Annual Report 2019
Department of Nursing
Chie Asanuma
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 based on the following key policies:
1. To provide nursing care founded on trust and reassurance, respecting the dignity and rights of patients 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 advances in medicine 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: participating in hospital management in a coordinated, cooperative and collaborative manner beyond occupational boundaries; providing high-quality nursing while expanding the specialty of nursing; and assigning personnel appropriately in order to handle the yearly increasing number of patients and workload. We also promote deci-sion-making and the division and transfer of operations in coordination and collaboration with doctors, nurse’s aids such as clerks and assistant nurses, and other co-medicals, and are establishing a system to provide high-quality, efficient and effective nursing services, improve operations, promote team medicine, promote medical cooperation within the region, and develop human resources.
In June 2019, we opened Outpatient Radiology Nursing Care comprising one specialized and three full-time certified nurses in radiation therapy nursing in the Department of Radiology, following the opening of Outpatient WOC (Wound Ostomy Continence) and Outpatient Nursing Care for Women, and established a system where we can continuously provide supplementary explanations on treat-ments, risk assessment, prevention and handling of adverse effects, etc. in cooperation with doctors, including before, during and after radiation therapy, so that patients can complete radiation therapy more safely and easily. In the future, we plan to continue to expand our services in areas where specialists including certified nurses and nurse specialists can fully demonstrate their respective strengths and play active roles.
Following the hospital’s policy of establishing departments that can properly handle oncology emergencies in order to continue providing pioneering cancer medicine, conducting clinical research and trials, and developing equipment, we reinforced the nursing and medical care system, reorganized the working environment, treatments, etc. in Building 4A, and in September obtained approval under facility standards as an ICU, thus strengthening our ability to handle oncology emergencies.
The system of coordination and support with outpatient departments, hospital wards, home care, and the community was further strengthened by establishing a nursing system capable of providing nursing services efficiently, effectively and continuously. This has resulted in improved management, including a dramatic increase in various medical service fees for nursing compared to the previous fiscal year.
We have also actively worked on weighted assignments of nurses depending on their workload, establishment of a temporary employment system, planned taking of holidays, reduction in overtime work (–35%), and improved job satisfaction of nurse employees.
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. However, recognizing that this system was insufficient for evaluating the aptitude, fairness, validity, etc. of career enhancement in line with the backgrounds and capabilities of individual nurses, we reviewed the education program and then designed and launched a new career ladder system in April 2019. By using this career ladder, it is now possible for individual nurses to work on self-improvement and human resource development while checking the stages of their own abilities, such as develop-ment of specialized nursing skills, stages of practical nursing abilities and nursing management abil-ities. We expect that it will also be an effective tool for human resource development.
3) Certified nurse specialists and certified nurses
In FY 2019, two nurses were newly certified as certified nurse specialists in cancer nursing, two as certified nurses in cancer chemotherapy, and three as certified nurses in cancer radiation therapy. There are now 13 certified nurse specialists in two fields, 45 certified nurses in eight fields, and three certified nurse administrators. These staff serve as role models for nursing practice in their respective specialty fields and provide education, instruction, etc. to patients and staff at various nursing units and in outpatient nursing care. They also work in cross-organizational roles as members of medical teams such as infection control, palliative care and nutrition support teams.
The in-hospital anticancer drug IV nurse curriculum, which was launched to improve the specialty of nurses and expand their operations, has entered its sixth year, and 117 in- hospital certified nurses in anticancer IV certified nurses and four in- hospital certified nurses in radiotherapy intravenous injection are currently working actively in the hospital wards, Outpatient Treatment Center, De-partment of Radiological Diagnosis, etc.
We provide “Training on communication skills in cancer medicine,” “Training for hospital nurses to improve the ability to handle dementia,” “Training for team leaders for handling delirium in cancer patients,” etc. (Appended Table 3), 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 ac-claimed.
4) Management of certified nurse curriculums and training of certified nurses
Our hospital received accreditation from the Japanese Nursing Association as an institution that is appropriately equipped to educate certified nurses after the Association highly evaluated our excellent record in medical and nursing care, rich educational human resources, and the content of our educa-tion programs. The “Certified Nurse Curriculum Division” was established within the hospital and we launched a “palliative care certified nurse curriculum” in 2015, “cancer chemotherapy certified nurse curriculum” in 2016, and “cancer radiation nursing certified nurse curriculum” in 2018, and have been running these nine-month curriculums every year so that the nurses can learn as they work.
In 2019, 10 trainees completed the curriculum in cancer radiation therapy 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, 30 trainees in the cancer chemotherapy nursing field over three terms, and 24 trainees in the radiation nursing field over two terms. Of these, 91 in the palliative care field, 29 in the cancer chemotherapy field, and 13 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 2019, 39 presentations were made at academic conferences, including two overseas, with support from the NCCE clinical research support teams, nursing research support team consisting of certified nurse specialists and certified nurses, and nursing research committee.
These support teams provide research support including advice during the research process, in addition to inspiring nurses to tackle challenges and issues that arise in clinical practice.
A total of 23 articles were published in journals.
In the future, we intend to further improve the quality of nursing research in order to develop and promote new and well-grounded cancer nursing methods from the NCCE.
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 adapting nursing to keep up with the evolution of medicine. We will also provide pioneering medical care appropriate for a core clinical research hospital and advanced treatment hospital, promote clinical research and trials, and strengthen the system for medical safety.
In addition, 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.