Objective: Avoiding injection incompatibilities is important. At our hospital, pharmacists are present at the intensive care unit (ICU),where they manage drip lines and use a lookup table for injection incompatibilities. We assessed the risk of injection incompatibilities in the ICU and the contribution of pharmacists toward their avoidance.Methods: We investigated the number of injections and main drip lines used for outpatients admitted to the general ward and ICU from an emergency setting. We further investigated inappropriate drip line conditions, subsequent interventions by pharmacists, and the actual number of injection incompatibilities. The investigation period lasted 1 year from April 2016 onward.Results: The number of injections and drip lines used in the ICU was significantly higher than that used in the general ward (p<0.001). Patients in the ICU received multiple continuous intravenous injections from one drip line despite the number of main drip lines being high. Even using the lookup table, 78.3% inquiries made by nurses were related to injection incompatibilities. Fourteen inappropriate drip lines selected by nurses were associated with a risk of injection incompatibility; these occurred during the absence of pharmacists and involved a combination of continuous intravenous injections to be administered from a side line. Subsequently,pharmacists intervened and avoided injection incompatibilities. There was no report of injection incompatibilities in the ICU.Conclusion: At ICU, the risk of injection incompatibilities is high and it is necessary to focus on the combination of injections to be administered from main drip lines and side lines as well as incompatibilities of multiple continuous intravenous injections to be administered from side lines. A lookup table is insufficient to avoid injection incompatibilities. Therefore, pharmacists can contribute to avoiding injection incompatibilities by maintaining constant presence in the ICU, designing drip line layouts, and proposing line selections.

A questionnaire was administered to identify differences between the information that ward nurses think should be provided on a discharge summary and the information that outpatient nurses consider is necessary for providing continuing nursing care. Respondents were asked to select from multiple choice answers which information they believe is necessary to provide on a discharge summary and their perceptions about continuing nursing care, and they were also asked to record the reasons for their selections. Multiple choice responses were aggregated by simple tabulation and reasons were aggregated by similarity. The results showed that ward nurses and outpatient nurses had the same perceptions of what information is needed on a discharge summary. However, whereas the outpatient nurses wanted to see specific information about what care should be continued on the discharge summary, the ward nurses considered continuing nursing care to mean sharing summarized information about the patient's hospital course. This difference can be attributed to the unique characteristics of ward nurses and outpatient nurses. To provide continuing nursing care, ward nurses and outpatient nurses should each understand the other's thinking and learn what information the other considers necessary.

Engaru-Kosei General Hospital expanded its pharmacist duties in hospital wards in April 2018 following the nationwide switch to out-of-hospital prescriptions. The purpose of this study was to examine the effect of pharmacists’ ward duties on nursing duties. Pharmacists expanded their duties to cover drug distribution management, infusions of total parenteral nutrition (TPN) mixed with drugs, and aseptic preparation of 24-h infusions (including peripheral parenteral nutrition). The effects were compared between April 2018 before the expansion of duties and May-September 2018 after the expansion, and we compared the number of meetings set up to discuss nurses’ overtime hours and patient problems. In addition, interviews were conducted about the changes experienced on site. Drug distribution management averaged 3,150 cases/month. The number of TPN mixed infusions was 25 cases/month before expansion and this increased to 88 cases/month after expansion. The number of mixed injections of 24-h infusions was 296/month. Nurses' overtime hours did not decrease significantly, but the number of meetings increased from 47/month to 79.4/month. In the interviews, positive responses were obtained about, for example, the increased number of meetings held and more time for patient care. The pharmacist and the nurse collaborated to improve work by using their expertise, we think that the results obtained from work improvement contributed to the improvement of medical quality and medical safety.

In 1952, the Japanese Society for Hygiene had once passed a resolution at its 22nd symposium on population control, recommending the suppression of population growth based on the idea of cultivating a healthier population in the area of eugenics. Over half a century has now passed since this recommendation; Japan is witnessing an aging of the population (it is estimated that over 65-year-olds made up 27.7% of the population in 2017) and a decline in the birth rate (total fertility rate 1.43 births per woman in 2017) at a rate that is unparalleled in the world; Japan is faced with a "super-aging" society with low birth rate. In 2017, the Society passed a resolution to encourage all scientists to engage in academic researches to address the issue of the declining birth rate that Japan is currently facing. In this commentary, the Society hereby declares that the entire text of the 1952 proposal is revoked and the ideas relating to eugenics is rejected. Since the Society has set up a working group on the issue in 2016, there have been three symposiums, and working group committee members began publishing a series of articles in the Society's Japanese language journal. This commentary primarily provides an overview of the findings from the published articles, which will form the scientific basis for the Society's declaration. The areas we covered here included the following: (1) improving the social and work environment to balance between the personal and professional life; (2) proactive education on reproductive health; (3) children's health begins with nutritional management in women of reproductive age; (4) workplace environment and occupational health; (5) workplace measures to counter the declining birth rate; (6) research into the effect of environmental chemicals on sexual maturity, reproductive function, and the children of next generation; and (7) comprehensive research into the relationship among contemporary society, parental stress, and healthy child-rearing. Based on the seven topics, we will set out a declaration to address Japan's aging society with low birth rate.
Aging ; Birth Rate ; trends ; Child ; Child Health ; Environmental Exposure ; adverse effects ; prevention & control ; Female ; Health Planning Guidelines ; Humans ; Japan ; epidemiology ; Male ; Occupational Health ; Reproductive Health ; education ; Research Design ; standards ; Societies, Scientific ; organization & administration ; Stress, Psychological ; prevention & control ; Women's Health