## Requirements # 5. Requirements This section outlines the functional and, where applicable, business and constraint requirements derived from the provided context. All requirements are referenced to their source blocks for traceability, in compliance with ISO-29148. --- ## 5.1 Functional Requirements ### 5.1.1 Home Nursing (訪問看護) - The responsibilities of administrators in home nursing stations must be clarified and requirements reviewed to ensure both the quality of provided home nursing and efficient station operation. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272] - Systems for abuse prevention measures in home nursing must be established as mandatory, and physical restraints are, in principle, prohibited. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272] [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] - The requirements and evaluation for frequent visit additions (頻回訪問加算) must be reviewed to ensure appropriate assessment according to patient condition in home medical care. [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0] - The requirements and evaluation for the 24-hour support system addition (24時間対応体制加算) must be revised, considering initiatives to reduce nursing workload and reviewing the handling of the communication system for 24-hour support. [KB-06db46ba-7647-483b-9f38-f7fa62a24d77] - The requirements and evaluation for emergency home nursing addition (緊急訪問看護加算) must be reviewed to ensure proper provision of emergency designated home nursing, and the content of the home nursing care fee claim form must also be reviewed. [KB-4be6a015-623d-440c-95dd-a51bf556ebbd] - The requirements and evaluation for home nursing management care fee (訪問看護管理療養費) must be reviewed to strengthen the functions of home nursing stations and ensure high-quality, effective care that meets diverse user and community needs. [KB-aeb72a17-5d44-4e89-9640-f4c1995c3d49] - Abuse prevention measures and the proper use of physical restraints in home nursing must be promoted, with system establishment for abuse prevention being mandatory and physical restraints generally prohibited. [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] - The requirements and evaluation for discharge support guidance addition (退院支援指導加算) must be enhanced according to the user's condition and the status of home nursing provision on the day of discharge. [KB-b375a84b-c77e-4084-a4a2-a2e0f2c22a9a] - The introduction of an online eligibility confirmation system (オンライン資格確認等システム) for home nursing must be considered, enabling acquisition and use of patient medical and medication information at the initial visit for planned management and provision of high-quality care. [KB-9e53203f-143a-4301-abb8-e7bd7dde87af] ### 5.1.2 Physical Restraint Minimization - Medical institutions must establish organizational systems to minimize the use of physical restraints as part of the basic hospitalization fee and related requirements. [KB-8445364a-473a-46bc-8207-fb1f2671bde6] [KB-edc81296-4474-4138-a404-f797f293eb19] ### 5.1.3 Nursing Staff Collaboration - The requirements and evaluation for the enhanced nursing assistant system addition (看護補助体制充実加算) must be reviewed to further promote division of labor and collaboration between nursing staff and assistants, and to promote efforts to minimize physical restraints. [KB-05c4460e-0933-40a9-962c-fc2be422e060] ### 5.1.4 Medication Management and Guidance - When a pharmacist confirms and evaluates a patient's medication status before consultation in outpatient chemotherapy for malignant tumors, and provides information or prescription proposals to the physician, a new evaluation must be established. [KB-ae822bb5-db0a-4310-9d78-651887df1be2] [KB-f700221a-650f-4f32-ada0-aff43c6a8ba9] - For patients prescribed multiple medications or those who have difficulty opening packages themselves, the pharmacist must obtain the prescribing physician’s understanding of the necessity for medication management support before supporting medication management for two or more oral medications or one medication with three or more types at each dosing time. [KB-ff3ce6e4-b5ec-4058-afe5-c24124781336] - When duplicate prescriptions are identified through comprehensive medication management at the request of the patient, family, or medical institution, the pharmacist must propose solutions to the prescribing physician in writing, and points are calculated once every three months. [KB-50d4fc2a-962d-4820-a105-6ba75b15cf4c] [KB-f2bbf07b-2196-40f3-9da7-66b45e6dd128] - For patients requiring special safety management drugs, pharmacists must confirm medication status, side effects, and provide necessary pharmaceutical management and guidance, with additional points calculated per specified requirements. [KB-f271747d-fadb-4d69-9ff8-ea0f4702f4f2] [KB-fde2b685-c7c4-44c8-9de7-3a7051dd9005] - For narcotic (麻薬) management, pharmacists must confirm usage, storage, and side effects, and provide necessary pharmaceutical management and guidance, with additional points calculated per occurrence. [KB-24385190-0703-42d1-a834-6854e998b904] [KB-31de50ce-f3df-4fb0-a0bd-6a1ce5795463] [KB-10f23eda-03d3-4220-8642-6ff7cbf64700] [KB-ad7d4dc3-8896-4c1b-92c7-8d969120b377] [KB-66969593-ac17-45cd-a41d-f335a2406225] [KB-08876a43-c1e4-4b7f-8517-0cd67e273533] - For pediatric patients with disabilities as defined by the Child Welfare Act, when necessary information is confirmed directly with the patient or family, and guidance is recorded in the handbook, the pediatric specific addition (小児特定加算) is calculated. [KB-6bb697eb-fdad-4cda-a697-9d148e072b9d] [KB-ba91d9ab-b335-4929-9779-694ba115ef39] - For inhalation drug guidance, pharmacists must use documents and practice inhalers to provide necessary pharmaceutical management and guidance, and provide required information to medical institutions in writing, with the inhalation drug guidance addition (吸入薬指導加算) calculated once every three months. [KB-604920cd-6896-4a10-97db-9faeb614d499] [KB-ef609548-ff37-4388-9fd5-c638d8bf6eab] - For adverse reaction management, pharmacists must confirm the occurrence of side effects and treatment plans in writing, provide necessary pharmaceutical management and guidance, and obtain patient consent. [KB-1deff0da-ee71-4c91-9c5b-76f0767d90da] [KB-e8ad7124-d716-4649-9f50-064344c869d7] - When providing information on generic drugs (後発医薬品), pharmacists must include information on availability and price as necessary. [KB-e4e6d119-b65b-4db3-b93a-0e4a5c7d7f32] ### 5.1.5 Discharge and Home Care Support - For patients discharged from insurance medical institutions, when the designated pharmacy pharmacist provides post-discharge home medication management guidance with patient consent, the discharge joint guidance fee (退院時共同指導料) is calculated. [KB-061bef49-5443-4529-80cb-0067c3bedc4f] [KB-1eebb670-f513-40ab-a8bc-7127863e3404] [KB-44db8f45-e972-47c4-ba46-8ad6a816615e] - For home patients with sudden changes in condition, if the home care pharmacist provides necessary guidance at the request of the attending physician, the home patient emergency joint guidance fee (在宅患者緊急時等共同指導料) is calculated. [KB-4fc322f9-642f-4801-89c3-cb70c9af6ab1] [KB-5b2ae222-dd34-4f8b-b2de-0e51e6778c29] ### 5.1.6 Information Sharing and Communication - For home nursing, the system must support acquisition and utilization of patient medical and medication information at the initial visit using an online eligibility confirmation system, to enable planned management and provision of high-quality care. [KB-9e53203f-143a-4301-abb8-e7bd7dde87af] --- ## 5.2 Business Requirements - The requirements and evaluation for home nursing management care fee (訪問看護管理療養費) must be reviewed to strengthen the functions of home nursing stations and ensure high-quality, effective care that meets diverse user and community needs. [KB-aeb72a17-5d44-4e89-9640-f4c1995c3d49] - The requirements and evaluation for the enhanced nursing assistant system addition (看護補助体制充実加算) must be reviewed to further promote division of labor and collaboration between nursing staff and assistants, and to promote efforts to minimize physical restraints. [KB-05c4460e-0933-40a9-962c-fc2be422e060] --- ## 5.3 Constraint Requirements - The use of physical restraints in home nursing and medical institutions is, in principle, prohibited, and organizational systems to minimize their use must be established. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272] [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] [KB-8445364a-473a-46bc-8207-fb1f2671bde6] [KB-edc81296-4474-4138-a404-f797f293eb19] --- ## 5.4 [GAP: Missing data for Requirements] - Any requirements not explicitly covered in the provided context are marked as gaps. Additional information is required to fully specify requirements in some domains. --- *All requirements are derived solely from the provided context and are traceable to their respective source blocks as per ISO-29148.*