Miwako Konishi

This paper describes a nursing fuzzy expert system for preventing pressure ulcer development in post-operative patients. First, knowledge of expert nurse for pressure ulcer development is derived. Second, a fuzzy expert system is constructed by a simple calculation of fuzzy membership functions expressing the knowledge. The expert system produces a fuzzy degree by averaging the calculated values obtained by these membership functions. This system performance is evaluated by leave-one-out cross validation on 10 patients. Then, the nursing fuzzy expert system can determine the pressure ulcer development with better precision, compared with the past work with statistical analysis on 360 patients.

新人看護師が看護基礎教育の周手術期実習に求める学習内容を明らかにすることを目的に、卒業後1年以内の新人看護師16名を対象に半構成的面接を実施した。内容分析の結果、新人看護師は周手術期実習の学習内容と臨床実践との違いを、【判断を求められる】【専門的な知識を求められる】【責任を一人で負うことを求められる】【忙しくて時間がない】などと感じており、周手術期実習の学習内容として【アセスメントの知識】【回復過程を予測するための知識】【アセスメントの技術】【実践で用いる技術】を求めており、【疑問をもち、解決する姿勢が必要】と感じていることが分かった。

The purpose of this study was to elucidate the learning content perceived to be necessary for students by nurses in charge of a perioperative nursing practicum and their expectations for basic nursing education. An interview survey using a semi-structured questionnaire was conducted with 21 nurses. The learning content perceived by nurses to be necessary for students before the practicum was classified into seven categories, including "basic knowledge and skills regarding perioperative nursing", "communication skills for developing human relationships", and "determination to learn toward a defined goal". The learning content perceived to be necessary for students during the practicum was classified into six categories, including "integration of knowledge and practice", "understanding of patients, including before treatment and after discharge", and "positive attitude toward self-study". In addition, expectations regarding basic nursing education were classified into six categories, including "nurturing of compassion toward the experiences of patients" and "improvements in thinking and self-expression abilities". These findings suggest the need for investigation of teaching content and methods in basic nursing education for nurturing self-expression ability, compassion toward patients, and awareness of the aspiration to become a nursing professional, in addition to enhanced learning of knowledge and skills.

The purpose of this research is to clarify the ideal learning contents of perioperative training as a fundamental nursing educational subject by hearing the experience of new graduate nurses. Semi-constructive interviews were conducted between October and December 2005, directed to 16 new graduate nurses with average age of 24 years who were working for the perioperative wards in two medical institutions of Osaka Prefecture, which had agreed the purpose of the research. Ethical consideration was paid to the interviews under the screening of the medical ethics council of the University, and the interviewees agreed their participation at their own free will. Although the 16 interviewees acquired necessary content of learning for perioperative nursing during their perioperative training at school, they felt a shortage of fundamental educational learning after their employment. As a result of the interviews, the differences between the perioperative training and clinical practice were classified into three categories "knowledge", "technique", and "attitude" as well as "time spent" that <a shortage of time resulting from an increasing number of patients>. The contents of perioperative training that new graduate nurses expect were classified into seven categories adding <assessment knowledge>, <assessment technique>, <practical technique>, and <attitudes to solve questions positively>. From the foregoing, it is considered necessary to have more practical basis education for perioperative training.

手術中の体圧管理に用いられている簡易体圧測定用具の有効性について,基礎的実験を行った.その結果,骨突起部の形状や支持面の硬さによっては正確な測定値が得られないことが明らかとなった.今後,手術体位を充分に配慮した測定用具の適用が求められることが示唆された

市販されている3種類の体圧計について,1)圧トランスジューサーの精度の比較,2)使用場面を想定した計測値の比較を行った.とくに使用場面を想定し,2種類(直径16cm,12cm)の隆起の異なる球面モデルを硬板,マットレス,敷き布団上に置き,これらの接触面において生じた圧力値を計測した.全ての圧トランスジューサーの精度は,実加圧値とr≧0.96と高い相関がみられた.しかし使用場面を想定した測定では,3種類の体圧計の計測値は異なっており,特に隆起が大きい球面モデルを用いた場合は,60mmHg以上での計測値に違いがみられた.今後,接触面や骨突起の形態の違いに応じた体圧計の機器特性の改善が求められる.更に,褥瘡予防において看護観察で使用する場合には,体圧計の測定精度を十分に把握した上で観察する必要性が示唆された

過去の360例の観察記録に基づき,手術中に発生する患者固有の褥瘡発生危険因子を予測し,看護ケアへの指針を得ることを目的とした.褥瘡発生予測は,数量化II類により行った.外的基準は[体位][年齢][標準体重][体位の持続時間][吸入麻酔薬使用の有無][術中の循環系薬剤使用の有無][既往歴の有無][低蛋白血症の有無][貧血症の有無]の9アイテムである.数量化によって各説明変数の重みづけを行い,360例にあてはめたところ褥瘡発生予測のための判別的中率は76.5%であった