Ethical challenges nurses face in perinatal care practice

In the field of perinatal care, fertility treatments, aided by advanced assisted reproduction technologies (ART), and prenatal and pre-implantation diagnoses are taking place alongside fetal reduction operations, or the removal of fertilized eggs, conducted in the case of multiple-fetus pregnancy. Also, highly advanced technologies covering a wide range of medical fields, such as critical care and the treatment of very-low- birthweight infants, have been further complicating various bioethical problems. Seeing the need to identify the ethical dilemmas nurses face in their clinical obstetric practice, the author conducted a literature review. Through the review, it was clarified that nurses at the various fronts of advanced medical care are required to achieve higher levels of competency to support patients. It may be important for nurses, the care experts at the beginning of life, to promote active discussions and remain aware of bioethical questions based on ethical principles

Differences in the level of students\u27 achievement in the implementation of nursing procedures between two hospitals in which they are and are not granted the right of access to an electronic medical record system

Students underwent a training class, Basic Nursing Training II, at three health care institutions for two weeks (90 hours). Electronic medical record systems had been adopted by two of the institutions. Hospital A, one of the two system-adopting institutions, had issued individual students with IDs and passwords, and they had free access to the electronic medical record system. On the other hand, since Hospital B had not issued the students with IDs and passwords, they had no free access to the system and had to ask a nurse each time they needed to view the electronic medical record system. A comparison of the two institutions was conducted, revealing significant differences in the time required to collect information and achievement levels in the nursing training class

Behavior, cognition, and future direction of psychiatry

The human behavior and cognition are the two most important functions for human life in the society. The cognitive function is declined in the elderly, but it is not always the case. Fluid intelligence may decline along with aging but crystalized intelligence can be maintained even in the elderly. In addition to neurocognitive disorders (dementia), cognitive function is impaired with various psychiatric disorders and it will be the main target for future psychiatry. Due to the knowledge obtained from the recent development in brain mapping, psychiatrists can perceive and understand the meaning of the psychiatric symptoms based upon the dysfunction of these networks. Subjective experience of the patients should be paid more attention by closer collaboration between psychiatrists/ researchers and patients/ families. Elucidating the brain network representing common sense will be important. Psychiatrists are recommended to expand the range of the frame of their common sense to be able to understand the meaning of the patient behavior

Students\u27 Learning of the Home Nursing Process Using Case Studies

In order to appropriately use case studies for learning, it is necessary for teaching staff to create contents that enable students to obtain standardized, consistent, and similar experiences. On the other hand, students are expected to learn about information classification and the thought process from understanding the aims of and grounds for support, as well as its relationships, to resolving problems. The present study examined students\u27 learning of the home nursing process and the contents of 4 cases presented to them, as shown in Tables 1 and 2. On analyzing the contents to determine more effective methods of learning and practice using a limited number of cases, the necessity of developin

Analysis of multidrug-resistant Pseudomonas aeruginosa in a hospital with a dominant population of geriatric inpatients

Bacterial resistance and opportunistic human pathogens have become serious problems in hospitals, particularly those in which the dominant population consists of immunocompromised elderly inpatients. Pseudomonas aeruginosa is a prevalent opportunistic human pathogen that causes acute pneumonia, cystic fibrosis, and septicemia, and it is also known to possess various mechanisms of natural and acquired resistance to antibiotics. Carbapenems have been used to treat infections caused by β-lactamase-producing gramnegative bacteria including P. aeruginosa, but metallo-β-lactamase (MBL) can render carbapenems ineffective, and so action is required to prevent the development of strains that produce MBL. Between September 2010 and August 2011, 8 multidrug-resistant P. aeruginosa (MDRP) strains were isolated from pressure ulcer, urine, or expectoration or aspiration sputum samples of patients with different infections in a hospital in Osaka Prefecture, Japan. After confirming MBL production, we identified 5 strains that produced IMP-type MBL. The strain variations of isolated MDRP were determined by multiplelocus variable-number tandem repeat analysis. Because the 5 IMP-type MBL-producing strains were of the same genotype, it was suggested that the infection had spread within the wards. The remaining non-MBL-producing MDRP strains were also of the same genotype, but antimicrobial breakpoint tests revealed that they were not exactly the same, and the wards from which they had been isolated were not close to each other. Therefore, more accurate typing of the non-MBL-producing genotype group is required to determine whether diffusion between the wards had occurred

Students\u27 Trends in the Selection / Prioritization of Nursing Diagnoses and Challenges of Case Presentation - An Analysis of Lists of Problems Created in Case Studies -

As a method to practice nursing process development, we provide guidance for students to perform a series of steps from assessment, diagnosis, planning, and implementation to evaluation using case studies. This study analyzed nursing diagnoses selected and prioritized by students, focusing on their lists of problems. Nursing diagnoses are defined and disseminated by the North American Nursing Diagnosis Association (NANDA-I). Such diagnoses are presented in the 10th original version of the NANDA-I Nursing Diagnoses: Definitions and Classification 2015-2017, developed by the association to unify interpretations based on identical nursing diagnoses. They are reviewed once every three years. In this system, nursing diagnoses are selected from 13 domains, and a list of problems is created, giving priority to life-threatening conditions, those requiring emergency management, and those in which problems are clearly (actually) present, in this order, in general. Students without clinical experience tend to face difficulty in appropriately selecting and prioritizing nursing diagnoses in case studies. This study compared nursing diagnoses and priorities entered by students and teaching staff in lists of problems used for case studies. The former showed a tendency to select nursing diagnoses with a focus on the advanced age of patients. On prioritizing nursing diagnoses, they faced difficulty in accurately recognizing the influences of symptoms on the body, possibly due to their insufficient understanding of pathologic physiology

Study of effective learning method of home nursing image that nursing students have

Regarding the positioning of home nursing care in basic nursing education, "home nursing care" was added to basic nursing education in response to an "Interim report of the investigative commission for improvement of curriculums, etc, regarding the training of nursing staff" in 1996. Then, with an indication that it is important to promote home-visit nursing that supports home-care patients and to secure nursing staff responsive to the advancement of medical care, home nursing care was positioned in an "integrated field" along with the suggestion of a "Report of the investigative commission for improvement of nursing basic education" in 2007. Nursing education is diverse and covers an integrated field. An "Investigation on the integrated field and home nursing care education" of Tanigaki et al. of 2008 indicated that the integrated field was created for the provision of nursing care similar to bedside nursing care, and each university exploited its characteristics in creating subjects nurturing the ability to practice nursing care, so that there is a wide variety of subjects. Home nursing care aims to provide education in anticipation of the cultivation of human resources capable of assuming a role in nursing care in regional societies in the future. In relation to the subject lineup in the integrated field and public health nursing, a clear image is required to learn home nursing care. Pointing out that nursing students are unlikely to have images of home nursing care, Yoshikawa et al. compared students before and after home nursing care practice to assess their changes. Hishitani also pointed out that, Strong capacity to imagine regarding an image and the capacity to imagine a weak capacity low unifying power. On the basis of the study results of Yoshikawa et al. we clarified the images that nursing students have to understand the subject so as to obtain suggestions beneficial for developing a teaching method and improving teaching materials. We investigated the images of home nursing care of 95 participants who were nursing students at the same university. As a result of analysis, six categories were obtained as their images of home nursing care. These categories were: [home nursing care subjects], [places and measures for home nursing care], [roles and tasks in home nursing care], [relationships with family members and related persons], [qualities required for home nursing care], and [characteristics of home nursing care]. As for the home nursing care subjects, heath stages and daily life conditions were extracted and the students had images of concerning the terminal phase, cancers, a bedridden state, persons with a low ADL, etc. Concerning the roles and tasks in home nursing care, the students imagined various roles and tasks such as treatment/medical care, daily life aid, assistance for families, etc. Furthermore as for the attitudes and abilities required for home nursing care, a wide variety of abilities and required attitudes were extracted, such as cooperation with many different types of procession communication, judgment, knowledge, the patient coming first, respecting their will, etc. As for the characteristics of home nursing care, the students had images of daily life advantages, the care burden, and dilemmas of nurses. Regarding developing and improving learning in order to expand and develop the images of home nursing care that the nursing students had, the following four items were suggested: 1. Emphasizing characteristics of subjects by ages, diseases, disorders, and home care conditions, 2. Associating the understanding of social resources for home-care patients to live at ease with team medical care and cooperation, 3. Intervening so that students can identity roles of home nursing care in both medical care and daily life, and 4. Necessity of associating characteristics of home nursing care with accidents in the home and with risk management

Analysis of the medical care of Masaoka Shiki, as seen in "Gyoga Manroku"

Masaoka Shiki published "Bokuju Itteki (A drop of Indianink)", "Gyoga Manron (Stay notes while lying on my back)", and "Byosho Rokushaku (A six-foot sickbed)" over a period of 7years, while he was bedridden with tuberculosis. During this time, his mother and sister took care of him devotedly at home. This short communication aims to analyze Shiki\u27s medical care in the Meiji era, by examining the medical conditions described in his works. I have identified five points about his care. First, he wanted to write despite the uncomfortable physical and mental state caused by his illness. He also wanted to eat, which might have been the source of his vitality. The pain caused by his illness had not been properly controlled, and his family provided good care for him. He also had the financial support for a long recuperation. Descriptions of the care provided by his mother and his sister were very limited in his work, and, this communication was limited to the medical treatment described by Shiki himself. - It will be necessary to further examine the medical care from multiple perspectives in the future

Molecular epidemiological analysis of drug-resistant Acinetobacter sp. strains detected in a northern Osaka Prefecture medical facility

In recent years, the spread of drug-resistant bacteria has become a serious problem worldwide. Species of the genus Acinetobacter, a group of pathogens that commonly cause opportunistic infections, have also become increasingly drug resistant, and cases of healthcare-associated infections have been reported.In this study, we characterized 16 drug-resistant Acinetobacter sp. strains detected at a medical facility in northern Osaka Prefecture in 2019 and 2020 through molecular epidemiological analyses. Although a multidrug-resistant Acinetobacter which showed resistance to three classes of drugs, namely carbapenems, aminoglycosides, and new quinolones was not detected, seven strains were resistant to two drugs. Moreover, species and strain identification using the POT method revealed that 15 of the strains were A. baumannii and three of them were international clones which are known to cause outbreaks. In addition, one strain that could not be identified by the POT method was found to be A. dispersus through analysis of the 16S rRNA gene sequence. Our results indicate that the number of detected strains and POT types increased and diversified over the years. In addition, some clonal strains with the same POT value showed expansion of drug resistant, suggesting that the trends in drug resistance must continue to be closely monitored

A methodological study on the application of Alfred Schutz\u27s theory of relevance in nursing research -- A comparison with the grounded theory approach (GTA) --

This study examines whether a research method using Alfred Schutz\u27s theory of relevance is the optimal approach to analyze clinical experiences of nurses. To this end, major features of a research method based on Schutz\u27s theory of relevance were weighed against those of the grounded theory approach (GTA), the most commonly used method for analyzing clinical nursing experiences. A comparison was made of how to deal with data between the relevance-theory approach and the GTA. As a result, it was found that the relevance-theory approach focuses on understanding the study subjects in the realm of their inner horizon, or their subjective meanings (theme, motive, interpretation, etc.), using data, and that GTA places importance on the objective explanation of the subjects by regarding data as external data (events), or the realm of their outer horizon (objective meanings). In short, the two approaches represent \u27two sides of the same coin.\u27 Therefore, it is argued that data analysis using the relevance-theory approach is necessary to make GTA-based research results more convincing and evident. It can also be concluded that the relevance-theory approach, which focuses on understanding the subjects (nurses) by exploring the "realms of subjective meaning", is the optimal method for analyzing clinical nursing experiences