2.Education in Hand Hygiene for Nurses to Visualize Hand Contamination
Yoko Yamamoto ; Murota Masako ; Yoko Iwawaki ; Yukie Takishita ; Akemi Shibata ; Kiyomi Harada ; Tomoko Matsuoka
Medical Education 2015;46(6):491-495
Background: Hand hygiene is recognized as the leading factor to prevent Healthcare-Associated Infection. This report describes an investigation of education in hand hygiene for nurses to visualize hand contamination.
Method: Twenty-nine nurses underwent education using adenosine triphosphate (ATP) measurements and fluorescent cream and black light, and a survey was conducted.
Results: A significantly higher number of nurses recognized the importance of hand hygiene after receiving education. Approximately 80% of nurses were able to: ″reflect on their methods for washing their hands″ , ″understand the necessity of keeping their hands clean after removing their gloves″ , and ″check for areas of the hands that had not been cleaned″ .
Discussion: This report suggested that education in hand hygiene using adenosine triphosphate (ATP) measurements and fluorescent cream and black light for nurses improves their perception of the importance of hand hygiene.
3.Lipoprotein(a) in the Abdominal Aortic Aneurysmal Wall.
Hironori Arakawa ; Hajime Hirose ; Koji Matsumoto ; Masaya Shibata ; Shigeyuki Fuwa ; Mitsuru Seishima ; Yoko Yano ; Akio Noma
Japanese Journal of Cardiovascular Surgery 1996;25(6):359-363
Lipoprotein(a) [Lp(a)] has been considered as an independent risk factor for arteriosclerotic diseases. With an anticipation that Lp(a) would also serve as a risk factor for abdominal aortic aneurysms (AAA), we analyzed serum and tissue Lp(a) levels of patients with AAA in relation to those in healthy individuals. Serum Lp(a) levels were significantly higher in the AAA group (53.2±60.8mg/dl) than in the healthy controls (14.6±13.6mg/d) (p<0.001). The Lp(a) level in the aneurysmal wall of patients with AAA was 49.8±38.2ng/mg. There was a significant correlation between serum and aneurysmal wall Lp(a) levels in AAA patients (r2=0.79, p<0.01). Immunohistochemical examination revealed Lp(a) in the extracellular matrix of the middle layer of the tunica intima, but not in the tunica media or externa.
4.The burden of introducing the Japanese language version of the Liverpool Care Pathway(LCP-J)for dying patients in general wards and their families:experience of health care professionals in a university hospital
Yusuke Kanno ; Kazuki Sato ; Yoko Hayakawa ; Yoshie Takita ; Takashi Agatsuma ; Tomoko Chiba ; Kazuko Honda ; Hiroko Shibata ; Kazuko Yamauchi ; Shin Takahashi ; Akira Inoue ; Mitsunori Miyashita
Palliative Care Research 2015;10(1):318-323
The purpose of this study was to explore the burden of introducing LCP-J in two wards(medical oncology and respiratory medicine)in Tohoku University Hospital. We administered audit evaluations about dying cancer patients and interviewed 2 doctors and 8 nurses regarding LCP-J intervention. LCP-J was used for 22 patients(38%), and no significant difference in infusion, potent opioid analgesic and sedative medication within last 48 hours were seen between users and nonusers. Responses were categorized into[confirm directions about dying care among health care professionals], and[training in dying care in a structured way]as usefulness facets of the LCP-J, and[difficulty in assessment of dying],[burden of health care professionals], and[difficulty using LCP-J without knowledge and training in dying care]as burdens of the LCP-J. We explored the burden of LCP-J in general wards, and found that use of the LCP-J could need education in dying care and backup of the palliative care team.
5.The educational effect of a training program in ambulatory care for residents
Yoko Obata ; Hisayuki Hamada ; Takashi Miyamoto ; Kayoko Matsushima ; Shintaro Hara ; Ruka Nakata ; Tomoko Narita ; Hidetaka Shibata ; Tomoo Nakata ; Hisayoshi Kondo ; Ryota Nakaoke
An Official Journal of the Japan Primary Care Association 2014;37(4):333-339
Introduction : We initiated an ambulatory care training program at five community hospitals in Nagasaki, including hospitals on remote islands, for the residents of Nagasaki University Hospital. We examined the educational effect of the ambulatory care training program in meeting the achievement targets for clinical training.
Methods : The study included all residents (n=49) working in Nagasaki University Hospital in 2012. Following completion of the ambulatory care training program, the residents answered a questionnaire on the number of patients and their symptoms, inaddition to a self-assessment, and assessment by their supervisor.
Results : The mean number of patients seen was 3.29 persons / training session. The number of symptoms to be encountered, which are established by Ministry of Health, Labour and Welfare, was positively correlated with the total number of patients seen. Although residents initially had a low rating of self-assessment on diagnosis or treatment, this rating tended to increase with time. The gap in levels on assessment of history taking, diagnosis, or treatment by residents versus those by the supervisors reduced with time in the program.
Conclusion : Our ambulatory care training program is an effective program for meeting the achievement targets in clinical training for residents.
6.Clinical Features and Treatment Outcome of Childhood Leukemia
Yuji MIYAJIMA ; Erika KITAMURA ; Yoko SHIBATA ; Chihiro HATANO ; Fumiko MIYAZAKI ; Sachie ITO ; Jun SAWAI ; Miyuki MAGOTA ; Kaname MATSUSAWA ; Tatsuya FUKAZAWA ; Koji TAKEMOTO ; Tetsuo KUBOTA ; Yuichi KATO ; Akimasa OGAWA ; Kuniyoshi KUNO
Journal of the Japanese Association of Rural Medicine 2011;60(4):527-534
We reviewed the clinical features and treatment outcome of 110 children with leukemia. Treatment was performed between 1980 and 2009 at our hospital. The mean age at onest was 5 years 6 months, the ratio of males to females was 1:0.72, and mean leukocyte count was 4.91×104/μl. Subtypes of leukemia were acute lymphoblastic leukemia (ALL) in 79.1% of the patients, acute myeloid leukemia (AML) in 17.2%, and chronic leukemia in 3.6%. In all patients, the overall 30-year survival rate estimated by the Kaplan-Meier method was 67.4%. In the three decades from the 1980s, the overall 10-year survival rate has been improved significantly from 46.4% in the 1980s, 69.2% in the 1990s to 87.2% in the 2000s (P<0.01). The overall 10-year survival rate was 70.7% in all children with ALL, and 70.6% in all children with AML. But in the last decade, the 10-year survival rate was improved to 87.0% in children with ALL and 87.3% in children with AML. Twenty-four patients received hematopoietic stem-cell transplantation, and the 10-year survival rate was 58.6% after transplant. Second malignancies were detected in three patients, and six patients have long-term sequelae. In conclusionn, the treatment result of childhood leukemia has improved considerably, so that more intensive treatment for patients with poor prognosis and less toxic treatment for patients with good prognosis will be necessary in future.