A Review of Japanese Literature on Learning through Shadowing Practice in Basic Nursing Education

Article目的：看護基礎教育におけるシャドーイング実習による学びについて整理し，本学の役割移行実習への示唆を得る． 方法：文献検索の結果，17 件の原著論文を分析対象とした．対象文献の研究目的や方法論などを検討し，シャドーイング実習による学びに関する結果のカテゴリーを抽出し，類似した内容ごとに再構成をしてテーマをつけた． 結果：シャドーイング実習の学びとして「患者の個別性をとらえた看護ケアの実際」「看護専門職としての姿勢や態度」などの 10 のテーマが明らかになり，看護過程の展開に必要な知識や技術の修得，看護職としての実務の理解，看護専門職者としてのあり様の理解の 3 つの効果が明らかになった． 結論：役割移行実習でシャドーイングの実習方法を用いることは適切であった．今後はロールモデルとなる看護師の選出，教員や指導者の意図的な関わりについて検討する必要性がある．Objective: The objectives of this study were to summarize learning through shadowing practice in basic nursing education and obtain suggestions for role transition practice at this university. Methods: As a result of a literature search, 17 original articles were selected for analysis. The research objectives and methodologies of the articles were reviewed, and categories of results related to learning through shadowing practice were extracted and reorganized by similar content to form themes. Results: Ten themes regarding learning from shadowing practice were identified, including “actual nursing care that captures the individuality of the patient” and “posture and attitude as a nursing professional”. In addition, three effects were identified: acquisition of knowledge and skills necessary for the development of the nursing process, understanding what is in-line with practical nursing work, and understanding what it means to be a nursing professional. The three effects of the study were: acquisition of the skills necessary to develop the nursing process, learning what is relevant to practice as a nurse, and understanding how to be a nursing professional. Conclusion: The use of shadowing as a practice method in role transition training was appropriate. In the future, the selection of nurses to serve as role models and the intentional involvement of teachers and instructors need to be considered.総説群馬県立県民健康科学大学紀要18,1-12.(2023)departmental bulletin pape

Verifiable Study of the Status of Bed Peripheral Equipment Used in Nursing Practice Rooms after Disinfection Using a Wiping-type ATP Detector and Microbial Culture

Article感染症対策としての感染経路は，飛沫感染，空気感染が主であると言われているが MRSA や VRE の場合，患者から医療スタッフを介した接触感染も存在することが指摘されている．この観点から，今回主に，当校の 2F 第 1 看護実習室にて行われている看護技術演習時に使用するベッド周囲の器具，その他の数か所の ATP 値，コンパクトドライ，ぺたんチェックを使用して汚れの程度，細菌，真菌を測定し，どの場所が清浄なのか，どの場所に問題があるのかを洗い出した．看護実習室以外にも測定箇所を広げ，総合的に判断し，その感度についても検討を行った．結果からは，複数の場所について清浄度に問題のある場所が見つかったので，感染予防の観点から消毒の必要性の有無を再検討し，消毒が不十分であったり，方法に問題がある箇所を指摘すると同時に，ATP 検査と細菌のコロニー数との相関関係についても検討した．Droplet and airborne transmission are said to be the main routes of infection to consider when devising countermeasures against infectious diseases, but infection through contact transmission from medical staff to patients has also been pointed out in the cases of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus. The present study examined the cleanliness of nursing skill training equipment located around the bed in our school’s nursing practice room using adenosine triphosphate (ATP) values and microbial colony counts calculated by the “Compact Dry method” and “Petan check stamp method” at specific locations. We measured the degree of dirt, bacteria, and fungi, and identified which areas were clean and which areas had problems. We expanded the measurement points to include areas other than the nursing practice room, made comprehensive judgments, and examined the sensitivity of the results. Consequently, we found multiple areas with cleanliness problems. Therefore, from the perspective of infection prevention, we reexamined whether disinfection was necessary and the relationship between the results of the ATP test and the bacterial colony count.報告群馬県立県民健康科学大学紀要18,1-12.(2023)departmental bulletin pape

Microbial Conditions in Nursing Practice Rooms and the Effectiveness of Disinfection with Wipes

Article目的：看護実習室において学生が演習中に頻繁に触れる箇所の微生物状況を演習前後で調査し，演習後の拭き取り消毒の効果を検討する． 方法：検体採取箇所は，ベッド柵，高さ調節ハンドル，オーバーベッドテーブル，ワゴンとした．微生物状況は，アデノシン三リン酸（Adenosine Tri-Phosphate；ATP）ふき取り検査法と細菌培養の 2 種類の方法を用いて調査した．検体採取は、演習前，演習後，消毒後に行った．ベッド上で体位変換を行った演習あり群と，対照群の演習なし群を設定した．分析は，各々の平均値と標準偏差，中央値を算出した． 結果：演習前と比較し，演習後は ATP 値やコロニー数が増加する傾向がみられ，消毒後は ATP 値やコロニー数が減少する傾向がみられた． 結論：微生物状況は，演習後に増加し，拭き取り消毒により減少する傾向から，患者に触れる前後での手指衛生の必要性や，アルコール製剤による拭き取り消毒の効果が確認できたと考える．Objectives: The objectives of this study were to investigate the microbiological status of areas frequently touched by students before and after exercises and the effectiveness of wiping and disinfecting after the exercises. Methods: Specimens were collected at the bed rail, height adjustment handle, overbed table, and wagon. Microbiological conditions were investigated using two methods: adenosine triphosphate (ATP) wiping and bacterial culture. Specimens were collected before and after the exercise and after disinfection. Two groups were established: a group that performed exercises with positional changes on the bed, and a control group that did not perform any exercises. For the analysis, the mean, standard deviation, and median were calculated. Results: The results revealed that ATP levels and the number of bacterial colonies tended to increase after compared with before the exercise, and that ATP levels and bacterial colony counts tended to decrease after disinfection. Conclusions: The microbiological status of areas frequently touched by students tended to increase after the exercise and decrease after disinfection with wipes. These results confirm the necessity of adequate hand hygiene before and after touching patients and the effectiveness of disinfection with wipes.報告群馬県立県民健康科学大学紀要18,29-40.(2023)departmental bulletin pape

Exploring Work-related Difficulties Faced by Head Nurses in A Prefectural Hospitals

Article目的：A 県立 4 病院に所属する看護師長が仕事上直面している困難を明らかにする． 方法：対象者は同意の得られた看護師長 10 名とした．インタビューガイドを用いた半構造化面接を行い，グラウンデッド・セオリー・アプローチを参考に分析した． 結果：≪看護師長としての仕事が思うようにできない≫をコアカテゴリーとし【自分の仕事に自信がもてない】【自分の求める理想の姿に近づけたいが近づけられない】【自分を取り巻く周囲の人との関係が上手くいかない】【看護師長の思いや業務は理解されにくく孤独である】【タイム・マネジメントが上手くいかない】【看護師長候補者や看護師長に対する継続的な教育システムがない】【コロナの影響によりこれまでと同じことができない】という 7 つのカテゴリーが生成された． 結論：看護師長が問題解決思考やコミュニケーション技法を発揮できる継続的な支援，意見交換の場の設定，相談窓口の明確化の必要性が示唆された．Objective: This study aimed to clarify the work-related difficulties faced by head nurses at four hospitals in A Prefecture. Methods: Semi-structured interviews using interview guides were conducted with 10 head nurses after obtaining consent. Data were analyzed using the grounded theory approach. Results: A core category, “things do not turn out the way I expect”, was integrated. In addition, the following seven categories were generated: “I am not confident in my work”, “I am unable to get closer to my ideal form, which I am desperate to change”, “I am unable to build good relationships with those around me”, “Head nurses’ work and thoughts are difficult to understand, and I feel lonely”, “I am not good at time management”, “No opportunities for continuing education are available for head nurses and candidates”, and “I am unable to do the same things as before the COVID-19 pandemic”. Conclusions: These results suggest the need for continuing support systems that enable head nurses to improve their problem-solving and communication techniques, and that opportunities for information exchange and dialogue among head nurses and dedicated consultation desks need to be established.報告群馬県立県民健康科学大学紀要18,13-28.(2023)departmental bulletin pape

重症心身障害児（者）の施設入所に関する母親の心理的プロセスの探索

群馬県立県民健康科学大学博士（看護学）2023年度doctoral thesi

X線画像検査における撮影条件の最適化に関する研究

群馬県立県民健康科学大学博士（放射線学）2021年度doctoral thesi

Identifying Learning Needs of Hospital Staff Nurses

Article目的：本研究の目的は，病院に就業するスタッフ看護師の学習ニードを解明することである． 方法：全国の89 病院に就業するスタッフ看護師1,923 名に学習ニードを問う質問紙を用いてデータを収集した．返送のあった502 名の記述をBerelson,B. の方法論を参考にした看護教育学における内容分析を用いて分析した． 結果：病院に就業するスタッフ看護師の学習ニードを表す39 カテゴリが明らかになった．39 カテゴリとは，【日常の看護実践の基盤となる疾患とその診断・治療に関わる知識】【感染予防に必要な知識と技術】【災害時の看護に必要な知識と技術】【外来看護】などである．Scotto,W.A. の式によるカテゴリへの分類の一致率は80％以上であった． 結論：考察を通し，「所属部署の日々の看護実践の基盤」「社会の変化と看護師の役割拡大に伴い求められる実践」などの側面が見出された．本研究の成果は，病院に就業するスタッフ看護師が自身の学習ニードを明確にするための指針となる．Objectives: This study aimed to identify the learning needs of staff nurses working in hospitals. Methods: Data were collected using a questionnaire containing open-ended questions about learning needs. The questionnaire was mailed to 1,923 staff nurses working in 89 hospitals throughout Japan who agreed to participate in this study. The content validity of the questionnaire was confirmed in a pilot study. Of the 975 questionnaires returned (50.7%), 502 valid responses were analyzed using qualitative analysis in nursing education based on Berelson’s content analysis method. Results: The analysis identified 39 categories representing the learning needs of hospital staff nurses. These 39 categories included: (a) knowledge pertaining to diseases and their diagnosis and treatment that forms the basis of daily nursing practice; (b) knowledge and skills necessary to prevent infection; (c) knowledge and skills necessary in disaster nursing; and (d) outpatient nursing. The agreement rates calculated by the Scott’s formula were over 80%; therefore, the reliability of these 39 categories was confirmed. Conclusions: Through careful consideration, the learning needs of hospital staff nurses were found to be characterized by “foundations of daily nursing practice in the nurses’ wards” and“ nursing practices required due to the expanding roles of nurses and a changing society.” The results of this study can be used as a guidepost for hospital staff nurses to identify their own learning needs, which will lead to effective learning.原著群馬県立県民健康科学大学紀要17,33-46.(2022)departmental bulletin pape

小児脳血流SPECTの非侵襲的測定法に関する研究

群馬県立県民健康科学大学博士（放射線学）2021年度doctoral thesi

The Relationships of eGFR Values with Health Checkup Results and Lifestyle Habits in Village A

Article目的：A 村の健康診査結果におけるeGFR 値と他の健康診査結果および生活習慣との関連を明らかにする． 方法：A 村の平成30 年度健診受診者2,056 人を対象とした．eGFR 値から腎機能正常群，低下群の2 群に分け，健診結果との関連および生活習慣との関連を分析した． 結果：対象者全体の腎機能低下群の割合は17.1％であった．腎機能2 群と健診結果との関連では，特定健診および後期高齢者健診の女性において，腎機能低下群はBMI と脂質の平均値が高かった．生活習慣との関連では，特定健診で腎機能低下群の方が，飲酒はしていない，遅い夕食を取らない，20 歳から10kg以上の体重増加がある，歩行速度が遅い者の割合が高かった． 結論：腎機能低下群は飲酒や夕食時間等の生活習慣が良好な者の割合が高かった．一方で，腎機能低下群の方が長期的な体重増加がある割合や，BMI と脂質の値が高い傾向があり，体重や脂質管理の必要性が示唆された．Objective: The purpose of this study was to clarify the relationships of eGFR values with health checkup results and lifestyle habits in Village A. Methods: The subjects were 2,056 persons who had health checkups in Village A in 2018. They were divided into 2 groups by their eGFR values, a group with normal renal function and a group with decreased renal function. The relationships between renal function and the results of health checkups and between renal function and lifestyle habits were examined. Results: Decreased renal function was present in 17.1% of all participants. Regarding the relationship between renal function and the results of health checkups, there was a significant difference in BMI and lipids in the specific health checkup and the latter period the elderly medical checkup in females. The mean BMI and lipids of the group with decreased renal function were high. Regarding the relationship between renal function and lifestyle habits, in the specific health checkup, the group with decreased renal function was associated included did not drink, did not eat supper late at night, had weight gain more than 10 kg from 20 years of age, and had a slow walking speed. Conclusion: The group with decreased renal function has good lifestyle habits related to drinking and dinner time. However, the group tended to have high long-term weight gain and lipids. These results suggest the need for lipid management and weight control from a young age.報告群馬県立県民健康科学大学紀要17,73-84.(2022)departmental bulletin pape

The Bactericidal Effect of Sodium Hypochlorite and Germicidal Lamps ── A Study of the Optimal Concentration of sodium Hypochlorite and of Conditions for Germicidal Lamps ──

Article病棟や介護施設の器具やベッド，ガウンなどの殺菌には，次亜塩素酸ナトリウム（以下SH）や殺菌灯などが利用されてきた．SH が文献に示されている希釈率で本当に細菌等が殺菌されているのか，また，希釈後の劣化の進度について示された研究は少ない．我々は，市販のSH をそれぞれの目的のためには，どの程度希釈すればよいのか，その希釈液の劣化の程度，殺菌灯の到達距離について，著者1 名の鼻粘膜常在菌と，市販大腸菌を用いて検証した．SH（原液5％程度）は，殺菌には0.02～0.5％（250 倍～10 倍希釈）が適当とされているが，実際には100 倍希釈でも細菌が増えている場合があること，塩素濃度は下がっていないのに，かなり劣化している場合があることが判明した．殺菌灯は，近距離では30 秒で十分であること，天井に設置した場合には，床面のサンプルに対し，1 時間程度の照射で効果があることがわかった．次亜塩素水の劣化についてもコメントする．Purpose: Sodium hypochlorite and germicidal lamps have been used to sterilize equipment, beds, and gowns in wards and long-term care facilities. With sodium hypochlorite, there are few studies on whether bacteria, etc. are actually sterilized at the dilution shown in the literature and on further deterioration after dilution. The aim of this study was to determine to what degree sodium hypochlorite on the market should be diluted for each purpose, how much the diluted solution deteriorates, and how far does the germicidal lamp reach. Methods: One of the authors' indigenous bacteria on the nasal mucosa and commercially available Escherichia coli were used for this study. The results of various experiments were evaluated by the number of bacterial colonies that appeared on the plate. Results: Sodium hypochlorite is said to have a stock solution of about 5% and is diluted to 0.02% to 0.5% (250 to 10times) for use, but in reality, bacteria sometimes increase, even though the residual chlorine concentration is sufficient at 1%. It was found that it deteriorated considerably even though the concentration was appropriate for sterilization. It was found that the germicidal lamp sterilized bacteria in 30 seconds at a short distance, and in the case of a germicidal lamp installed on the ceiling, the sample on the floor was sterilized in about 1 hour. This paper also presents some results on the deterioration of hypochlorite water.報告群馬県立県民健康科学大学紀要17,61-71.(2022)departmental bulletin pape