Annual Report 2020
Department of Nursing
Chie Asanuma, Kazue Hayasaka, Tamae Hiramatsu, Miki Kondo, Nao Katagiri, Megumi Yamagishi, Emiko Yasukawa, Mifumi Nakajima, Wakana Kitazawa, Aki Yaguchi, Miyuki Kanemitsu, Maki Ito, Akiko Murayama, Michiko Murata, Chiemi Saito, Yoshiko Kaneda, Chisato Ichikawa, Kayoko Nakata, Tomoko Maekawa, Mayumi Hara
Introduction
Under the nursing philosophy to “contribute as active members of the team working in state-of-the-art cancer treatment, and to participate in the development of cancer nursing at the core hospital providing cancer nursing care in Japan,” the Nursing Division of the National Cancer Center Hospital East (NCCE) conducts activities according to the following basic policies:
1. To provide nursing care founded on trust and reassurance, respecting the patients' rights and dignity of life,
2. To pursue the essential values of nursing and practice scientific and creative nursing,
3. To facilitate clinical studies and disseminate new information concerning 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 business management efficiency 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 and that embraces the medical advances and the needs of patients and their families, with an awareness and sense of responsibility as nurses of Hospital East, the Nursing Division actively engages in the following activities: participates in hospital management in a coordinated, cooperative and collaborative manner beyond the boundaries of occupational categories; provides high-quality nursing while expanding the nursing specialty; and ensures appropriate personnel assignment so that we are able to handle the increasing number of patients and workload every year. We also promote decision-making and the division and transfer of operations in coordination and collaboration with doctors, nurses’ aides such as clerks and assistant nurses, and other co-medicals, and are establishing a system to provide high-quality, efficient and effective nursing services to improve operations, promote team medicine, promote medical cooperation within the region, and develop human resources.
In April 2020, we opened Outpatient Cancer Chemotherapy Nursing, comprised of two full-time nurses certified in cancer chemotherapy nursing in the Department of Cancer Chemotherapy, following the opening of Outpatient WOC (Wound Ostomy Continence) and Outpatient Nursing Care for Women, Outpatient Radiology Nursing Care. We established a system where we can continuously provide supplementary explanations on treatments, risk assessment, prevention and handling of adverse effects, etc., including before, during and after chemotherapy, so that patients can complete chemotherapy more safely and easily. For the future, we plan to continue expanding our services in areas where specialists including certified nurses and nurse specialists can fully demonstrate their respective strengths and play active roles.
To strengthen the hospitalization and discharge support system, PFM (patient flow management), and nursing management system, the Supportive Care Center was made independent from the Nursing Department manager's office.
2) Educational activities
Conventionally, the in-house 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.
Since April 2019, we have been operating a career ladder system that evaluates the aptitude, fairness, and validity of career advancement according to the background and abilities of individual nurses.
By using this career ladder, it is now possible for individual nurses to work on self-improvement and human resource development while assessing the extent of their own abilities, such as specialized nursing skills, practical nursing abilities and nursing management abilities. We expect that the career ladder system will also be an effective tool for human resource development.
3) Nurse specialists and certified nurses
In fiscal 2020, we had the following nurses newly certified: one certified nurse in cancer radiation therapy, one certified nurse in dysphagia nursing, one certified nurse in perioperative nursing, one certified nurse in infection control.
There are now 13 nurse specialists in three areas, 43 certified nurses in nine areas, and two certified nurse administrators, who serve as role models in nursing practice in their respective specialties and who provide education, instruction, etc. to patients and staff in various nursing units and outpatient nursing care. They also work in cross-organizational roles as members of medical teams such as infection control, palliative care and nutrition support.
The in-house education program for certified nurses in anticancer IV, which was launched to expand the specialties and operations of nurses, has entered its seventh year, and 123 in-house certified nurses in anticancer IV and 14 in-house certified nurses in radiotherapy intravenous injection are currently working actively in the hospital wards, Outpatient Treatment Center, Department of Radiological Diagnosis, etc.
We provided an online “Open Cancer Nursing Seminar” 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 acclaimed.
4) Operation of certified nurse education courses and training of certified nurses
Our hospital was accredited by the Japanese Nursing Association as an educational institution equipped to educate certified nurses. The association rated us highly for our excellent record of medical and nursing care, rich educational human resources, and the content of our education programs, establishing “certified nurse education courses” within the hospital. We provided “Education course for certification in palliative care” in 2015, “Education course for certification in cancer chemotherapy” in 2016, “Education course for certification in cancer radiation therapy” in 2018, and “Education course for certification in cancer chemotherapy” in 2019.
In 2020, 8 trainees in cancer chemotherapy completed the course and are currently waiting for the qualification exam.
Since the education courses were established, 93 trainees have completed the five terms of the palliative care course, 37 trainees the four terms of the cancer chemotherapy course, and 23 trainees the two terms of radiation nursing. Of these, 91 trainees passed the certification examination by the Japanese Nursing Association in palliative care, 29 in cancer chemotherapy, and 21 in cancer radiation nursing, and they are now actively working in their respective medical institutions as certified nurses, providing high levels of nursing with advanced nursing skills and helping to raise the care skills of nurses based on the three roles of practice, instruction and consultation.
Research activities
In fiscal 2020, 2 presentations were made at academic conferences, with support from the clinical research support team at Hospital East, the nursing research support team consisting of nurse specialists and certified nurses, and the nursing research society. These research support teams provided advice during the research process and inspired nurses to take on challenges and tackle issues that arise in clinical practice. In addition, 17 articles were published in journals.
In the future, we intend to further improve the quality of nursing research so that the Nursing Division of our hospital can create and promote new, well-grounded methods of cancer nursing.
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 Nursing Division, Hospital East will continue to secure, cultivate and appropriately assign nurses as the foundation for improving nursing quality and to adapt nursing to meet the evolution of medicine. We will also provide pioneering medical care fit for a core clinical research hospital and advanced treatment hospital, promote clinical research and trials, and strengthen the medical safety system.
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.