Makoto Tsukuda

We organized a family nursing seminar employing virtual simulation for home visiting nurses. The seminar utilized gamification and a digitally simulated family to enhance family nursing competence. This study aims to evaluate the effectiveness of a seminar by conducting a β test of a virtual simulation. This study employed a descriptive design. Study period was from November of 2022 to January of 2023. Study participants were seven home visiting nurses at four Home-Visit Nursing Agencies in Japan. In the virtual simulation, participants communicated with the digitally simulated family created with Unreal Engine 5.0.0. Before and after the seminar, participants were asked to complete the Family Nursing Competency Scale and data were gathered through an open-ended questionnaire. The total scores on the Family Nursing Practice Competence Scale all increased after the seminar. In feedback, the instructor commented that the simulation scenarios and level of difficulty were appropriate but that the time schedule needed to be revised. Participants also commented on the reality and tension in the digitally simulated family and the lack of discussion. The integration of gamification and the digitally simulated family was positively accepted and increased the sense of reality and tension of the participants. However, there were problems with the recognition of achievement, time management of the debriefing sessions. Further modifications to this seminar design are needed.

The essential skills required for nursing practice for patients on ventilator support include knowledge of ventilators, invasive techniques for preventing complications, and risk prediction for safe management. Therefore, management in the intensive care area is generally recommended for patients on ventilator support. In addition, the coronavirus disease 2019 pandemic has rapidly increased ventilator-related patients. Nursing practice for ventilator-associated patients is complex and requires advanced knowledge and skill. Therefore, this study aimed to develop a nursing practice self-assessment scale for clinical nurses and evaluate its reliability and validity. A survey of 629 nurses found that the scale could be classified into the machine and patient management. The management of the ventilator comprised the following 31 items with six factors: “initial confirmation,” “artificial airway,” “alarm management,” “humidification management,” “emergency management,” and “airway fixation.” For patient management, 27 items of five factors, including “complication prevention,” “prevent VAP,” “transfer safely,” “skin management,” and “assessment post transferred” were extracted. Finally, we believe that our study contributes significantly to the literature because it provides relevant evidence-based findings, which indicate that this scale can help in the safe practice of ventilator care.

There exists an international consensus on the importance of family-centered care (FCC) in intensive care settings and the evaluation of collaboration between nurses and families; however, FCC is currently practiced blindly in Japan. In this study, we developed a Japanese version of the questionnaire, Factors that Influence Family Engagement (QFIFE-J) and examined its reliability and validity. A web-based survey was conducted with 250 nurses working in the intensive care unit (ICU). Exploratory and validatory factor analyses were used to ascertain factor validity. Criterion-related validity was tested using correlation analysis with the ICU Nurses’ Family Assistance Practice Scale. Internal consistency and reproducibility were verified for reliability. Following exploratory and confirmatory factor analyses, a 15-item measure emerged comprising four factors: “ICU environment”, “nurses’ attitudes”, “nurses’ workflow”, and “patient acuity”. Confirmatory factor analyses showed a generally good fit. Cronbach’s α for the overall scale was 0.78, indicating acceptable internal consistency. The intraclass coefficient for test–retest reliability was 0.80. It was found that the QFIFE-J was reliable and valid and may help determine the factors that promote or inhibit FCC. Additionally, this study has also clarified the current status and family support related issues in ICUs in Japan.