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application/pdf, 【目的】COVID-19の影響により臨地実習などの制約を受けた新人看護職員に対する本大学基盤型卒前・卒後フォローアップ研修のニーズ調査の結果、企画と実施状況、参加者からの評価を報告し、今後の研修での取り組みの資料とする。 【方法】2021年度卒業予定の本学看護学科4年生87名を対象に、どのようなフォローアップ研修を希望するかのニーズ調査を行い、研修内容を決定した。2022年3月に計6回の卒前研修、5月から8月に計4回の卒後研修を実施し、各回の参加者に評価とその理由についてWeb調査した。 【結果】ニーズ調査（回収率43.6％）において要望の多かった「診療に伴う援助技術（96.2％）」「フィジカルアセスメント（88.5％）」「生活援助技術（84.6％）」等に沿って研修内容を組み立てた。卒前研修は講義・演習、セルフトレーニング、卒後研修は講義、演習、参加者同士の情報交換会とした。卒前研修には本学卒業生が延べ68名、卒後研修には本学卒業生以外の新人看護職員を含めて延べ83名が参加し、研修を肯定的に評価した。卒前研修の評価理由は「復習になった」「今後の自分の気持ちの持ちようを学べた」等、卒後研修は「基本内容が確認できた」「知識の再獲得と新しい知識が習得できた」等であった。 【結論】2年目に入った大学基盤型フォローアップ研修により、新人看護職員の復習あるいは知識・技術の修得を支援し、かつメンタルヘルスサポートを効果的に実施できた。

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目的：A県の高齢者向け住まいのサービス提供体制と医療的ケア及び看取りの受け入れ意向との関連を明らかにする．方法：A県の高齢者向け住まい（463か所）に勤務する管理者等を対象とし，入居者の状況，サービス提供体制等の自記式質問紙調査を実施した．サービス提供体制と医療的ケア及び看取りの受け入れ意向の有無との関連について，χ2検定又はFisherの直接確率検定を行った．結果：有効回答は130施設（有効回答率28.1％）であった．医療的ケアの受け入れ意向では，「施設に看護師が常駐」「夜間ケアを提供する職員の配置」等の11項目，看取りの受け入れ意向では，「施設に常勤の介護職員」「施設に常勤の看護師」「協力医療機関の24時間緊急往診要請への対応」「看取りのマニュアルの整備」等の14項目に関連があった．結論：高齢者向け住まいにおける医療的ケア及び看取りの受け入れには，看護職員・介護職員の配置及び医療機関等との連携の必要性が示唆された．, Objectives: To clarify the relationship between the service provision system of housing for the elderly in A prefecture and the intention to accept medical care and end-of-life care.Method: A self-administered questionnaire survey was conducted on residents’ status and components of the service provision system for managers working in residences for senior citizens in A Prefecture (463 facilities). The χ2 test or Fisher’s exact test was performed on the relationship between the service provision system and the intention to accept medical care and end-of-life care.Results: 130 valid responses were returned (effective response rate 28.1%). For the intention to accept medical care, 11 items were extracted, including “nurse resident in facility” and “allocation of staff providing night care”. For the intention to accept end-of-life care, 14 items were extracted, including“ full-time caregiver at facility”,“ full-time nurse at facility”,“ responding to 24-hour emergency visit requests with cooperating medical institutions” and“ maintenance manual”.Conclusion: It was suggested that the placement of nursing staff and cooperation with medical institutions are necessary for the acceptance of medical care and end-of-life care for the elderly., 報告

目的：群馬県訪問看護事業所における医療処置及び人工呼吸器装着者の事故発生状況，安全対策への取組を明らかにし，地域における安全対策の体制整備を検討する．方法：群馬県の訪問看護事業所の管理者421人を対象に自記式質問紙調査を実施した．有効回答は67人（15.9％），記述統計量を算出し，自由記述は類似性に基づき整理した．結果：医療処置の事故は訪問看護提供時間内に14件（n＝31），影響度はレベル3以下，人工呼吸療法に関する事故は介護者在宅時が11件（n＝25），影響度はレベル4が1件（4.0％），レベル5が3件（12.0％）であった．発生時の対応は，介護職のケア時間に発生した事故の検討47.4％，地域の多機関で話し合う30.6％であった．結論：人工呼吸器装着者の安全対策は，介護者のみの時間の療養者・家族が行う対策が重要であり，支援チーム，地域の多機関での事故に関する情報共有・検討が課題である．, Purpose: This study examined the development of local safety measure systems by clarifying the incidence of accidents in medical procedures and among users of ventilators, as well as initiatives for safety measures at home-visit nursing stations in Gunma Prefecture.Methods: A self-administered questionnaire was distributed to 421 administrators of home-visit nursing stations in Gunma Prefecture and valid responses were obtained from 67 respondents (15.9％). Each item was subject to descriptive statistics and open-ended answers were organized based on similarities.Results: The respondents reported 14 (45.2％) medical procedure accidents that occurred during home-visit nursing hours with an impact level on patients of 3 or lower, and 11 (44.0％) ventilation therapy accidents that occurred while the caregiver was home, one of which had an impact level of 4 (4.0％) and three of which had an impact level of 5 (12.0％). Measures taken to address accidents were investigations into accidents that occurred during care hours by care workers in 47.4％ of cases and discussions among various local agencies in 30.6％ of cases.Conclusions: Regarding safety measures for users of ventilators, measures carried out by the patient and their family while only the caregiver was home were important. In the future, it is necessary to address the sharing and review of information on accidents among support teams and various local agencies., 報告

目的：全国及び群馬県の訪問看護ステーション（以下，ST）の経営状況と事業所特性及び地域特性，経営管理との関連を明らかにし，比較検討する．方法：全国2,000人及び群馬県163人のST管理者を対象とし，自記式質問紙調査を実施した．有効回答は全国473人，群馬県55人で，経営状況と各項目との関連はχ2検定及びKruskal-Wallis検定を，さらに経営状況を目的変数とするロジスティック回帰分析を行った．結果：全国では，看護師常勤・看護師非常勤・事務職員非常勤の従業者数，1人1日平均訪問回数，北海道・東北地域，収支のモニタリングが黒字に関連していた．群馬県では関連がみられず，全国に比して赤字のST割合が多く，経営管理の得点が低かった．結論：経営状況の改善には，ST規模の拡大やST管理者の収支のモニタリングに焦点を当てた行動の有効性が示唆された．群馬県では，経営管理に関する分析の強化が必要である．, Objectives: The financial status of home-visit nursing stations (STs) was analyzed in relation to business office characteristics, local community characteristics and business management, and the results between Gunma Prefecture and all prefectures in Japan were compared.Methods: A self-administered questionnaire survey was completed by 163 ST managers in Gunma Prefecture and 2000 ST managers from all over Japan. Valid responses were collected from 55 managers from Gunma Prefecture and 473 managers from all over Japan. The association between management status with each variable was analyzed by the chisquare test and Kruskal-Wallis test. In addition, logistic regression analysis was carried out with the status of management as the dependent variable.Results: For STs all prefectures in Japan, profitable business (black-ink balance) was associated with the number of employees (full-time nurses, part-time nurses and part-time clerical staff), the mean number of care receiver homes visited daily by each nurse, the district (Hokkaido/Tohoku) and revenue/expenditure balance monitoring. In Gunma Prefecture, the percentage of red-ink operation STs was higher and the score for business management was lower than in all prefectures in Japan.Conclusions: These results suggest that management actions focusing on expansion of the scale of STs and on revenue/ expenditure balance monitoring by ST managers are effective in improving the status of management. In Gunma Prefecture, reinforcement of how to analyze business management is needed., 原著

Lobomycosis is a chronic fungal disease caused by the etiologic agent, Lacazia loboi, in the skin and subcutaneous tissues in humans and dolphins in tropical and transitional tropical climates. An Indo-Pacific bottlenose dolphin (Tursiops aduncus) stranded in Kagoshima, Japan, had severe skin lesions characterized by granulomatous reactions and hyperkeratosis that were similar to those of the lobomycosis, but no fungal organism was observed in the skin lesion. In this paper, we report a stranded Indo-Pacific bottlenose dolphin with lobomycosis-like lesions based on pathological examinations in Japan.