A vascular access catheter has been widely used for hemodialysis patients in an emergency when an arteriovenous shunt get clogged and cannot be reopened or when patients have no arterio-venous fistula. However, it often causes deterioration in activities of daily living (ADLs) and other troubles. Therefore, we place the catheter into the internal jugular vein in the neck to minimize the risk of complications and patients' inconvenience. Nevertheless, free spaces tend to be created between the dressing agent and skin because the articular excursion is wide in the neck. Although the CDC (Centerfor Disease Control and Prevention) guidelines recommended that the dressing tapes should be changed once every seven days, we change the tapes every two or four days to avoid peeling-off. In this study, we examine the difference in fixation ability between two types of tapes;standard size (10×12 cm) and 1/4 cut-size (5×6 cm). Our results showed that there were significant differences in peeling-off area between the two tapes. The smaller-sized tape had better adhesion to the skin so that you could not peel it off easily. Furthermore, the smaller one stuck fast to the catheter and needed less replacement. Consequently, the skins seemed to be more protected.
Catheter ; Blood vascular ; SIZES ; Access ; Fixation - action

  A vascular access catheter has been widely used for hemodialysis patients in an emergency when an arteriovenous shunt get clogged and cannot be reopened or when patients have no arterio-venous fistula. However, it often causes deterioration in activities of daily living (ADLs) and other troubles. Therefore, we place the catheter into the internal jugular vein in the neck to minimize the risk of complications and patients' inconvenience. Nevertheless, free spaces tend to be created between the dressing agent and skin because the articular excursion is wide in the neck. Although the CDC (Centerfor Disease Control and Prevention) guidelines recommended that the dressing tapes should be changed once every seven days, we change the tapes every two or four days to avoid peeling-off. In this study, we examine the difference in fixation ability between two types of tapes;standard size (10×12 cm) and 1/4 cut-size (5×6 cm). Our results showed that there were significant differences in peeling-off area between the two tapes. The smaller-sized tape had better adhesion to the skin so that you could not peel it off easily. Furthermore, the smaller one stuck fast to the catheter and needed less replacement. Consequently, the skins seemed to be more protected.

Five years have passed since the Japan Nursing Association started the Diagnostic Service for Improving Labor and Nursing Quality (DiNQL). We have participated in DiNQL data input support analysis activities since 2013, and the DiNQL Promotion Committee was launched in 2015. Here, we report on the activities of the DiNQL Promotion Committee and evaluate the results of these activities. The DiNQL Promotion Committee's four main activities involve being in charge of the floor at meetings, clarifying the input method aimed at shortening data collection time, supporting analysis of the DiNQL data input, and holding workshops for analysis and utilization. A self-administered questionnaire was administered to 43 ward nursing managers (including section chiefs and managers) to evaluate these committee activities. Both section chiefs and clerical staff responded that DiNQL data input time was shortened by more than 90%. Section chiefs comprised 64% and managers 79% of those who responded that DiNQL data could be utilized for determining annual departmental goals. In total, 71% of managers and 50% of section chiefs responded that DiNQL data is useful for nursing management. Based on these results, we confirmed that setting up the DiNQL Promotion Committee and its activities has led to nursing management support.

​Objective: The purpose of this study was to clarify the characteristics of physical quality of life (QOL) and activities of daily living (ADL) in patients with advanced cancer undergoing home-visit rehabilitation. Method: In this prospective study, we included 35 patients with advanced cancer undergoing home-visit rehabilitation. Physical QOL was assessed using the Physical Functioning (PF) score on the QLQ-C15, and ADL was assessed using the Barthel Index (BI) and Functional Independence Measure (Motor FIM) scores. Changes in physical QOL and each ADL scores from the start of rehabilitation to 4 weeks later were investigated. Also, patients were divided into two groups according to the PF score and characteristics of physical QOL and ADL between the two groups were explored. Result: PF score was significantly improved after 4 weeks compared to baseline. In the PF score maintenance/improvement group, motor FIM score was significantly improved after 4 weeks compared to baseline. Conclusion: The physical QOL of patients with advanced cancer undergoing home-visit rehabilitation was maintained and improved 4 weeks after the start of rehabilitation. It was suggested that maintaining ADL may lead to maintenance and improvement of physical QOL.

Objectives: Approximately 17% of Japanese women have hemoglobin concentrations less than 12 g/dL. Therefore, anemia prevention and early intervention are crucial public health issues in Japan. This study aimed to identify the symptoms and characteristics of anemic individuals in the general adult population by comparing survey responses of individuals with anemia and without anemia visiting blood donation centers.Materials and Methods: This cross-sectional study used self-administered questionnaires. Individuals who visited two Japanese Red Cross Society blood donation centers in Fukushima Prefecture, Japan were included. Hemoglobin levels were measured at blood donation, and the levels of 13 g/dL for men and 12 g/dL for women were defined as anemia.Results: Of the 857 individuals analyzed, 530 were men and 327 were women, of whom 19 (3.6%) and 12 (3.7%) had low hemoglobin levels, respectively. Logistic regression analysis was performed in men, and the results showed that “lightheadedness” (odds ratio [OR]=8.4) and “depressive symptoms” (OR=3.6) were significantly associated with hemoglobin levels. None of the evaluated items were significantly associated with hemoglobin levels in women.Conclusion: Among healthy Japanese men, those who exhibit lightheadedness and depressive symptoms have an increased risk of anemia. Lightheadedness and depressive symptoms may be indicative of undiagnosed anemia in men, which necessitates greater clinical attention.

Retrograde type A aortic dissection (RTAD) following thoracic endovascular aortic repair (TEVAR) is a lethal complication. A 54-year-old woman with bovine aortic arch presented with dilatation of the descending aorta due to chronic type B aortic dissection. She underwent TEVAR in zone 2 for closure of the entry site just below the origin of the left subclavian artery. On the day after TEAVR, she showed right hemiparesis, and was diagnosed with cerebral infarction on MRI and RTAD on CT. She underwent an emergent operation. The entry was at the proximal end of the bovine trunk, where the edge of the bare stent stuck out. We performed partial arch replacement with entry resection. Her postoperative course was uneventful. She was transferred to another hospital for rehabilitation 37 days after the surgery.