酒井 郁子

Objective: The objective of this review is to explore the experiences and attitudes of physicians, nurses, and nursing assistants regarding task-shifting and task-sharing in hospitals. Introduction: Despite multiple health care professionals performing overlapping tasks, the need for effective task-shifting and task-sharing remains a concern. Understanding task-shifting and task-sharing experiences, as well as the attitudes of health care providers in hospitals, is essential for providing safe and patient-appropriate care with limited human resources. Inclusion criteria: Qualitative studies that examine the experiences and attitudes of physicians, nurses, and nursing assistants in hospitals regarding task-shifting and task-sharing will be included. The review will include physicians, advanced practice nurses who are nurse practitioners or clinical nurse specialists, registered nurses, and nursing assistants. Midwives, pharmacists, occupational therapists, physical therapists, and students will be excluded. Methods: PubMed, MEDLINE, CINAHL, PsycINFO, Cochrane Database, and Web of Science will be searched as part of a 3-step search strategy. We will search for unpublished research and gray literature using Google Scholar and ProQuest Dissertations and Theses. Inclusion criteria will be studies published in English or Japanese from the time each database was established to the present. The methodological quality of all studies will be evaluated by screening against the inclusion criteria and by at least 2 critical evaluations using the standardized JBI checklist. Synthesized results will be pooled by meta-aggregation and published as a ConQual Summary of Findings. Review registration: PROSPERO CRD42023409612

Background. Strategic leadership is key to implementing evidence-based practice (EBP). Evaluating the readiness and processes necessary to implement EBP using the Japanese version of the implementation leadership scale (ILS) may be useful to systematically promote the implementation of EBP in Japan. This study aimed to evaluate the reliability and validity of the Japanese version of the ILS for nurse managers and staff nurses. Methods. Data were collected in a cross-sectional study. The original ILS was translated into Japanese and back-translated into English. Clinical nurses reviewed it and confirmed its face validity. We distributed a web questionnaire to 119 nurse managers and 2,858 staff nurses working at three university hospitals in Japan’s metropolitan areas. Construct validity was assessed for nursing managers and staff nurses, respectively, using confirmatory factor analysis. Known-group validity for nurse managers was assessed by verifying differences in ILS scores by educational background and experience of learning EBP and working on EBP. We evaluated reliability using Cronbach’s alpha and test-retest reliability. Results. The response rates for nurse managers and staff nurses were 56.3% and 16.9%, respectively. Data from 67 nursing managers and 484 staff nurses were analyzed, excluding duplicate responses. Confirmatory factor analyses of both samples supported the four-factor structure of ILS. The ILS total score of nurse managers with experience learning EBP or experience working on EBP was statistically significantly higher than that of those with no experience, and known-group validity was supported. Across both samples, internal consistency reliability was strong (Cronbach’s alpha: 0.91–0.97) and test-retest reliability was moderate. Conclusion. This study illustrated the reliability and validity of Japanese versions of the ILS for both nurse managers and staff nurses. This study enabled international comparisons of the leadership required for EBP implementation and may support the development of intervention programs and strategies to promote EBP’s implementation in different countries. Trial Registration. UMIN Clinical Trials Registry (UMIN-CTR). This trail is registered with UMIN000045782.

本研究は,急性期病院で特定行為研修修了者の効果的な活動を支援するため,施設管理者および看護管理者の管理実践の要素を明らかにすることを目的として実施した.特定行為研修を受講した看護師がいる病院の施設管理者と看護管理者を対象にオンラインで半構造的面接法による個別インタビューを行った.インタビューは1人あたり20分程度行い,録画をもとに逐語録を作成しデータを収集した.調査期間は2021年3月である.研究協力者は施設管理者8名と看護管理者11名だった.特定行為研修修了者の活動を支援する管理者の管理実践には,「組織における修了者の活躍を期待する」「組織における修了者活用のニーズを把握する」「特定行為研修制度及び修了者に対する理解を得る」「組織の機能に応じた修了者の配置計画を立案する」「特定行為研修に看護師を送り出して受講継続を支援する」「組織の構想に応じて修了者を配置する」「組織で修了者が活動継続するための環境を整える」「修了者の活用による効果を見出す」「組織の構想に応じて修了者の活動を調整する」「修了者の活動を多様な対象に周知する」が含まれていた.これらは特定行為研修修了者を導入して複数の修了者を組織で配置・活用するための管理実践の要素として解釈でき,構想・育成・配置・活用・最適化・周知が見いだされた.(著者抄録)