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The evidence-based fall risk assessment tool requires further modification and re-examination of interrater reliability is warranted. In particular, the cognitive impairment items need to be reconsidered in order to enable nurses to better assess patient cognition on the admission day.

ObjectivesTo explore the awareness and practice of clinical research integrity among Japanese physicians.DesignA nationwide cross-sectional study conducted in March 2020.SettingAll hospitals in Japan.ParticipantsPhysicians aged <65 years who work at hospitals participated in clinical research over the past 5 years. The sample was stratified according to geographical location and subspecialty, and 1100 physicians were proportionally selected.Primary and secondary outcome measuresKnowledge and awareness of research integrity.ResultsAmong the 1100 participants, 587 (53%) had the experience of being the first author, 299 (27%) had been co-authors only and 214 (19%) had no authorship. A total of 1021 (93%) had experienced learning research integrity, and 555 (54%) became aware of research integrity. The experience of learning about research integrity was highest among those with first authorship (95%) and lowest among those without authorship (89%) (p=0.003). The majority of participants learnt about research integrity for passive reasons such as it being ‘required by the institution’ (57%) or it being ‘required to obtain approval of institutional review board (IRB)’ (30%). Potentially inappropriate research behaviours were observed in participants, with 11% indulging in copying and pasting for writing the paper, 11% for gifted authorship and 5.8% for the omission of IRB approval. Factors significantly associated with copying and pasting were being below 40 years old (OR: 1.84; 95% CI: 1.05 to 3.26), being the first presenter (OR: 1.64; 95% CI: 1.05 to 2.57) or having passive reasons for learning research integrity (OR: 2.96; 95% CI: 1.57 to 5.59). Furthermore, gifted authorship was significantly associated with being a co-author only (OR: 1.84; 95% CI: 1.18 to 2.87) and having passive reasons for learning about research integrity (OR: 1.79; 95% CI: 1.03 to 3.12).ConclusionsMost physicians conducting clinical research have learnt about research integrity, but potentially inappropriate research behaviours are associated with passive reasons for learning.

Aim This study aims to examine the association between nursing delivery models (fixed‐team nursing model and Partnership Nursing System® [PNS®]) and patients' health outcomes (30‐day in‐hospital mortality and functional decline, indicated by a decline in Barthel Index or in‐hospital mortality). Methods This study used a retrospective cohort design based on the data from the Diagnostic Procedure Combination database, which included routinely collected health data for Japanese administrative claims. Participants were inpatients aged 20–99 years admitted between July 2010 and August 2012 (fixed‐team nursing period) and July 2014 and August 2017 (PNS® period) to an academic teaching hospital in Japan. Odds ratios and 95% confidence intervals were estimated using multivariable logistic models. Results We included 24,108 and 23,872 patients for the analyses of 30‐day in‐hospital mortality and functional decline, respectively (median age: 62 years; 52% women). The 30‐day mortalities in both fixed‐team nursing and PNS® groups were 0.5%. There was no significant association between the nursing delivery models and 30‐day in‐hospital mortality (adjusted odds ratio = 1.15, 95% confidence interval = 0.78–1.70). However, the PNS® group was found to have a higher proportion of patients with functional decline (2.7%) than the fixed‐team nursing group (2.2%; p = .030). The adjusted odds ratio of declined function in the PNS® group, compared to the fixed‐team nursing group, was 1.40 (95% confidence interval = 1.17–1.68, p < .001). Conclusions Further studies are needed to examine how the PNS® model influences patient outcomes, especially nurse‐sensitive patient outcomes.

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