Objective: This study aimed to clarify the circumstances and challenges in home care-oriented hospital nurse training on the basis of results of hospital nurse self-evaluations of nursing activities implemented in preparation for home care.

Methods: Group interviews were conducted with 13 nurses at 9 different hospitals, and the results were qualitatively and inductively analyzed.

Results and Discussion: Six categories for actual nursing activities implemented in preparation for home care were extracted. These categories were "I leave home care to other medical professionals," "No form of inter-hospital cooperation has been established," "There is disparity in cooperation with home-visiting nurses," "Social resources are not being used due to a lack of knowledge," "Able to develop a perspective of home care through workshop participation, years of experience, and interest," and "Competency is lacking despite knowledge of home care." Home care was apparently not being utilized by hospital nurses due to a lack of knowledge of social resources and a lack of interdisciplinary cooperation.

Conclusions: Challenges in nurse training implemented in preparation for home care included compensating for the lack of practical knowledge of social resources and devising a duty system and inter-facility exchanges to allow nurses to build experience in other areas and departments. The results of this study suggested the need for organizational training initiatives and for improvement of the quality of individuals in order to put acquired knowledge into practice.

BACKGROUND: To improve postoperative outcomes associated with interstitial pneumonia (IP) in patients with lung cancer, the management of the postoperative a cute exacerbation of IP (PAEIP) was investigated. METHODS: Patients with primary lung cancer were considered to be at risk for PAEIP (possible PAEIP) based on a preoperative evaluation. The early phase of this study was from January 2001 to December 2008, and the late phase was from January 2009 to December 2014. In the early phase, chest computed tomography (CT) was performed for patients for whom PAEIP was suspected based on their symptoms, whereas in the late phase, chest CT was routinely performed within a few days postoperatively. The numbers of possible PAEIP cases, actual PAEIP cases, and deaths within 90 days due to PAEIP were compared between both phases. RESULTS: In the early and late phases, surgery was performed in 712 and 617 patients, 31 and 72 possible PAEIP cases were observed, nine and 12 actual PAEIP cases occurred, and the mean interval from the detection of PAEIP to starting treatment was 7.3±2.3 and 5.0±1.8 days, respectively. Five patients died in the early phase, and one patient died in the late phase. Significantly fewer PAEIP-related deaths were observed in the late phase (p<0.05). CONCLUSION: Identifying patients at risk for PAEIP by routine postoperative CT examinations led to the early diagnosis and treatment of PAEIP, resulting in the reduction of PAEIP-related mortality.
Early Diagnosis ; Humans ; Lung Diseases, Interstitial* ; Lung Neoplasms* ; Lung* ; Mortality ; Thorax* ; Tomography, X-Ray Computed