Annual Report 2017
Department of Nursing
Chie Asanuma
Introduction
The Department of Nursing of the National Cancer Center Hospital East (NCCHE), as a member of the cutting-edge cancer medical team and a core hospital for cancer nursing in Japan, strives hard to fulfill its responsibility to improve cancer nursing. Under this nursing philosophy, we perform our duties according to the following basic policies:
1) Respect the dignity and rights of patients' lives and value relationships with patients to provide comforting care.
2) Pursue essential nursing and conduct scientific and creative care.
3) Promote clinical studies and disseminate novel information on cancer nursing.
4) Train prospective leadership-position personnel.
The Department of Nursing also actively participates in planning hospital management by providing good medical and nursing services and pursuing operational efficiency in a harmonious way.
Routine activities
1. Nursing
The staff of the Department of Nursing shoulder responsibility as members of the NCCHE. Accordingly, we seriously engaged in the following approaches: (1) We actively participated in planning hospital management under multidisciplinary coordination, collaboration, and cooperation to deliver the best, safe, robust care which meets the needs of patients and their families, (2) We optimally assigned personnel to expand nursing expertise in order to provide high-quality nursing and cope with the increasing number of patients and workloads, (3) We strengthened decision-making abilities and operational collaboration with doctors, (4) We promoted work sharing and transfer with auxiliary personnel including clerks, nursing assistants, and other co-medicals. Through such efforts, we sought to achieve the followings and provide high-quality, efficient, and effective nursing services: (1) System organization; (2) Operational improvement; (3) Team medicine promotion; (4) Community healthcare linkage promotion; and (5) Personnel training and staffing.
2. Training
Our in-hospital training programs comprise two major types of training: Basic Training, which provides basic nursing knowledge and skills, and Special Training on Cancer Nursing, which provides cancer nursing practice.
The in-hospital training program aims to produce nurses who can mitigate patients' distress with basic nursing knowledge and skills as well as excellent expertise and skills related to cancer, and who provide patient-oriented "palliative care" for patients and their families. Patients can thus receive treatment and care which patients and their families themselves select, while we can utilize our specialties in practice.
We support the professional development and career enhancement of nurses by providing in-hospital training programs for nurse administrators, researchers, and instructional leaders, and we actively help aspiring nurses to participate in further education, overseas training, and out-of-hospital training.
For nurses working at other institutions, we held training including "Communication Skills in Cancer Medicine Training", "Programmed Training on Delirium", "Programmed Training on Dementia", and "Cancer Nursing Open Lecture" to improve nursing quality and to help participants to enhance their careers at the NCCHE and other institutions.
3. Certified Nurse Specialists and Certified Nurses
In 2017, our staff gained the following nursing qualifications: three and one certified nurse specialists in cancer nursing and in liaison psychiatry, respectively, and two certified nurses in cancer chemotherapy. Consequently, we now have nine certified nurse specialists in two fields, 34 certified nurses in eight fields, and two certified nurse administrators. With this new staff lineup, each of our nursing units is striving hard to serve as a nursing practice model in specialized fields. At the same time, we are actively serving as members of medical teams including infection control, palliative care, and nutrition support teams in a multidisciplinary manner.
Four years have passed since the introduction of the Anticancer IV In-Hospital Certified Nurse Education System, which was brought in to expand the expertise and work areas of nurses. Through this system, we have 100 anticancer IV in-hospital certified nurses and four in-hospital certified nurses to conduct IV injection of radioimaging agents, and they are now playing an active role in practice.
4. Management of Nursing Training Programs for Credentialing and Nurturing Certified Nurses
The NCCHE is highly evaluated for our excellent medical and nursing track record, adequacy in the number of high-quality instructional leaders, and training contents. The Japanese Nursing Association certified the NCCHE as an educational institution which has excellent conditions for offering education to become a certified nurse. In response to such certification, we established the Department of Certified Nurse Curriculum, then developed a Curriculum for Certified Nurses in Palliative Care in 2015, and a Curriculum for Certified Nurses in Cancer Chemotherapy in 2016. We run these two courses every year, with a nine-month period of education. Nurses can study these curriculums while working.
In 2017, 20 staff completed the Curriculum for Certified Nurses in Palliative Care and 11 staff completed the Curriculum for Certified Nurses in Cancer Chemotherapy, and they are now preparing to take the qualification exam for the certifications.
Since these curriculums were set up, we have run the Curriculum for Certified Nurses in Palliative Care five times, which a total of 94 staff completed, and the Curriculum for Certified Nurses in Cancer Chemotherapy two times, which a total of 21 staff completed. Of the staff who completed these curriculums, 71 certified nurses in palliative care and 13 certified nurses in cancer chemotherapy passed the Japanese Nursing Association's qualification exam for certification. These certified staff are now providing high-standard care using the advanced palliative care nursing skills they have learned. At the same time, they are playing an active role in improving care nurses' skills by fulfilling the three duties of: providing high-standard care, giving instruction on practice, and offering advice to nurses. Their efforts are greatly contributing to the respective medical institutions to which they were dispatched as certified nurses.
Research activities
In 2017, we made conference presentations on 38 subjects including one subject presented overseas. The number of researches increased largely thanks to support from a clinical research support team and nursing-research support team comprising certified nurse specialists and certified nurses in the NCCHE. These support teams stimulate nurses' ambitions and help with their studies by answering questions which they encounter in practice.
A total of 34 articles were published in journals. In February 2018, we published a book titled "Skill Up on Cancer Chemotherapy and Biotherapy Nursing" in joint authorship with the Department of Nursing of the National Cancer Center Hospital (NCCH).
We aim to further improve the quality of our nursing research, and to disseminate new evidence-based cancer nursing from the NCCHE.
Future prospects
The NCCHE is expected to make further progress as a core hospital for clinical research and for developing world-leading new drugs and equipment. We are also expected to serve as an advanced treatment hospital that provides the cutting-edge medical care.
The Department of Nursing of the NCCHE, as a member of team medicine, will strive hard to provide high-quality pioneering medical care appropriate for a research core base hospital and an advanced treatment hospital with special functions, to promote clinical studies and trials, and to strengthen medical-safety systems. Meanwhile, to address the evolving needs of medical care, we will work to secure nursing staff resources and promote the retention of nurses and proper staffing which are essential to improve nursing quality and to create novel nursing.
As a cancer research center, we share the view that we cannot achieve our philosophy and mission without stable operation. Accordingly, the Department of Nursing of the NCCHE will continue to improve management by working closely with other departments.
List of papers published in January 2017 - March 2018
Journal
1. Kako J, Kobayashi M, Kanno Y, Tagami K. Intranasal Vinegar as an Effective Treatment for Persistent Hiccups in a Patient With Advanced Cancer Undergoing Palliative Care. J Pain Symptom Manage, 54:e2-e4, 2017
2. Kako J, Morita T, Yamaguchi T, Sekimoto A, Kobayashi M, Kinoshita H, Ogawa A, Zenda S, Uchitomi Y, Inoguchi H, Matsushima E. Evaluation of the Appropriate Washout Period Following Fan Therapy for Dyspnea in Patients With Advanced Cancer: A Pilot Study. Am J Hosp Palliat Care, 35:293-296, 2018