We aimed to summarize the evidence of an association between nurse staffing and nursing sensitivity outcomes in Japanese hospitals. A scoping review was conducted and reported following the PRISMA-SR 2020 statement. The ICHUSHI and CiNii databases were searched for published articles written in Japanese and PubMed and CINAHL for those written in English. Out of the 15 included studies, all observational studies, 3 were written in Japanese and the others in English. The nurse staffing level measures were grouped into three categories: patient-to-nurse ratio, nursing hours per patient day, and nurse-to-bed ratio. The outcome measures were grouped into three categories: patient outcome, nursing care quality reported by nurses, and nurse outcome/nursing care quality. Some studies reported that the nursing staff increasingly favored positive patient outcome. Conversely, the findings regarding failure to rescue, in-hospital fracture, and post-operative complications were inconsistent. Although some studies indicated that more nurse staffing was favored toward better patient and nurse outcomes, due to the sparse accumulation of studies and heterogeneity among the findings, it is difficult to draw robust conclusions between nurse staffing level and outcomes in Japanese acute care hospitals.
A training opportunity in which ongoing education is encouraged is one of the determinants in recruiting and retaining nurses in home-visit nursing care agencies. We investigated the association between ensuring training opportunities through scheduled training programs and the change in the number of nurses in home-visit nursing agencies using nationwide panel data at the agency level. We used nationwide registry panel data of home-visit nursing agencies from 2012 to 2015 in Japan. To investigate the association between planning training programs and the change in the number of nurses in the following year, we conducted fixed-effect panel data regression analysis. We identified 4760, 5160 and 5025 agencies in 2012, 2013, and 2014, respectively. Approximately 60–80% of the agencies planned training programs for all staff, both new and former, during the study period. The means and standard deviations of the percentage change in the number of full time equivalent (FTE) nurses in the following year were 4.2 (19.8), 5.7 (23.5), and 5.8 (25.1), respectively. Overall, we found no statistically significant association between scheduled training programs and the change in the number of FTE nurses in the following year. However, the associations varied by agency size. Results of analysis stratified by agency size suggested that the first and second quartile sized agencies (2.5–4.0 FTE nurses) with scheduled training programs for all employees were more likely to see a 9.0% (95% confidence interval [CI]: 4.5, 13.5) and 8.5% (95% CI: 2.4, 14.5) increase in the number of FTE nurses in the following year, respectively. Similarly, the first and second quartile sized agencies with scheduled training programs for new employees were more likely to see a 4.7% (95% CI: 2.1, 7.2) and 3.3% (95% CI: 0.4, 6.2) increase in the number of FTE nurses in the following year, respectively. Ensuring training opportunities through scheduled training programs for all staff, both new and former, in relatively small-sized home-visit nursing agencies might contribute to an increase in the number of nurses at each agency.
Studies have indicated that higher numbers of nurses regarding staffing ensure patient safety and a better practice environment. Using citation analysis, this study visualizes the landscape of nurse staffing research over the last two decades to show the overall publication trends, major contributors, and main research topics. We extracted bibliometric information from PubMed from January 2000 to September 2022. After clustering the network, we analyzed each cluster’s characteristics by keyword. A total of 2167 papers were considered for analysis, and 14 clusters were created. The analysis showed that the number of papers published per year has been increasing. Researchers from the US, the UK, Canada, Australia, and Belgium have led this field. As the main clusters in nurse staffing research during the past two decades, the following five research settings were identified: nurse outcome and patient outcome research in acute care hospitals, nurse staffing mandate evaluation research, nursing home research, and school nurse research. The first three clusters accounted for more than 80% of the total number of published papers, and this ratio has not changed in the past 20 years. To further develop nurse staffing research globally, evidence from other geographic areas, such as African and Asian countries, and from long-term care or community settings is necessary.
Objectives: The aim of this study was to elucidate the factors affecting the difficulties in receiving a medical consultation among workers with mental health problems. Methods: The present study was performed using a cross-sectional survey. We requested occupational physicians and nurses who were members of the Japan Society for Occupational Health to distribute self-administered questionnaires to their clients. Results: Ninety-nine workers (68 males and 30 females), aged 40.6 ± 9.1 yr, returned completed questionnaires; 65% of the respondents had been diagnosed with depression. The most common difficulty perceived by them was that there were no intra-office counselors. Multiple regression analysis revealed that the number of months between the onset of mental health problems and the first medical consultation was significantly associated with age and having no sick leave allowance. Conclusions: The implementation and enhancement of sick leave allowance may promote early intervention in regard to workplace mental health problems. Mental health education and regular checkups for older workers is also critical for early detection and intervention of mental health problems.