社会実装看護創成研究センター

Ryoko Murayama

  (村山 陵子)

Profile Information

Affiliation
Professor, Research Center for Implementation Nursing Science Initiative, Reseach Promotion Headquarters, Fujita Health University
Degree
Doctor(Eng)(Nihon University)

J-GLOBAL ID
201101039091532212
researchmap Member ID
1000296219

Papers

 110
  • 村山 陵子, 阿部 麻里
    看護理工学会誌, 11 106-111, 2024  
    超音波検査装置(エコー)は,非侵襲,非拘束,リアルタイムに皮下組織のアセスメントが可能である.それを活用し,末梢静脈カテーテル留置の際にエコーで観察しながら穿刺,および留置を可能とするカテーテル留置技術を考案した.しかし観察する際に用いるプローブやエコーゼリーによって清潔野が確保しにくく,感染の恐れを伴うことが課題であった.そこで超音波透過性のよいカテーテル固定用ドレッシングフィルムを,産学連携(看護理工学会員と賛助会員の企業との連携)により製作し,一般医療機器として上市にいたった.入院患者に対し新ドレッシングフィルムを使用し,視診できない血管をエコーで画像描出できたことでカテーテル留置が成功し実用化できたことより,開発が完了したことを報告する.今後はさらに使用実績を積み,ユーザビリティーや医療従事者,患者双方の満足感,費用対効果の検証もしながら,さらなる現場のニーズを開発者にフィードバックしていく必要がある.(著者抄録)
  • 村山 陵子, 芦田 沙矢香, 南谷 真理子, 松崎 政代, 吉田 美香子, 春名 めぐみ
    日本助産学会誌, 37(3) 243-251, Dec, 2023  
    目的 骨盤臓器脱(POP)を含む骨盤底障害のリスクファクターとして最も多いのは妊娠・出産である。しかし,POPの原因は胎児による産道への負荷だけでなく,腹腔内圧の上昇による骨盤内臓器の下降がある。POPは多彩な自覚症状を示すため,問診による診断が困難である。POPの特異的症状の有病率と腹腔内圧を上昇させる習慣などの危険因子との関係がわかれば,産後の女性のPOP発症を予防できる可能性がある。本研究の目的は,産後5年間の骨盤臓器脱の自覚症状の有病率を産褥期ごとに明らかにすることである。さらに,これらの自覚症状の危険因子を明らかにすることである。方法 本調査は,東京大学医学部附属病院で経腟分娩を行った人を対象とした横断的研究であった。質問票は,Prolapse Distress Inventory(POPDI-6)を含むPelvic Floor Distress Inventory-short form 20 日本語版を使用した。産後半年ごとにPOPの症状経験率を算出した。またライフスタイルや出産記録など参加者の特徴を質問票やカルテから把握した。参加者を症状のあり,なしの2群に分け,2群間で有意差のある変数を用いてロジスティック回帰分析を行った。結果 合計3776名に質問票を配布し,1056名(28.0%)から回答を得た。有効回答数は681名であり,産後5年間にPOPの自覚症状があった女性は36%,産後半年以内にあった女性は43%であった。産後の各期間において,POP症状を持つ割合に有意な差はなかった。POP症状を有する女性は,そうでない女性に比べて,失禁,硬便,妊娠前の排便時に力む習慣,産後の硬便を経験する割合が有意に高かった。結論 妊娠前の生活習慣と産後の排泄状態が産後のPOP症状に関係していたため,POP症状の悪化,発症を予防するためには,産後早期の症状の有無のモニタリングや排泄ケア,骨盤底に負担をかけない日常生活行動へのアドバイスなどのケアの必要性が示唆された。(著者抄録)
  • Mari Abe-Doi, Ryoko Murayama, Kojiro Morita, Gojiro Nakagami, Hiromi Sanada
    Asian Nursing Research, 17(5) 269-275, Dec, 2023  
  • Ryoko Murayama, Mari Abe-Doi, Yosuke Masamoto, Kosuke Kashiwabara, Chieko Komiyama, Hiromi Sanada, Mineo Kurokawa
    Drug discoveries & therapeutics, 17(1) 52-59, Mar 11, 2023  
    Intravenous infusion using a peripheral intravenous catheter (PIVC) is often complicated by catheter failure (CF). We hypothesized that catheterization of an upper arm vein instead of a forearm vein may help prevent CF. This study was designed to compare the incidence of CF in patients receiving hyper-stimulant drugs when catheters are placed in the forearm using short PIVCs (SPCs) with that when catheters are placed in the upper arm using the new long PIVCs. Patients admitted to a university hospital in Tokyo, Japan were enrolled in this study and were assigned to the SPC or the new long PIVC group. The primary outcome was the incidence of CF until 7 days. The secondary outcomes were the number of CFs per 1,000 days, the duration of the indwelling catheter, and the presence of thrombi and subcutaneous edema. Forty-seven patients were analyzed (median age, 67.0 years). The incidence of CF was 0% in the new long PIVCs and 32.0% (8 catheters) in the SPCs (p = 0.007), and the number of CF per 1,000 days was 0/1,000 and 81.7/1,000 days, respectively (p = 0.001). A significant difference in the duration of the indwelling catheter until CF occurrence was observed between the two groups (p = 0.004). Thrombi and subcutaneous edema were observed more frequently in the SPC group (p < 0.001). Catheterization of an upper arm vein using the new long PIVC to administer a hyper-stimulant drug might reduce CF compared with catheterization of a forearm vein using SPC.
  • Mari Abe-Doi, Ryoko Murayama, Toshiaki Takahashi, Masaru Matsumoto, Nao Tamai, Gojiro Nakagami, Hiromi Sanada
    The Journal of Vascular Access, 112972982311564-112972982311564, Mar 9, 2023  
    Background: Ultrasound guidance increases the success rate of peripheral intravenous catheter placement. However, the longer time required to obtain ultrasound-guided access poses difficulties for ultrasound beginners. Notably, interpretation of ultrasonographic images is considered as one of the main reasons of difficulty in using ultrasound for catheter placement. Therefore, an automatic vessel detection system (AVDS) using artificial intelligence was developed. This study aimed to investigate the effectiveness of AVDS for ultrasound beginners in selecting puncture points and determine suitable users for this system. Methods: In this crossover experiment involving the use of ultrasound with and without AVDS, we enrolled 10 clinical nurses, including 5 with some experience in peripheral intravenous catheterization using ultrasound-aided methods (categorized as ultrasound beginners) and 5 with no experience in ultrasound and less experience in peripheral intravenous catheterization using conventional methods (categorized as inexperienced). These participants chose two puncture points (those with the largest and second largest diameter) as ideal in each forearm of a healthy volunteer. The results of this study were the time required for the selection of puncture points and the vein diameter of the selected points. Results: Among ultrasound beginners, the time required for puncture point selection in the right forearm second candidate vein with a small diameter (&lt;3 mm) was significantly shorter when using ultrasound with AVDS than when using it without AVDS (mean, 87 vs 247 s). Among inexperienced nurses, no significant difference in the time required for all puncture point selections was found between the use of ultrasound with and without AVDS. In the vein diameter, significant difference was shown only in the absolute difference at left second candidate among inexperienced participants. Conclusion: Ultrasonography beginners needed less time to select the puncture points in a small diameter vein using ultrasound with AVDS than without AVDS.

Misc.

 73
  • 高橋聡明, 新谷結衣, 村山陵子, 村山陵子, 野口博史, 阿部麻里, KOUDOUNAS Sofoklis, 仲上豪二朗, 仲上豪二朗, 森武俊, 真田弘美, 真田弘美
    日本創傷・オストミー・失禁管理学会誌(Web), 25(3), 2021  
  • 村山陵子, 村山陵子, 阿部麻里, 木暮貴政, 高橋聡明, 菅野智穂, 石垣真理, 真田弘美, 真田弘美
    看護理工学会誌(Web), 8, 2021  
  • 阿部麻里, 大江真琴, 池田真理, 村山陵子, 村山陵子, 小見山智恵子, 真田弘美, 真田弘美
    看護理工学会誌(Web), 8, 2021  
  • Mari Abe-Doi, Ryoko Murayama, Chieko Komiyama, Hiromi Sanada
    Japan journal of nursing science : JJNS, e12329, Feb 9, 2020  
    AIMS: Following chemotherapy, induration may occur. This study was conducted to survey induration incidence and risk factors, and investigation for actual condition of induration. METHODS: A cohort study was conducted for survey of incidence and risk factors, and a cross-sectional observation study was conducted to examine actual condition of induration. The sites of chemotherapy administration were recorded, and these were observed on the next treatment day. Clinical nurses judged the presence or absence of induration by palpation. The sites were observed using ultrasonography. To investigate the risk factors associated with the induration, logistic regression analysis was performed using independent variables based on univariate analysis or previous reports. RESULTS: In total, 69 patients were analyzed. The induration incidence was 17.4%, and three abnormal conditions were confirmed: subcutaneous edema, thrombosis, and thickening of the vessel wall. Breast cancer, non-vesicant drug, vein diameter, and fosaprepitant use were included in the logistic regression model. Breast cancer: odds ratio (OR) 9.25; 95 CI 1.91.-44.71; non-vesicant drug: OR 1.37; 95 CI 0.13-14.95; vein diameter: OR 0.40; 95% CI 0.16-0.97; fosaprepitant use: OR 0.16; 95% CI, 0.18-10.32. CONCLUSIONS: The induration incidence was 17.4%. Risk factors for induration following chemotherapy administration were breast cancer and smaller vein diameter. Abnormal cases of subcutaneous tissue were confirmed, including subcutaneous edema, thrombosis, and thickening of the vessel wall. Induration may be prevented by selecting larger diameter vessels using ultrasonography when catheterizing for chemotherapy.
  • Chiho Kanno, Ryoko Murayama, Mari Abe-Doi, Toshiaki Takahashi, Yui Shintani, Junko Nogami, Chieko Komiyama, Hiromi Sanada
    Drug discoveries & therapeutics, 14(1) 27-34, 2020  
    Up to 50% peripheral intravenous catheters (PIVs) are removed prematurely because of failures. Catheter failure (CF) leads to replacement and is a great concern for patients and medical staff. It is known that visualization of catheters and vessels with ultrasonography (US) during placement prevents CF. However, US is not a common technique for general nurses. In order to standardize US-assisted PIV placement techniques, an algorithm is needed. This study aimed to develop an algorithm using US-assisted PIV placement to reduce CF rate. Furthermore, to evaluate the effectiveness of the algorithm, CF rates were compared before and after intervention. A pretest-posttest study was performed. The intervention was PIV placement by 23 nurses undergoing training sessions for the algorithm. Intention to treat, per protocol analyses were applied. Logistic regression analysis was used for factor analysis. The CF rate in the pre-intervention group 35.2% (19/54) did not significantly differ from post-intervention group 33.6% (48/143) (p = 0.831), yet significantly differ from complete algorithm-use group 8.7% (2/23; p = 0.017). In factor analysis, compliance to the algorithm was significantly correlated with CF (p = 0.032). The compliance rate was low 16.1% (23/143). Algorithm compliance reduced CF by confirming appropriate catheter tip position from the insertion to the securement phase. This algorithm effectively reduced CF, however, the compliance rate was unacceptable. In order to increase the compliance rate, modified algorithm and new visualizing technology is required.

Books and Other Publications

 10

Professional Memberships

 8

Research Projects

 27