Urinary tract infections (UTIs) are among the most common entities in hospitals, accounting for about 40% of nosocomial infections. It is said that more than 80% of UTIs are associated with the use of catheters. The discharge opening of the Uro Bag, a type of urine storing bag, is alive with bacteria. The microorganisms can enter the bag and then bladder, causing UTIs. It can also be said that the longer the catheters are used, the greater the risk of catheter-related UTIs becomes. Furthermore, Pseudomonas aeruginosa, Staphylococcus aureas, Serratia mareescensand other kinds of bacteria that have acquired the resistance to drugs are increasing. The incidence of mixed infections with different organisms are on the rise. Such being the present situation, to prevent UTIS we think that the proper management of urinary catheterization and right use of urethral catheters are of the primary importance. Those health providers who handle catheters frequently need to take every precaution against inadvertently acting as intermediaries in the incidence of nosocomial infectious diseases including catheter-related UTIs. Recently, we reviewed the prophylactic measures which had been taken by our hospital, assessed the findings using the checklist made by the Nosocomial Infection Prevention Committee. Later, we held a seminar and discussed the standardization of prophylactic measures. As a result, the assessment items which were rated low in June marked 100% in September and March. Thus, our efforts have led the hospital employees to deepen their knowledge and understanding of the need to watch out nosocomial infection constantly. For the guidance of employees, we included in the educational program on-the-job training, which proved to be helpful for the trainees to have imagery. To maintain the effect of infection prevention and to keep up the interest awakened in the hospital staff, the holding of seminars and meetings for reviewing on a regular basis are called for.

　　This study is designed to clarify the effects of increases in a rehabilitation session on the functional outcome of hip fractures in the subacute phase.　　Of 95 patients with hip fractures admitted to our subacute care ward between November 2010 and March 2012, five patients transferred to another ward due to complications were excluded, and 90 patients were taken up. The 90 patients were divided into two groups: 22 patients who underwent rehabilitation before an increase in the frequency of rehabilitation sessions (early-phase group) and 68 who underwent rehabilitation after an increase in the frequency (later-phase group). Outcomes, such as the number of rehabilitation sessions, length of hospital stay, FIM at the time of discharge, FIM efficiency and destination after hospital discharge, were compared between the two groups.　　In a comparison of all patients, the number of rehabilitation sessions significantly increased (p<0.001), but there was no significant difference in FIM at the time of discharge from hospital, FIM efficiency and post-discharge destination. Group “Rank A” stood out in a comparison of the degree of independence enjoyed by the disabled elderly in their daily life before they suffered injuries (p<0.05). Group “Rank I” stood out in a comparison of the degree of independence in the daily life by the elderly with dementia, while they were in hospital (p⁢0.05). The FIM efficiency of the later-phase group was significantly higher than that of the early-phase group.　　It is presumably effective to begin intensive rehabilitation for patients whose ADL ability is somewhat reduced and those who have cognitive impairments. It has been thought that cognitive impairment was one of the factors that inhibit rehabilitation for hip fractures. However, it has been suggested that improvements in ADL are possible with increases in rehabilitation sessions for cases with mild cognitive impairment.

We conducted a questionnaire survey of nurses to develop a scale for the Japanese version of the Quality of Dying and Death in the Intensive Care Unit (ICU-QODD) instrument for use by nurses. The questionnaire was based on “patient’s experience at the end of life” in ICU-QODD for health professionals in the United States. We assessed whether it could be used as a comprehensive evaluation tool. Respondents included 1,372 nurses for factor validity and internal consistency, and 39 nurses for test-retest reliability. Two factors, “physical symptoms” and “dignity” that comprised 6 items were identified. Cronbach’s alpha values were 0.89 and 0.75, respectively. Intraclass correlation coefficients were 0.62 and 0.72, respectively. Sufficient reliability and validity were confirmed. It was suggested that 6 out of 15 items could be used as for comprehensive evaluation of the ICU-QODD.

Objective: This study aimed to investigate the feasibility of a patient registry system for assessing PCT (palliative care team) by PRO (Patient-reported outcome) in Japan. Methods: We operated a patient registry system with electronic data collection at eight hospitals in 2021 in Japan. We consecutively included newly referred patients for a month and followed up with them for a month. IPOS or ESAS obtained as PRO at the start of the intervention, three days later, and every week after. The primary endpoint was the response rate to the symptom rating scale by patients and providers. Results: 318 patients were enrolled. The patient response rate was 59.1% at intervention and 37.0% after intervention, and the medical provider response rate was 98.4% at intervention and 70.3% after intervention. Interviews with PCT members indicated that participants required support to input PRO responses required support and paper questionnaire was better and that managing the survey date and overall management was burdensome. Discussion: Although only about half of the patients were able to respond to the PRO, this was the same level as in previous studies. The system and its operation method have many problems. We found that improvements such as reducing items and making the patient interviews paper-based are necessary to expand the system nationwide.