) nurture of hope, 11) support individualized daily living styles, 12) encouragement of the patients'own problem solving abilities, 13) respect of individuality, 14) self-utilization, 15) self-control based on professional identity, 16) utilization of team power. DISCUSSION: Nurses choose from the sixteen dimensions of psychosocial nursing and organizing them in order to stabilizing the patients' conditions.

[The relationship between the family system and the family coping among families with a chronically ill child].

The purposes of this study were to identify the family coping strategies among families with chronically ill children and to explore the relationship between the family system (variables), the family burden and the family coping. One hundred fifty-two families with chronically ill children were studied. The Japanese version of Family Adaptability and Cohesion Evaluation Scales II and the Family Coping Behavior Inventory II were used. The result were 1) the family cohesion and adaptability in families with a chronically ill child tended to be lower than normal families; 2) the integration coping pattern was positively related with family cohesion and the family burden; 3) the problem solving coping pattern was positively related with the family burden; 4) the normalization coping pattern was negatively related with the family burden and positively related with the family cohesion; 5) the crisis response coping pattern was positively related with the family burden and negatively related with the family cohesion.