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Akiko Araki, RN, PHN, DNSc, MBA
Executive Officer of JNA
Nursing Innovation in Primary Health Care
JNA efforts toward the creation of community-based integrated care system
for all generations
Akiko Araki, RN, PHN, DNSc, MBA
Executive Officer
Japanese Nursing Association
2019 ICN Congress
June 29th, 2019
Japanese Nursing Association
Live life, together we create
Todays topics
1. Current situation in Japan
2. JNA’s “Future Vision of Nursing”
3. JNA efforts toward establishment of nursing provisional structure at the community-based integrated care system
Japanese Nursing Association 3
Population aging: age 65 years and over
Japanese Nursing Association 4
Source:United Nations Population Division of the Department of Economic and Social Affairs, World Population Prospects: The 2017Revision, http://esa.un.org/unpd/wpp/(accessed on April 10, 2019)Japan: Population Census for data between 1950 and 2010 ; National Institute of Population and Social Security Research, Population Projections for Japan (2017) for data after 2015
http://www.ipss.go.jp/pp-zenkoku/j/zenkoku2017/db_zenkoku2017/db_s_suikeikekka_1.html (accessed on April 10, 2019)
(%)
Society of super-aged and fewer children
0
5
10
15
20
25
30
35
40
45
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 2055 2060
Japan
Mexico
Singapore
China
Korea
India
Thailand
Jordan
Denmark
Spain
Netherlands
United States of America
Australia
South Africa
Japan
Increase in Social Security Benefits
0
200,000
400,000
600,000
800,000
1,000,000
1,200,000
19
70
19
71
19
72
19
73
19
74
19
75
19
76
19
77
19
78
19
79
19
80
19
81
19
82
19
83
19
84
19
85
19
86
19
87
19
88
19
89
19
90
19
91
19
92
19
93
19
94
19
95
19
96
19
97
19
98
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
20
11
20
12
20
13
20
14
Welfare etc. Pension Healthcare
Japanese Nursing Association 5
Created from Trends in Social Security Benefits, “Financial Statistics of Social Security in Japan FY 2017” , National Institute of Population and Social Security Research http://www.ipss.go.jp/ssj-db/ssj-db-top.asp (accessed on April 17th, 2019)
(JPY)
*100 JPY=1.21 SGD (exchange rate of April 17th, 2019)
Reference:This figure is created and rearranged by JNA based on the figure of community-based integrated care system posted on the website of Ministry of Health, Labour and Welfare http://www.mhlw.go.jp/stf/seisakunitsuite/bunya/hukushi_kaigo/kaigo_koureisha/chiiki-houkatsu/ (accessed on June 25,2018)
Toward healthcare and nursing supported by community
Building community-based integrated care system
Japanese Nursing Association 6
Long-term care
Facilitating smooth transition from healthcare to long-term care
Consultation and coordination of service
Healthcare
Integrated management
Living
Preventive long-term care support/ Livelihood
support
Inpatient
Advanced acute care phase
Acute care phase
Chronic phase
Recovery phase
JNA’s “Future Vision of Nursing”
Japanese Nursing Association 7
Society that people in any condition of health can live with by one’s own value
Viewpoint of“Healthcare”
Viewpoint of“Quality of life”
Nursing Supports and Sustains Human Life, Living and Dignity
Future Vision of Nursing
Published on June 2015
Japanese Nursing Association8
Nursing links living and health, medical and welfare
throughout life
Being Born and Grow Healthy
LivingHealthy
Recoveringfrom
Emergency /Critical
Condition
Returning to
Familiar Community
Living with Diseases
and Disabilities
Dying Peacefully
JNA’s “Future Vision of Nursing”Published on June 2015
Nursing professions should function on all occasions from the birth of people through to their end. They support all people at the community-based integrated cares system.
○ Formulating relationships and communities where families, pregnant and parturient women, and local residents help each other in child-rearing.
○ Helping people to acquire knowledge, behavior and habits to maintain health from their child age.
○ Promoting, in collaboration with people, the formulation of communities and workplaces where people’s healthy habits are set in place and maintained.
○ Supporting people with diseases/disabilities to live an independent life that matches them with reassurance.
○ Supporting people to live a life with dignity that matches them through to the final stage of their life.
- Future Vision of Nursing
Building community-based integrated care system for all generations
Japanese Nursing Association9
All persons including not only convalescent elders, but also people rearing children, children and people with disabilities live with a sense of reassurance.
Population in community
HospitalClinic
Municipality, Municipality’s Health Center
・Special nursing home for elderly・Healthcare facility for elderly・Group shared residence for people with dementia
Function enhanced visiting nursing provider
Visiting nursing station Visiting nursing by hospital
Home-based service・Day care service・Home visit bathing・Short-term stay
Periodical round
Community general support center
Nurse-led comprehensive community careMultifunctional long-term care in a small group home
In-home long-term care support service provider
Community based service
The population needs in community become
complicated and varied.Link among service resources in community is essential. Nursing professions working at institutions and serviceproviders are the key for coordination and management.(e.g. diseases, disabilities, values, housing, family composition,
living environments and economic resources)
Enhancing partnership among nursing professions in community
Japanese Nursing Association10
Created by JNA
Aim:Establishing mechanism to support lives of population with a sense of reassurancethrough development of intra-professional collaboration among nurses
Strengthen networking among nursing profession in community
Japanese Nursing Association 11
JNA commissioned projects to regional branch of prefectural nursing associations etc. at 20 settings in order to strengthen networking foundation among nurses and among related professions in their community.
1. Activities toward regular networking among nursing professions in community
2. Events with community or intra-professions
Central District of Okinawa Nursing Association;Opinion exchange meeting aiming to establish network among related organization of nursing professions
Okitama Branch, Yamagata Nursing Association;Physical exercise to prevent long-term care at “town corner healthcare consultation room”
Support for children’s transition of from hospital to home-based care
Japanese Nursing Association 12
Japan is the one of the top class countries of rescue rates on extremely low-birth-weight baby and severely ill newborn.
The number of children requiring medical care including management of respirator and gastric fistula at home is about 18,000 in Japan.1)
There were gaps in notions between hospitals and visiting nursing stations about “the timing to inform discharge” and “the image of medical care at home” .2)
9,987 9,967
8,438
10,413
13,968
10,702
14,886 13,585
15,892 16,575
17,209 18,272
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
The number of children requiring medical care1)
1) The Health and Labour Science Research Grant, Comprehensive Research on Disability Health and Welfare; The report from “ Actual situation survey on children requiring medical care and research on collaboration among medical, welfare, health, education etc. by Tamura group”Source: ministry of Health, Labour and Welfare; document no. 1 of the FY 2018 Joint Meeting for persons in charge of establishment of community support system for children requiring medical care and others https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000181001_00001.html(accessed on April 18, 2019)2) Interview of nurses working at hospital and visiting nursing stations conducted by JNA in 2015
(persons)
(year)
Training of trainers program on support for children’s transition from hospitals to home based care
JNA Activities
FY2016 : Developed “the pathway and education program for NICU/GCU on support for children’s transition from hospitals to home based care”
FY2017-: Training of Trainers on support for children’s transition from hospitals to home based care
Japanese Nursing Association 13
Outcomes: The number of training graduates in FY 2017, 2018 : 290
Report from Graduates(response through questionnaire)
Increased number of facilities were introduced, on the development and under consideration of the pathway and/or education program
Increased communication among staff on discharge support
Increased opportunities to collaborate with other health workers
Issues: Nursing professions working at hospitals with NICU/GCU are required to provide care to children, including extremely low-birth-weight baby, with a view of their living after discharge throughout their admission.
Other JNA activities on enhancing intra-professional collaboration among nursing professions in community
JNA also works at other activities aiming for people to receive seamless care by the collaboration of nursing professions working throughout community which enable them to play their role.
• Development of effective and efficient collaboration model of nursing professions in community
• Development of business proposition toward inclusive society with nurse-led community based care at the core
Japanese Nursing Association 14
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