Aim: In order to clarify how nurses respond to telephone consultations in a Kampo medicine outpatient clinic, a fact-finding survey was conducted on the difficulties involved in handling telephone calls. Methods: The subjects were two outpatient nurses. The contents of consultations that the nurse could not handle alone were extracted from the descriptive data of the telephone calls that each nurse was not able to handle and categorized. Guidelines developed in conjunction with physicians were introduced to clarify and address the causes of the difficulty. One year later, we again administered the telephone response survey so as to compare the results with those of the first survey. Results: Telephone consultations that were difficult for nurses to handle were classified into four categories: 1) consultations about physical disorders, 2) questions about prescribed Kampo medicines, 3) reports and questions based on the patient's own judgment, and 4) questions about treatment and hospitalization. The questions about Kampo medicines related to their "continued administration" and "mix-ups of drugs," and the questions based on patients' self-judgments related to the "reduction of" or "change in" Kampo medicines. One year later, the number of such cases declined to less than half, and no telephone consultations were made within one week after the first visit. Conclusion: As a result of the creation and introduction of guidelines in consultation with physicians, outpatient nurses are now able to answer questions and receive fewer phone calls after patients' first visits.

We conducted a factfinding survey about the difficulties of handling the telephone consultations at a Kampo medicine outpatient clinic. We extracted the details of consultations that could not be handled by an outpatient nurse alone from the descriptive data of the telephone responses described by the nurses in the sur vey. We, then, identified the factors that were involved in the difficulties encountered in these consultations, and countermeasures were established and implemented. One year later, we compared and examined the status of telephone consultations between before and after the factfinding survey. We classified the telephone con sultations that were difficult for the outpatient nurses to handle alone into four categories : (1) consultation about a physical disorder, (2) questions about prescribed Kampo medicines, (3) reports and questions based on the patient's own judgment, and (4) questions about treatment and hospitalization. Some of the questions about Kampo medicines included the continued use of the medicine and drug interactions, and the main topics of the survey's nurse selfjudgment reports were dose reductions and changes in Kampo medicine regimens. As a re sult of the introduction of guidelines prepared by the nurses together with physicians at the clinics, the outpa tient nurses became able to handle telephone consultations about frequently asked questions (FAQs). At 1 year after the survey, the number of cases of difficulties in handling telephone consultations decreased to less than half the original value, and no telephone consultations were made within 1 week after the patients' first visits to the outpatient clinic.