Effect of web-based assertion training for stress management of Japanese nurses.

AIM AND BACKGROUND: The purpose of this study was to examine the effects of web-based assertion training programmes for Japanese hospital nurses based on their assertion knowledge, attitude and behaviour, job stress and depression. Job stress has been reported to be high among Japanese hospital nurses, and it is thought that assertion, one type of communication skill, could help nurses to better manage their job stress. METHOD: Twenty-five nurses from an urban tertiary hospital in western Japan completed the 70-minute assertion programme during 3 weeks. The changes between pretraining and post-training and between pretraining and 1 month after the training were tested. RESULT: Results showed that assertion knowledge and voluntary behaviour in assertive behaviour had increased at post-training and remained higher a month later. With regard to job stress, mental workload decreased. CONCLUSION: The results show the effects of web-based assertion training on assertion skills and stress management for Japanese hospital nurses.

Methods developed to elucidate nursing related adverse events in Japan.

Financial resources for quality assurance in Japanese hospitals are limited and few hospitals have quality monitoring systems of nursing service systems. However, recently its necessity has been recognized. This study has cost effectively used adverse event occurrence rates as indicators of the quality of nursing service, and audited methods of collecting data on adverse events to elucidate their approximate true numbers. Data collection was conducted in July, August and November 2000 at a hospital in Tokyo that administered both primary and secondary health care services (281 beds, six wards, average length of stay 23 days). We collected adverse events through incident reports, logs, check-lists, nurse interviews, medication error questionnaires, urine leucocyte tests, patient interviews and medical records. Adverse events included the unplanned removals of invasive lines, medication errors, falls, pressure sores, skin deficiencies, physical restraints, and nosocomial infections. After evaluating the time and useful outcomes of each source, it soon became clear that we could elucidate adverse events most consistently and cost-effectively through incident reports, check lists, nurse interviews, urine leucocyte tests and medication error questionnaires. This study suggests that many hospitals in Japan could monitor the quality of the nursing service using these sources.

Role expectations of nurses in health service facilities for the elderly.

In order to investigate nurses' roles in health service facilities for the elderly in Japan, questionnaires were mailed to institutional managers, nurse managers and care work leaders of all registered facilities. Among 2244 facilities, responses were received from 479. Role expectations of nursing personnel were largely similar among the managers of the three fields. They regarded medical treatment, medication administration, health status monitoring and general care management as within the domain of nursing, whereas they regarded environmental regulation, recreational activities and rehabilitation as less suited to nursing personnel. Although there was basic agreement, care work leaders were more likely to expect nursing personnel to participate in matters of personal care, and nurse managers were more likely to view matters related to admission/discharge, which were actually shared with support counselors, as belonging to the domain of nursing. Role expectations of nursing personnel will change especially at the margins of other professions, as the other professions develop.