JNA News Release2016.March Vol.20

JNA News Release
Japanese Nursing Association
5-8-2 Jingu-mae, Shibuya-ku, Tokyo 150-0001, JAPAN

Tel: +81-3-5778-8559

Fax: +81-3-5778-8478

http://www.nurse.or.jp/jna/english/

Message from JNA President, Dr. Suga Sakamoto
I am now in the sixth and last year of my term as
President of JNA. In the fiscal year 2015, importantnursing-related legal systems were implemented andsuch systems include “the Training System for
Nurses to Perform Specific Medical Interventions”,“the Notification System for Nurses at the Time ofLeaving Nursing Jobs etc” and “the Medical Accident
Investigation System”i). It is clear that the last year
was a year of transition for nursing. In the midst of
this transition, JNA took various actions, such asaddressing

responding

to

these

newly

implemented legal systems, in preparation for 2025

JNA Priority Policies
andEstablishment and Promotion of thecommunity based integrated care systemEnhancementof
positiveenvironments for nurses



Promotion of the role expansion of nurses



Development of nursing human resources
capable of meeting the needs of thesuper-aged society with fewer children

practicewhen the baby-boom generation

born after WorldWar II will reach the age of 75 or over. Also, JNA
developed and published “Future Vision of Nursing:Nurses’ Endeavour toward 2025 – Nursing Supports
and Sustains Human Life, Living and Dignity”ii).
In this fiscal year of 2016, JNA will steadily move
forward with our four priority policies, making themconcrete with our main projects, and will examine andevaluate past actions and their outcomes. Furthermore, we aim to enhance our organizational strength, to
put nursing policies into practice, and to create a better society. Hereafter, one field we should devotespecial attention to is home-based care. We will take more actions to promote the community based
integrated care systemiii), particularly placing emphasis on home-based nursing and visiting nursing, sothat people can continue to live their lives comfortably in their familiar communities as long as possible.

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For information on “the Medical Accident Investigation System”, please refer to our official English website (Nursing andPatient Safety in Japan – 1. Patient Safety in Japan).
http://www.nurse.or.jp/jna/english/ii)

For information on “Future Vision of Nursing: Nurses’ Endeavour toward 2025 – Nursing Supports and Sustains Human
Life, Living and Dignity” (Future Vision of Nursing), please refer to Background of the Development of Future Vision of
Nursing on Page 4.

iii)

For information on the community based integrated care system, please refer to JNA News Release Vol. 17.
http://www.nurse.or.jp/jna/english/news/index.html

JNA News Release2016 Vol.20

Dr. Judith Shamian, President of International Council of Nurses, Visited JNA
Dr. Judith Shamian, President of International
Council of Nurses (ICN), visited Japan twice inJanuary. She participated in the following two
events,aseriesoflecturesessions“theSignificance of Home-care Nursing in Aged
Society” hosted by Sasakawa Memorial HealthFoundation (Chair: Dr. Etsuko Kita), and “theGlobal Appeal to End Stigma and Discrimination
against People Affected by Leprosy” hosted by the
Nippon Foundation (Chairman: Yohei Sasakawa).
During her stay in Japan, Dr. Shamian visited theFrom the left, Dr. Ikumi Nakaita (JNA Executive
Officer), Dr. Kumiko Ii (JNA Executive Director), Dr.
Suga Sakamoto (JNA President), Dr. Judith Shamian(ICN President) and Dr. Masako Kanai-Pak (ICNFirst Vice-President) at the JNA headquarters.

JNA headquarters together with Dr. Masako
Kanai-Pak, the First Vice-President of ICN, on
January 15. They exchanged information andopinions with Dr. Suga Sakamoto, President of

JNA, and other JNA executive members.
Dr. Shamian explained about the progress and updates of ICN projects, since her appointment as ICN
President in 2013, from a wide range of perspectives. She indicated that ICN has been taking JNA’s
recommendations and proposals seriously and incorporating them into ICN activities. Dr. Kanai-Pak
added that JNA had exhibited a strong presence among other National Nurses' Associations in various
countries she had visited as the First Vice-President of ICN. Dr. Sakamoto stated that she welcomedefforts made by ICN Board of Directors led by Dr. Shamian and that JNA would like to continue to devote
ourselves to maintaining a close collaboration with ICN.
Other than participating in the events and visiting JNA, Dr. Shamian and Dr. Kanai-Pak also proactively
engaged in exchange, paying a courtesy call on 4 members of the Diet with a nursing background as wellas on Health Policy Bureau, Ministry of Health, Labour and Welfare.

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JNA News Release2016 Vol.20

JNA’s Strategies for People with Dementia, Expecting its Prevalence on Rise
Japan

is

alreadyasuper-agedsocietyandJapan’s National Strategy

furthermore its population aging is progressing rapidly.

In order to address an increasing number ofWith this demographic change, the number of thepeople with dementia further in the near future, theelderly aged 65 and over with dementia was estimatedMinistry of Health, Labour and Welfare established

to be 4.62 million1) (15% of the entire elderly population)“a Comprehensive Strategy for the Promotion of

in 2012 and moreover the number is expected to

Dementia Measures ～ Towards a Community

increase further with an estimate of approximately 7
million1) (20% of the entire elderly population) in 2025
when the baby-boom generation born after World War II
reach the age of 75 and over.
In response to the increasing number of people with

Friendly to the Elderly with Dementia, etc.～(NewOrange Plan)” in collaboration with relevant
government ministries and agencies in January
2015. The New Orange Plan has been developed
and promoted along with the following 7 pillars.
1)

Promoting awareness and understanding of
dementia

2)

Providing timely and appropriate healthcare
and long-term care

3)

Strengthening strategies against young-onset
dementiawith dementia and their families can live comfortably in

4)

Supporting caregivers

their familiar communities as long as possible. Also,

5)

Creating communities friendly to the elderly

JNA has been tackling strategies for people with

6)

Promoting research development and its
outcome dissemination

7)

Valuing the perspective ofdementia and their families

dementia associated with population aging in Japan andto the national strategy set by Japanese government,
JNA developed “JNA’s strategic directions on Dementia
Measures.” JNA aims to create a society where people

dementia from various directions, such as education,dissemination of information and policy proposal, alongwith the following two pillars.

peopleTwo pillars of JNA’s strategies for people with dementia
1) Developing a framework for dementia friendly nursing
JNA has been designing and developing an educational and training framework with an aim toenhance the competence of all nurses to care for people with dementia. Specifically, JNA runs acredentialing systemi) and trains nurses with knowledge and skills in dementia care, such as
Certified Nurse Specialists (CNSs) and Certified Nurses (CNs). Also, JNA has been developing apractical guideline for dementia nursing in collaboration with relevant organizations and academic
societies.
2) Supporting communities where people with dementia can live comfortably
JNA has been working to develop a structure to support people with dementia together with
communities. Specifically, JNA holds dementia forums suited for people in the community, promotes
community awareness and understanding of dementia, and provides information on support
services for people with dementia and their families.
i) For information on the credentialing system, CNSs and CNs, please refer to Learn More about Related Topics in Nursing
on Page 5.
Reference:
1) Ninomiya, Toshiharu. Research on Population Projections of the Elderly with Dementia in Japan. Ministry of Health,Labour and Welfare Grants System; 2015. [in Japanese]
http://mhlw-grants.niph.go.jp/niph/search/NIDD00.do?resrchNum=201405037A (Accessed 2016-02-04)

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with

JNA News Release2016 Vol.20

Development of Clinical Ladder for Nurses (JNA version)
As a part of “Future Vision of Nursing: Nurses’
Endeavour toward 2025 – Nursing Supports andSustains Human Life, Living and Dignity”, JNA isdeveloping Clinical Ladder for Nurses, which will be
published in this year of 2016. This will be the firstclinical ladder standardized nationwide in Japan,
which can be adapted and utilized across different
settings or fields within nursing.
Currently, there are some healthcare institutions
where their own clinical ladder has been already
implemented into practice. On the other hand, there
are other institutions, such as small/middle-scale
facilities and long-term care facilities, where theirown clinical ladder is not yet developed andintroduced. Also, there has been an ongoingtransition from healthcare facilities to homes as aplace to provide healthcare and long-term careservices toward 2025, when the baby-boom
generation born after World War II reach the age of
75 or over. This transition has been creating ademand for nurses to be capable of serving invarious settings.
With

the

development

andnationwide

standardization of Clinical Ladder for Nurses by
JNA, it will be possible to assess nursing practical

Background of the Development of “Future
Vision of Nursing: Nurses’ Endeavour toward2025 – Nursing Supports and Sustains Human
Life, Living and Dignity” :The environment surrounding nursing has been
undergoing major changes toward 2025 when thebaby-boom generation born after World War II
reach the age of 75 or over. We are witnessing ashift from healthcare facilities to homes as a place
to provide healthcare and long-term care services.
Also, healthcare and long-term care provisionsystems have changed and practicing settings andfields for nurses have diversified further. Associatedwith these transitions, nurses are expected topossess perspectives of both “living” and“health/healthcare” and to fully play nursing roles atvarious settings.
To fulfill our responsibility as a professionalorganization, JNA developed “Future Vision of
Nursing: Nurses’ Endeavour toward 2025 – Nursing
Supports and Sustains Human Life, Living andDignity” (Future Vision of Nursing) in the fiscal yearof 2015. The Future Vision of Nursing lays out the
future roles of nursing and our strategic directions
as a professional organization. As the subtitle of the
future vision indicates, nurses play an importantrole in supporting people’s living in the communityand healthcare through their life course.

self-assessment and self-study for nurses, and as

Hereafter, JNA will disseminate the Future Visionof Nursing widely not only to nursing andhealthcare communities, but also to the society andpublic as well. The English version is available on
our official English website.

an indicator for human resource utilization and

JNA official English website:

employment conditions in nursing management.

http://www.nurse.or.jp/jna/english/activities/index.ht
mlcompetence commonly required for all nurses,
regardless of their practicing settings or fields. Also,
the clinical ladder can act as an indicator for

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JNA News Release2016 Vol.20

Learn More about Related Topics in Nursing
Q Who are Certified Nurse Specialists and Certified Nurses expertized in dementia care
by JNA’s credentialing system?
【JNA’s Credentialing System】
In Japan, licensure for a Public Health Nurse, Midwife, Nurse and Assistant Nurse is defined by the law.
However, those for nurses who possess expert knowledge and skills in any particular field within nursing are
not specified by the law.
Therefore, JNA runs a credentialing system as our own independent system with an aim to provide quality
nursing and health care services to the public. Under the credentialing system, certification as the following 3
titles has been granted; Certified Nurse Specialist (CNS), Certified Nurse (CN) and Certified Nurse
Administrator. Here, we introduce about CNSs and CNs.
Certified Nurse Specialist (CNS) :CNS is a nurse who is certified through the credentialing system as one who possesses in-depth nursing
practical competence in one of the CNS speciality fields. The number of CNSs is 1,678 as of January 2016.
Certified Nurse (CN) :CN is a nurse who is certified through the credentialing system as one who possesses high level of nursing
skills and knowledge in one of the CN speciality fields. The number of CNs is 15,817 as of January 2016.
In order to obtain the certification as a CNS or CN, candidates are required to pass credentialing
assessment by JNA after fulfilling requirements to take the assessment, such as successful completion ofpractical experience and educational course (Table 1).
Table 1：Requirements to Obtain Certification as a CNS or CN
Comparison by certification type
Practical experience
Educational course
CNS
5 years with at least 3 years educational courses for(11 fields)
in one of CNS speciality CNSs at graduate schools
fields（2 years）
CN
5 years with at least 3 years educational courses for(21 fields)
in one of CN speciality fields CNs（6 months）

Credentialing assessment-document screening-written examination-written examination

Note: For CNSs, completion of practical experience is not mandatory prior to entering an educational course.
For CNs, completion of practical experience is required before entering an educational course.

With further advancement and specialization in healthcare, there have been more settings and places for
CNSs and CNs to utilize their expert knowledge and skills and also their number has been increasing year by
year. JNA will continue to make an effort to improve nursing quality based on expertise from education andtraining.
【Credentialing System for Dementia Care】
Under the credentialing system mentioned above, JNA trains and certifies nurses expertized in dementia
care. Certification of the following 2 titles are the ones particularly expertized in dementia care; CNS in
Gerontological Nursing and CN in Dementia Nursing. The number of these CNSs and CNs has been on therise. However, distribution of their working places is not even among prefectures across the country and there
are still some prefectures where none of them is working (Table 2).
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JNA News Release2016 Vol.20

Table 2：Number of CNSs and CNs in Dementia Care by Working Place
Hospitals Visiting
Long-term
Educational
nursing
careinstitutions
stations
facilities
CNSs in
Gerontological77
3
4
6
Nursing
CNs inDementia
551
13
45
11
Nursing

Othersi)Currently
notworking

Total

1

2

93

10

21

651

Note: Data was obtained in January 2016.
i) Others include clinics, nursing associations and other working places.

【Educational Course for Certified Nurses in Dementia Nursing】
In 2004, JNA approved dementia nursing as one of CN fields in order to train nurses who can practicequality dementia nursing. In the following year of 2005, JNA established a course for dementia nursing within
Institute for Graduate Nurses, which is one of JNA facilities, and commenced the education and training.
Currently, 10 educational institutions across the country offer the course.
The course for dementia nursing is characterized by the following unique educational objectives andsubjects:
The educational objectives for the course are to acquire knowledge and skills relating to dementia
nursing and support for people with dementia and their families and to develop the following 3
competences:- To provide high-standard nursing practice for people with dementia and their families- To offer guidance and advice for nurses- To collaborate with nurses and other workers and to provide care that respects the quality of lifeand dignity of people with dementia in various settingsThe educational subjects for the course are common subjects, fundamental subjects, advanced
subjects, simulation seminars and clinical practice. The simulation seminars include simulations andcase studies, and the clinical practice includes training to acquire professional practicalcompetence.

Common subjects
Fundamental subjects
in dementia nursing

Subjects to acquire competence commonly required as CNs
Principles of dementia nursing, Pathophysiology of dementia, Healthcare andwelfare systems relevant to dementia

Advanced subjects
in dementia nursing

Ethics in dementia nursing, Communication with people with dementia, Support
methodology in dementia nursing (assessment and care, creation of anenvironment for living and recuperating, care management), Support for thefamily of people with dementia / coordination of family relationships

For more information on JNA credentialing system, please refer to our official English website on Nursing Education in Japan –Credentialing System.
http://www.nurse.or.jp/jna/english/nursing/index.html

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