JNA News Release2020 January Vol.30

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

Tel: +81-3-5778-8559

Fax: +81-3-5778-5602

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

Nursing Now Campaign in Japan meeting was held
On October 2, 2019, the Japanese Nursing Association (JNA) held the meeting of the Nursing Now Campaign
in Japan with the participation of 26 nursing groups and a representative from the Ministry of Health, Labourand Welfare as an observer.
In this meeting, the participating groups exchanged information about their progress on the Nursing Now
campaign activities and upcoming schedule. It was shared that a majority of the groups has been promoting
the campaign not only among nurses, but also to other professions, students and the general public, utilizing
various opportunities and tools. The activities of the 30 participating groups are updated on ongoing basis on
the special website (in Japanese). The content of the special website will be enhanced in the future.
https://www.nurse.or.jp/nursing/practice/nursing_now/nncj/index.html
In the latter half of the meeting, the groups had a discussion about the session organized by the groups for"Nursing Now Forum in Japan". The event is scheduled for May 2020 in commemoration of the 30th
anniversary of the establishment of the Nursing Day & Nursing Week, and the 200th anniversary of the birthof Florence Nightingale.
This event will provide an opportunity to share specific achievements and have evidence-based discussions
concerning the contribution of nursing in Japan to "improving health," "promoting gender equality" and"supporting economic growth," as indicated in the “Triple Impact” report that provided an impetus to the
Nursing Now.
The global goals known as "Sustainable Development Goals (SDGs)" have been widely disseminated to
citizens. By clearly indicating the nursing contribution to SDGs, we will continue taking action to enhance theawareness of nurses to establish a healthy society, and to facilitate social understanding of nursing
professions, thereby promoting its initiatives aimed at the realization of nursing policies and the advancement.
The next meeting of Nursing Now campaign in Japan will be held in January 2020.

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At the meeting of the Nursing Now campaign in Japan
with the group members

JNA News Release2020 January Vol.30"Management Ladder for Hospital Nurse Managers (JNA version)" waspublished
In recent years, the environment surrounding healthcare and nursing has been substantially changing,including the community-based integrated care system, and nurse managers are expected to take expanded
roles accordingly. JNA established the committee consisting of experts in FY2018 for the purpose of indicating
the roles and competences of nurse managers required in the era of the community-based integrated care.
Through a series of discussions, JNA published the "Management Ladder for Hospital Nurse Managers (JNA
version)" in February 2019.
In the face of establishing the community-based integrated care system, this ladder visualizes competences
required for hospital nurse managers to practice nursing management with a broader perspective including
community, in order to provide seamless care. In addition, the ladder provides indicators for the systematicand staged development of hospital nurse managers.
The scope of this ladder includes not only nurses who are already in the positions of hospital nurse managers,
but also other nurses willing to become hospital nurse managers.
It is expected that each hospital will utilize this ladder for preparing its own management ladders for nurse
managers.
The following table indicates the basic structure of this ladder which consists of the six competences required
for the practice of hospital nurse managers, and the four levels of acquisition of these competences. The six
competences focus on the competencies of hospital nurse managers to respond to the changing needs ofthe general public, with a broader perspective including community (see the following table). The descriptionof each level of this ladder does not indicate the job description or the range of responsibility of the eachposition, but states the competences to be acquired by hospital nurse managers as goals.

< Definitions of six competences >Competence

Definition

Organizational management

Ability to utilize resources and build nursing organization in order torealize policy

Quality management

Ability to respect the life, living and dignity of patients and assure thequality of nursing throughout the organization

Human resource development

Ability to develop and support nursing human resources systematicallyfor the future

Crisis management

Ability to hedge expected risks, ensure safety and to minimize theimpact in the event of crisis

Policy formulation

Ability to utilize and formulate systems and policies for improving
nursing quality

Creativity

Ability to identify the direction of the organization with a broad
perspective and to take on challenges for creating innovation

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JNA News Release2020 January Vol.30< Levels of acquisition of competences required for hospital nurse managers >The positions in brackets indicate the approximate guidelines for each level.
I:

Able to practice management together with nurse managers in the department (charge nurse
or equivalent)II:

Able to practice management in the department (head nurse or equivalent)

III: Able to practice management as a member of the management executives (deputy nursing
director or equivalent)
IV: Able to practice management with a broader perspective including community while
participating in the management and administration of the entire hospital (director of nursing or
equivalent)
Source: Management Ladder for Hospital Nurse managers (JNA version) (in Japanese)
https://www.nurse.or.jp/home/publication/pdf/guideline/nm_managementladder.pdf

Results of "Baseline Survey on the Fundamentals of Public Health Nurse
Activities"
JNA conducted the "Baseline Survey on the Fundamentals of Public Health Nurse (PHN)" in 2018, andpublished its results in March 2019.
In Japan, the way of PHNs activities to play expertise are in discussion as the activity areas of PHNs are
expanded. At the same time, human resource development has become a requirement in each area andorganization as the generations change in the PHNs. Under these circumstances, JNA had conducted the"Baseline Survey on the Fundamentals of PHN" three times in the past, FY2009, FY2010 and FY2014, andhad discussed and made policy proposals to play expertise.
The survey in 2018 was aimed at clarifying the actual status of career development and employment
conditions for PHNs, as well as problems and requirements in their activity environment, in response to thediversifying social needs. In addition to existing items, the survey also asked about the recruiting and retentionof PHNs, and the roles played by PHNs for Interdepartmental Coordination (PHNs-IC).
The survey provided valuable results, suggesting the necessity of securing measures that matches thestrengths and characteristics of organization, and the importance of indication in the job description to help
PHNs-IC exercise their roles.
This issue shares four points from the survey results.

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JNA News Release2020 January Vol.30< Overview of survey >1) Target: approx. 51,000 PHNs across Japan2) Survey period: September 5 - October 30, 20183) Survey method: online survey4) Response: 18,775 valid responses (response rate: 36.6%)*The response rate is based on the number of employed PHNs in Japan (51,280)(estimated from the "Report of Healthcare and Public Health Administration Operations FY2016")

1. Activity areas and duties of entire respondents
1) Activity areas
The most active area was "Local governments" at 81.2%, followed by "Industry" at 6.4% and "Medicalcare" at 4.2%.
Frequency%

1 Local governments

15,22281.2

2 Industry

1,194

6.4

3 Medical care

787

4.2

4 Welfare

694

3.7

5 Education

357

1.9

6 Others

501

2.7

18,755

100.0

Total

2) Duties that take up the longest work hours/long work hours• Among PHNs active in the " Local governments” area, the most common response was "Maternal andchild care" at 46.5%, followed by "Prevention of lifestyle-related diseases (including measures against
cancer)" at 35.9%, "Public health and long-term care prevention for the elderly" at 24.1%, and "Mental
health (including measures against suicide)" at 20.7%.
• Among PHNs active in the "Industry" area, the most common response was "Health checks,
subsequent measures/support" at 68.3%, followed by "Health counseling in the specific medical
checkups, specific health guidance, etc." at 43.6%, and "Mental health measures" at 40.5%, and all ofthem were selected as "Duties that take up the longest work hours."• In areas other than Local governments and Industry (Medical care, Welfare, Education, etc.), the mostcommon response was "Lifestyle counseling" at 28.4%, followed by "Health checks" at 27.8%, and"Health counseling in specific health guidance, etc." at 27.6%.

2. Securement of PHNs: Conditions that they prioritized in job hunting that led to current employment• The most common response was "Place of birth, residence, and/or presence of family or relative" at
66.3%, followed by "Regular full-time employment" at 51.7% and "No night shift" at 30.1% (Figure 1).

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JNA News Release2020 January Vol.30

Figure1：Conditions prioritized in job hunting (multiple answers)• Only 3.0% of all respondents considered that their workplace had "Established systems for humanresource development and continuing education”. When looking at this by age groups, a relatively larger
share of respondents considered so at 7.2% in the group in their 20s and at 11.1% in the group of 24
years or younger, which represented newly-graduated, compared to other age groups.
It was suggested that established systems for human resource development and continuing education
would provide advantage in the securement of PHNs in their 20s, who would work actively in the future.

Figure 2: The percentage of respondents who chose “Established systems for human resource
development and continuing education”(Age)

60+ years
55～59 years
50～54 years
45～49 years
40～44 years
35～39 years
30～34 years
25～29 years
Under 24years

2.3
2.7
1.9
1.4
1.6
2.1
3.6
5.6
11.1
0

2

4

6

8

10

12
(%)

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JNA News Release2020 January Vol.30• As the reasons for continued working for the present organization, many respondents emphasized thepresence of colleagues and seniors that they could consult with, financial aspects, and the sense offulfillment to the current job. Approximately half of the respondents in their 20s emphasized the presenceof PHN colleagues and seniors that they could consult with and good interpersonal relationship, at rates
higher than among all respondents. Among respondents aged 35 to 44 years, more than 40% selected"Ease of balancing pregnancy, childbirth, child-rearing with employment."
3. Career development
More than 20% of respondents had experience of leaving their jobs. The most common reason was "Career
enhancement" among respondents in their 20s or 30s. It is considered important to establish workplaceenvironment that facilitates career enhancement in order to secure retention in these age groups. Only
46.2% responded that their organization had internal human resource development plans (Figure 3).
Regarding the presence/absence of continuing education systems, less than 50% responded that theirorganization managed the history of individual training and education, and/or had medium-term and longterm human resource development plans. However, the figures have increased in all items compared to theresults of the past surveys in 2010 and 2014, suggesting that training systems are being gradually
established (Figure 4).
Figure 3: The presence/absence of human resource development plans for PHNs (%)

46.2
0%

20%

36.6
40%
Yes

17.2

60%
No

80%

100%

Not sure

Figure4: The presence/absence of continuing education system (Annual change) (%)
Securing budget for attendance at trainings FY2010

61.9

FY201469.4

FY201844.6

FY2014

25.8

39.2

24.9
36.0

34.2

FY2014FY2018

52.1
10%

18.5

49.6
48.0

0%

18.5

43.0

45.5

Continuing education programs FY2010

19.9

34.0

35.9

FY2018

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38.9

31.2

20%

30%

40%

50%

11.0

22.7

47.6

Training and education history management FY2010

14.8
8.0

41.2

FY2018Not sure

15.8

32.7

FY2014

No

17.6

81.0

Medium-term and long-term human resource
development systems
FY2010

Yes

20.5

60%

16.2
39.4

12.6

32.9

15.1

70%

80%

90%

100%

JNA News Release2020 January Vol.30

4. PHNs for Interdepartmental Coordination (PHNs-IC)
When respondents working in local governments with PHNs-IC were asked about the roles of the PHNs-IC,
the most common response was "Human resource development" at 74.5% (Figure 5). The survey alsosuggested that human resource development plans were formulated (Figure 6) and continuing education
programs were established at higher rates in local governments with PHNs-IC than in local governments
without PHNs-IC.
For PHNs-IC to exercise their functions in a cross-sectional manner, it would become important that theirroles are recognized throughout the organization, rather than limited to recognition among PHNs or
instructions by supervisors. Therefore, JNA analyzed difference by position in the roles of PHNs-IC indicatedin the job description, and observed difference. Adequate positions are considered necessary for PHNs-IC
to exercise their roles in an advanced manner.

Figure 5: Roles played by PHNs-IC (multiple answers)
Figure 5: Roles played by supervising public healthGeneral management pertaining to human resource development for all PHNs in

74.5

the organization
nurses (multiple choice)
Cross-sectional coordination among PHNs for the promotion of activities by
PHNs throughout the organization

72.4

Cross-sectional response, liaisoning, coordination and collaboration in theorganization representing PHNs

64.4

Disaster relief/Coordination of disaster relief

64.0

Proposal of priority decisions in the technical and professional aspects pertaining
to measures and projects for the promotion of activities by PHNs throughout theorganization

59.5

Coordination and collaboration for recruiting PHNs

58.0

Response, liaisoning, coordination and collaboration beyond the organization asa representative of PHNs

57.4

Establishment of systems for the identification of health issues in the entire local
community and the formulation, implementation and evaluation of business
plans

44.8

Division of duties and adjustment and management of workload throughout
PHNs

42.2
36.4

Proposals for job rotation aimed at the human resource development of PHNs
Incorporation of inputs into job rotation aimed at the human resource
development of PHNs

31.9

Coordination and collaboration for the establishment and promotion of thecommunity-based integrated care system for all generations

20.3
0%

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10%

20%

30%

40%

50%

60%

70%

80%

JNA News Release2020 January Vol.30

Figure 6 : The presence/absence of human resource development plan
based on the presence/absence of PHNs-IC (%)

The presence of PHNs-IC's personnel assigned

61.4

The absence of PHNs-IC's personnel assigned

24.9

28.5

Not sure
Unknown

57.2

37.2

0
The
ofhumanhumanresource
resource
development
The presence
presence ofdevelopment
plan

10

13.6

20

14.3

18.8

30

40

50

44.0

60

development
plan
The absence
absence ofofhumanhumanresource
resource
development

70

80

90

Not
sure
Unknown100(%)

Q What is PHNs for Interdepartmental Coordination (PHNs-IC)?
PHNs-IC are to be defined on this survey as PHNs taking integrative roles and coordinating andfacilitating public health activities of PHNs cross-sectionally.

Q What is a public health nurse?
A public health nurse is a person who engages in health guidance using the title of public health nurses
under the license of the Minister of Health, Labour and Welfare (Article 2 of the Act on Public Health
Nurses, Midwives and Nurses) .
The workplaces of public health nurses are public health centers, public administrations including thoseof municipalities, cities or villages, as well as in industry, schools or hospitals. Among these, those working
for municipalities, cities or villages have been increasing year after year.
Public health nurses, being the leaders of public health nursing operations, are professionals who conduct
such operations as community activities or methods of getting into communities. Through the activities,
the professionals find common health problems within a community and seek solutions valuing
partnership and collaboration with residents.

To solve diversified and complicated health problems, there are great expectations of public healthnurses. Particularly in these years, their roles in urgent and troublesome issues including measuresagainst lifestyle-related diseases and suicide are critical. And there have been increased needs fortheir activities.

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