JNA News Release2015.July Vol.17

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 Suga Sakamoto
I am now in my third term as President of JNA. The
environment surrounding health care and nursing in Japan
has been undergoing major changes. As our super-agedsociety with fewer children is progressing rapidly, it is anurgent priority for nursing to provide a suitable environment
for people, including the elderly, with chronic diseases,
dementia and disabilities, in order for them to continue tolive their lives comfortably in their familiar communities aslong as possible. We have ten years left until 2025 when
the baby-boom generation born after World War II will reachthe age of 75 or over. This is the time for nurses practicing
theirprofessionindifferent

areas

to

strengthen

collaboration and coordination in the community and toharness the full potential of nursing.
With the JNA’s three missions, namely “improvement of nursing quality,” “creation of theenvironment in which nurses are able to continue working,” and “development and expansion ofnursing areas to meet people's needs” firmly in mind, I will take the helm and lead to the right
direction in order to implement and deliver concrete activities.

Annual General Convention and Nationwide Exchange Meetings by
Each Professional Category in Nursing were HeldOn June 9th and 10th, JNA held
its annual general convention for the
fiscal year 2015. The convention

・ Establishment and Promotion of the community based
integrated care system

was attended by approximately

・Enhancement of positive practice environments for nurses

2,800

・Promotion of the role expansion of nurses

representatives

and

JNA

members, and featured reports andactivediscussions

regarding・Development of nursing human resources capable of meetingthe needs of the super-aged society with fewer children

subjects such as priority policies andGiven that reformation of systems for the provision of healthmain projects for the current fiscal

and long-term care has been promoted by the government,

year and JNA’s “Future Vision for
Nursing

1/8 |JNA Priority Policies–

Nursing

Challenges

JNA’s top priority policy for this fiscal year is the “establishment
and promotion of the community based integrated caresystem”, in order for nurses to exert their expertise.

JNA News Release2015 Vol.17

toward 2025 (tentative title in English)”fiscal year 2015. JNA President, Suga(which is due to be translated into English).

Sakamoto, delivered the key note address

Elections to the executive board saw

on JNA initiatives for the future of dementia

Suga Sakamoto re-elected as President,

nursing. This is the first time to announce

Kiyoko Okubo and Hiromi Sanada as Vicethat JNA would be pursuing various ways to

President, and Rieko Kawamoto and Aiko

approach and address dementia, revolving

Koaround two main pillars,asExecutive

Officers.

Hamakonamely the

Katsumata meanwhile was newly elected as

creation of more robust nursing structures

an Executive Officer. Members were thenfor dementia

appointed to their respective posts to form

support for a dementia friendly community.

the new Executive Board.

With these initiatives, JNA aims to create aand the developmental

Also, on June 11th, JNA organizedsociety in which people with dementia andNationwide Exchange Meetings by Eachtheir families can continue to live their lives

Professional Category in Nursing for the

comfortably in their familiar communities.

Community based integrated care system isa system that provides housing, health care, long-term care, long-term care prevention andlivelihood support in an integrated manner in community settings. This system aims to enablepeople, including the elderly, to continue to live their lives comfortably with dignity andindependence. The establishment of this system is promoted by the government by 2025 when
the baby-boom generation will reach the age of 75 years or over1).
For more information on the community based integrated care system, please refer to the following
website.
Nursing for the Older People in Japan - Nursing for the Older People: Current Situation andChallenges.
http://www.nurse.or.jp/jna/english/pdf/info-02.pdf
Reference:
1) Service Guide 2014. For people, for life, for the future. Ministry of Health, Labour and Welfare.
http://www.mhlw.go.jp/english/org/pamphlet/dl/pamphlet-about_mhlw.pdf(accessed on July 6th, 2015)

A Survey on the Actual Situation of Visiting Nursing was Conducted
JNA conducted its first survey on thewhereas an average length of experience in

actual situation of visiting nursing from Junenursing was 22.3 years. Most respondents

to July of 2014, surveying JNA members

had entered visiting nursing mid-career fromworking at visiting nursing stations. The

other nursing areas, with just 0.6% ofresults revealed the following findings.

respondents started visiting nursing as new

Among respondents, an average length ofgraduates. When asked about workload andexperience in visiting nursing was 9.1 years,

working conditions considered to be a

2/8 |

JNA News Release2015 Vol.17

burden in visiting nursing (refer to Figure 1),

will be necessary to increase efficiency

items

of

through steps such as making better use of

respondents rated “strongly agree” orinformation and communication technology“somewhat agree” were “heavy workloads(ICT) and transferring clerical duties to staff

other than visiting clients, such as keeping

other than nurses. Also, educational training

records and answering phone calls,” “heavy

systems and healthcare safety measures

responsibility to make a decision alone” andwill need to be prepared and implemented“concern to cause medical errors.”

in order to address and correspond to thewithhigherpercentages

In order to reduce the burden fromandseverity

peripheral workloads other than nursing, it

complexityofclients’conditions and the diversity of care needs.

Total number of valid responses: 2,262
Heavy workloads other than visiting clients

32.5

43

18.1

3.6
2.8

Heavy responsibility to make a decision alone

27.1

45.4

22.1

3.2
2.3

Concern to cause medical errors

22.5

49.4

23.1

3.5
1.4

Low wages

22.5

36.5

Diffiicult to take days off

26.7

31.6

Excessive overtime work

18.6

Heavy workloads related to visiting clients

14.5

34.1

37.3

30.9

27.8

33.1

39.6

6.2 3.8

10.7 3.3

10.6 3.6

4.93.8

0%
10%
20%
30%
40%
50%
60%
70%
80%
90% 100%Note) Only workload and working conditions with more than 50% “strongly agreed” or“somewhat agreed” are presented in this figure.

Strongly agree

Somewhat agree

Somewhat disagree

Strongly disagree

Not answered・Unknown

Figure 1 :Workload and Working Conditions Considered to Be a
Burden in Visiting Nursing

3/8 |JNA News Release2015 Vol.17

Demand for Visiting Nursing and Nurses Engaged in this Area
The number of demand for visiting nursing in 2012 was 310,0001) people per day. The
government estimates that the number of demand will increase to 510,0001) people per day by
2025. These figures mainly refer to the number of users of visiting nursing services aged 65 orover with long-term care needs.
In 2012, there were approximately 30,0002) nurses engaged in visiting nursing(approximately 2%2) of all nurses employed and practicing nationwide). According to simple
calculations based on the demand estimates for visiting nursing by the government, at least
50,000 nurses would need to be engaged in this area by 2025. Combined with users ofvisiting nursing services other than the above-mentioned population aged 65 or over withlong-term care needs, the number of demand and required nurses in this area will be evenmuch higher.
Therefore, securing human resources for visiting nursing is an urgent issue to be addressedfor 2025 when the baby-boom generation will reach the age of 75 or over. JNA is committed toestablishing backup systems that will remove any obstacle preventing nurses, including ones
currently not engaging in nursing practice and new graduates, from entering visiting nursing.
Reference:
1) Future Vision Aimed by Comprehensive Reform of the Social Security and Tax System. Ministryof Health, Labour and Welfare.
http://www.mhlw.go.jp/seisakunitsuite/bunya/hokabunya/shakaihoshou/dl/shouraizou_120702.p
df(accessed on July 6th, 2015)
2) Statistical Data on Nursing Service in Japan 2014, Japanese Nursing Association Publishing
Company
For general information on the visiting nursing stations, please refer to Nursing in Japan on Page 7.
For further detailed information, please refer to following websites.
JNA News Release Vol 8
http://www.nurse.or.jp/jna/english/news/pdf/2012nr_8.pdf
Nursing for the Older People in Japan - Nursing for the Older People: Current Situation andChallenges
http://www.nurse.or.jp/jna/english/pdf/info-02.pdf

A Nationwide Survey on the Demand and Supply of Hospital Nurses was
Conducted
In October of 2014, JNA conducted abeen conducted on nurse managers atnationwide survey on the demand andhospitals nationwide annually since 1995 insupply of hospital nurses. In this year, theorder to ascertain trends in the demand andsurvey collected data on roles and activities

supply of hospital nurses and their workingof hospitals in the community, in addition to

conditions.

data usually collected, such as turnover

following findings.

rates and average salary. The survey has
4/8 |

The

results

revealedtheJNA News Release2015 Vol.17

were “assigning nurses as members ofcommittees or meetings for relevant outside【Turnover Rates of Nurses】

organizations or professions” (44.8%), and

The turnover rate of full-time nurses in the“assigning nurses as instructors to seminars,

fiscal year 2013 was 11.0%(the same asworkshops

andhealthclassesforthe previous year). The turnover rate ofcommunity residents” (37.5%). Compared

newly graduated nurses came to 7.5% (0.4

to the previous survey in 2012, somepoint decrease from the previous year). As

collaborations

with previous years, there was a trend

increased,

towards lower turnover rates in hospitals

participating in “meetings to strengthenwith more beds among both full-time nurses

collaboration in visiting nursing, home careand newly graduated nurses. Also, turnoverand long-term care” (40.6%, 9.3 point

rates of full-time nurses by prefecture

increase from the fiscal year 2012), andcontinue to show higher particularly in“meetings to strengthen nurse-to-nurse

prefectures with large cities.

collaboration among healthcare facilities”

inthe community

such

as

conducting

were
or

(31.3%, 4.1 point increase). The mostselected future role of hospitals in thecommunity【Monthly Salary】
The expected starting salary for newly
graduated nurses due to be employed in thefiscal year 2015 was ¥262,565 before tax
forgraduates completing three-year

courses (¥491 increase from the previous
year)

and

¥270,806

for

graduates

completing four-year university courses(¥606 increase) on average. The averagesalaryfornon-managerial“mid-career”

nurses supposedly with 10 years of service
and aged 31 to 32 was ¥318,117 before tax(the same as the previous year).

(refer to Figure 2 on Page 6)

was “to perform multiple functions and caterto a wide range of needs in the community”(26.6%).
Reforms to medical reimbursement feesin the fiscal year 2014 and long-term carereimbursement fees in the fiscal year 2015areleaningheavily

towards

theestablishment of the community based
integrated care system. It is expected for
hospitals to provide services looking into
needs after discharge and to coordinate
and collaborate with the community. Also, it
is desired to actively explore ways of
opening up hospitals to the community and【Roles and Activities of
Hospitals in the Community】
Top selected activities undertaken by
nurses outside hospitals that are related tocommunity collaboration and contribution

5/8 |to make more effective use of nurses.

JNA News Release2015 Vol.17

Total number of valid returns: 4,016
Total

9.7

14.7

26.6

12.3

14.9

3.2 3.1
0.5

12.9

5

12.7

1.9
Less than 99
2.2
beds

12.4

100～199
2.7
beds

11.1

200～299
beds

20.4

15.3

19.4

2.8

8.4

1.3
33.3

17.4

15.9

2 2.1
1.7 0.4

13.5

1.6
4.4

16.3

33.8

10

15.3

3.6

13.8

1
1.2

300～399
beds

13.4

27.9

30.1

3.8

9.1

13.6
1

400～499
beds

26.4

25.9

18.2

2.7 7.7

4.1

14.1

0.5 0.5

More than
500 beds

66.1

Not
answered・Unknown

10.5
0%

10.5
10%

20%

21.1
30%

0.4
7.4 2.1 5.3
7.4
1.4

9.9

40%

15.8

5.3

50%

60%

10.5
70%

5.3

5.3
80%

15.8
90%

100%

Nurse managers were asked to select one role that was considered to be the most important for their hospitals to play.
Primarily treat severely acute diseases by providing highly specialized health care in inpatient settings
Primarily treat acute diseases and relatively minor acute patients requiring inpatient health care
Cater to a wide range of needs in the community by providing multiple fuctions for acute, recovery and chronic phases
Take care of patients returning home by supporting acute care hospitals and providing rehabilitation services
Take care of patients with diseases or disabilities requiring long-term home care
Take care of patients at home by visiting and providing health care
Treat relatively minor acute diseases and perform health maintenance as a primary care provider for community residents
OthersDon’t know
Not answered・Unknown

Figure 2 : Future Roles of Hospitals in the Community
Survey results by number of beds

6/8 |

JNA News Release2015 Vol.17

Nursing in JapanQ What are function enhanced visiting nursing providers?
Function enhanced visiting nursing providers are facilities that provide 24-hour services andarrange flexible visits, corresponding to the severity and complexity of clients’ conditions andthe diversity of care needs, such as terminal care. Also, they are expected to provide support
forsmaller-scale visiting nursing stations in the community and to function as a base fortraining as part of human resource development and for the provision of information andconsultation to community residents.
【Background to the establishment of function enhanced visiting nursing providers】
Visiting nursing stations＊）are the base for the provision of visiting nursing services and there
are approximately 8,2001) visiting nursing stations nationwide. However, the majority of visiting
nursing stations are small-scale, staffed by less than five nurses. These small-scale visiting
nursing stations have been struggling to provide 24-hour services, arrange flexible visits anddevelop human resources. With an increasing demand for visiting nursing, it has beenchallenging to maintain the quality and quantity of services, corresponding to the severity andcomplexity of clients’ conditions and the diversity of care needs.
With this in mind, JNA set out a policy for visiting nursing stations to be larger-scale andmultifunctional and advocated for the government accordingly. As a result, function enhanced
visiting nursing providers were introduced in2014 as a new system. For 2025 when thebaby-boom generation will reach the age of 75 or over, capacity and competence of nurses
serving in the community have been challenged and tested. As a place for nurses todemonstrate and exert their capacity and competence, function enhanced visiting nursing
providers will play a crucial role.
＊）

Visiting nursing stations are facilities designated by governors of respective prefectures andspecialized in the provision of visiting nursing services. Nurses are authorized to open andrun visiting nursing stations.

Reference:
1) Survey on the Number of Visiting Nursing Stations
Home-visit Nursing Care.

7/8 |in 2015.

The National Association for

JNA News Release2015 Vol.17

News Topics in Japan
Development of a “Comprehensive Strategy for the Promotion of Dementia
Measures (New Orange Plan)”
On January 27th, the Ministry of Health, Labour and Welfare announced a“Comprehensive Strategy for the Promotion of Dementia Measures ～ Towards a
Community Friendly to the Elderly with Dementia, etc.～(New Orange Plan).” This is arevised version of the “five-year Plan for Promotion of Measures against Dementia(Orange Plan)” originally formulated in 2012 and this revision was developed withcollaboration of relevant government ministries and agencies. The aim is to create asociety that respects the decision of people with dementia and that enables them tocontinue to live their lives comfortably in their familiar communities as long as possible.
In order to accomplish this aim, it is necessary for various actors, such as private sectors
and community residents, to take and play their roles in this process, as well as forrelevant government ministries and agencies to collaborate with each other. The New
Orange Plan is due to run until 2025 when the baby-boom generation will reach the ageof 75 or over.
Reforms to Long-term Care Reimbursement Fees in the Fiscal Year 2015
On February 6th, the Subcommittee for Long-term Care Benefits, the Social Security
Council, unanimously approved a proposal to reform long-term care reimbursement feesin the current fiscal year. Overall, long-term care reimbursement fees have been revised
down by a rate of 2.27%. This reform has been implemented in line with three basic
directions, with an aim to establish the community based integrated care system by2025 when the baby-boom generation will reach the age of 75 or over. These directions
involve further strengthening services for people with moderately severe conditions
requiring long-term care and the elderly with dementia, promoting measures to secure
human resources in the long-term care sector, and ensuring appropriate service
assessments and establishing effective systems to provide services. Also, combined
services, which integrates visiting nursing with multifunctional long-term care in small
group homes, will now be known as“nurse-led comprehensive community care,” tobetter reflect the specific nature of the services in an effort for more people to use theservices.
For more information on the combined service, please refer to JNA News Release Vol 8.
http://www.nurse.or.jp/jna/english/news/pdf/2012nr_8.pdf

8/8 |