A U.S. nursing home case-mix system, Resource Utilization Group, Version III (RUG-III), was tested in a variety of Japanese long-term care facilities. Staff time and resident characteristics were measured for a sample of 871 patients. Acceptable reliability was found for items defining RUG-III, and the system explained 44% of the variance in wage-weighted staff time (cost). Also, Japanese and U.S. costs had similar patterns across RUG-III categories. However, there was wide discrepancy between the stated purpose of Japanese facilities and their patient populations, and the current payment mechanism did not reflect actual use of resources.
Aim: To investigate the predictors of pressure ulcer and physical restraint prevalence in Japanese acute care units and their relationship to the nursing hours, skill mix, and Nursing Need Scores (NNS). Methods: In this descriptive study, quantitative methods were employed to determine if pressure ulcers and physical restraint prevalence, as outcomes of nursing care, were related to the nursing hours, skill mix, and intensity of nursing-care needs. The sample included 87 acute care units in 42 hospitals in Tokyo and its surrounding prefectures in Japan. The NNS was used as the instrument to measure the intensity of nursing-care needs. The data were analyzed with descriptive statistics, correlations, and multiple regression analyses. Results: Pressure ulcer prevalence was positively correlated with the NNS-A and NNS-B. Physical restraint use was positively correlated with the NNS-B and negatively correlated with the NNS-A. However, the total nursing hours per patient day was positively related with both pressure ulcer and physical restraint prevalence.
Conclusions:The nursing hours and NNS are predictors of pressure ulcer development and physical restraint use. The results also suggest that we should revise our process of nursing care. Many functions that might be shared with other personnel are performed by nurses, which results in longer total nursing hours but shorter direct nursing hours, used in order to observe and care for patients. Japan's aging population will result in higher NNS, requiring more direct nursing hours and other personnel to participate in our process of nursing care.
This research examined the reliability and validity of the Nursing Management Minimum Data Set in Japan, version1 NMMDS1 , which was developed for nurse managers as a practical self evaluation index. Method The NMMDS1 questionnaire mail survey was conducted from July to October,
Purpose: The aim of the survey was to identify the characteristic of employment and turnover of experienced nurses at Japanese Hospitals.Method: Stratified sampling by hospital size identified 1,200 Japanese hospitals invited to participate in the survey. Nurse executives from each hospital provided the number of experienced nurses who were hired and left within 2013. The same data about newly graduated nurses were also collected for comparison.Results: Returned were 246 valid responses. Experienced nurses tended to be hired by smaller, long-term care and psychiatric hospitals; by contrast newly graduated nurses were hired by larger and advanced treatment hospitals. While 75.7% of experienced nurses were hired full-time compared to 99.2% new graduates, 24.3% of experienced nurses were hired part-time compared to 0.8% of new graduates. The turnover rate of experienced nurses was 17.9%, and was higher than 7.9% for new graduates. Smaller hospitals with under 100 beds had difficulty in retaining experienced nurses.Conclusion: The retention of experienced nurses was much lower compared to new graduates. It is proposed that each hospital develop tactics tailored to support experienced nurses continuing with their employment.
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