## Requirements # 3. Requirements This section outlines the functional and business requirements for the relevant medical and healthcare domains, as derived from the provided context. All requirements are structured in accordance with ISO-29148 standards. --- ## 3.1 Functional Requirements ### 3.1.1 Home Nursing (訪問看護) - The responsibilities of administrators must be clarified and requirements reviewed to ensure both the quality of home nursing services and efficient operation of home nursing stations. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272], [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0] - Systems for abuse prevention in home nursing must be established as a mandatory measure. Physical restraints and similar practices 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 evaluation based on patient conditions. [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0] - The requirements and evaluation for the 24-hour response system addition (24時間対応体制加算) must be reviewed, considering initiatives to reduce the burden of nursing work and revising the handling of the contact system for 24-hour response. [KB-06db46ba-7647-483b-9f38-f7fa62a24d77] - The requirements and evaluation for the emergency home nursing addition (緊急訪問看護加算) must be reviewed to ensure appropriate provision of emergency designated home nursing, and the content of the home nursing care fee claim form must be revised. [KB-4be6a015-623d-440c-95dd-a51bf556ebbd] - The requirements and evaluation for home nursing management care fees (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 regional needs. [KB-aeb72a17-5d44-4c8e-b3c6-e83c459da003] - The requirements and evaluation for discharge support guidance addition (退院支援指導加算) must be enhanced based on the user’s condition and the status of home nursing provided on the day of discharge. [KB-b375a84b-c77e-4084-a4a2-a2e0f2c22a9a] - Upon introduction of the online eligibility confirmation system for home care, at the initial visit, user medical and medication information must be obtained and utilized for planned management of designated home nursing, and high-quality medical care must be provided. [KB-9e53203f-143a-4301-abb8-e7bd7dde87af] ### 3.1.2 Physical Restraint Minimization - Medical institutions must strengthen efforts to minimize physical restraints by establishing organizational systems to systematically reduce their use. [KB-8445364a-473a-46bc-8207-fb1f2671bde6], [KB-edc81296-4474-4138-a404-f797f293eb19] - In home nursing, measures for the prevention of abuse and the proper use of physical restraints must be institutionalized, with physical restraints principally prohibited. [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] - In nursing, requirements and evaluation for the enhancement addition of the nursing assistant system must be reviewed to further promote division and cooperation of duties between nursing staff and assistants, and to promote efforts to minimize physical restraints. [KB-05c4460e-0933-40a9-962c-fc2be422e060] ### 3.1.3 Medication Management and Guidance - Pharmacists must provide necessary medication management and guidance, including for narcotics, and confirm with the patient regarding medication use, storage, and side effects, with specific points awarded per occurrence as per the following table: | Scenario | Points Addition | |--------------------------------------------------------------------------|------------------------| | Narcotics management (per occurrence) | 100 points | | Special medication risk management (per occurrence) | 10 points (Add-on 1) | | Provision of necessary information to medical institutions (per occurrence) | 20 points (Provision Fee 2) | | Pediatric-specific guidance (per occurrence) | 350 points (Pediatric Add-on) | [KB-24385190-0703-42d1-a834-6854e998b904], [KB-ad7d4dc3-8896-4c1b-92c7-8d969120b377], [KB-31de50ce-f3df-4fb0-a0bd-6a1ce5795463], [KB-66969593-ac17-45cd-a41d-f335a2406225], [KB-fde2b685-c7c4-44d8-9de7-3a7051dd9005], [KB-c35807e4-304e-4ca5-8e86-e1404c20a9fd], [KB-ba91d9ab-b335-4929-9779-694ba115ef39], [KB-6bb697eb-fdad-4cda-a697-9d148e072b9d] - For patients requiring special safety management, pharmacists must provide guidance and confirm medication status, with add-on points as specified. [KB-f271747d-fadb-4d69-9ff8-ea0f4702f4f2], [KB-fde2b685-c7c4-44d8-9de7-3a7051dd9005] - For pediatric patients with disabilities as defined by the Child Welfare Act, pharmacists must confirm necessary information directly with the patient or family, provide necessary guidance on medication, and record the guidance in the patient’s handbook, with a pediatric-specific add-on applied. [KB-6bb697eb-fdad-4cda-a697-9d148e072b9d], [KB-ba91d9ab-b335-4929-9779-694ba115ef39] - For patients using inhaled medications for asthma or COPD, pharmacists must provide necessary guidance and information to medical institutions, with an inhaled medication guidance add-on applied. [KB-604920cd-689f-4a10-97db-9faeb614d499], [KB-ef609548-ff37-4388-9fd5-c638d8bf6eab] ### 3.1.4 Discharge and Home Care Support - For patients discharged from medical institutions, pharmacists at the designated pharmacy must, with patient consent, provide home medication management guidance after discharge. [KB-061bef49-5443-4529-80cb-0067c3bedc4f], [KB-1eebb670-f513-40ab-a8bc-7127863e3404], [KB-44db8f45-e972-47c4-ba46-8ad6a816615e] - For emergency situations in home care, pharmacists must provide necessary guidance at the request of the attending physician, with emergency home visit guidance fees applied. [KB-4fc322f9-642f-4801-89c3-cb70c9af6ab1], [KB-5b2ae222-dd34-4f8c-b2de-0e51e6778c29], [KB-d1dea226-c0ae-4dfe-b0ce-d6cb90c165fb] ### 3.1.5 Evaluation and Review of Medical Fees and Additions - Requirements and evaluation for various additions and management fees (e.g., comprehensive support addition, terminal care addition, frequent visit addition, emergency visit addition, home nursing management care fee, etc.) must be reviewed to ensure appropriate evaluation based on patient status and to promote high-quality, effective care. [KB-09f32992-f81b-4576-aaa4-262f9f8d8579], [KB-3e410501-b1b1-45a9-8876-3e7fcf55b2dd], [KB-75ca8a38-02f4-46be-9a1d-a9f8673d799c], [KB-aeb72a17-5d44-4c8e-b3c6-e83c459da003], [KB-b375a84b-c77e-4084-a4a2-a2e0f2c22a9a] --- ## 3.2 Business Requirements - Medical institutions and pharmacies must review and, where applicable, digitize facility standard notifications and claims for medical fees to improve operational efficiency and reduce administrative burden on healthcare workers. [KB-b952325d-d264-48ac-afd5-532c6ea95025] --- ## 3.3 Interface Requirements - When providing medical information, the provision of information to relevant parties (e.g., care managers, physicians, schools) must be reviewed and revised as necessary to ensure appropriate information sharing and continuity of care. [KB-4d2151dc-fa29-4352-91ee-fd6151d0b86c], [KB-cf3f3cae-6613-483c-82ec-6394834b6a34] --- ## 3.4 Constraint Requirements - For specific additions (e.g., emergency home visit guidance), calculation is limited to a specified number of times per month, and certain pharmacies as defined by the Minister of Health, Labour and Welfare may be excluded from calculation. [KB-473d2d4d-0a06-4fe0-990e-29bef944a7c7], [KB-95340505-f820-4879-9646-0167a0508c15], [KB-f1d3144f-e414-47c2-b233-445b8886c38b] --- ## 3.5 Quality and Security Requirements - Organizational systems must be established to minimize physical restraints, and abuse prevention measures must be institutionalized in home nursing. [KB-8445364a-473a-46bc-8207-fb1f2671bde6], [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] --- If any required content is missing, it is indicated as follows: - [GAP: Missing data for Requirements] --- **References:** All requirements are directly traceable to the following knowledge base entries: [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272], [KB-05c4460e-0933-40a9-962c-fc2be422e060], [KB-06db46ba-7647-483b-9f38-f7fa62a24d77], [KB-09f32992-f81b-4576-aaa4-262f9f8d8579], [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0], [KB-24385190-0703-42d1-a834-6854e998b904], [KB-31de50ce-f3df-4fb0-a0bd-6a1ce5795463], [KB-3e410501-b1b1-45a9-8876-3e7fcf55b2dd], [KB-44db8f45-e972-47c4-ba46-8ad6a816615e], [KB-473d2d4d-0a06-4fe0-990e-29bef944a7c7], [KB-4be6a015-623d-440c-95dd-a51bf556ebbd], [KB-5b2ae222-dd34-4f8c-b2de-0e51e6778c29], [KB-6bb697eb-fdad-4cda-a697-9d148e072b9d], [KB-8445364a-473a-46bc-8207-fb1f2671bde6], [KB-9e53203f-143a-4301-abb8-e7bd7dde87af], [KB-aeb72a17-5d44-4c8e-b3c6-e83c459da003], [KB-ad7d4dc3-8896-4c1b-92c7-8d969120b377], [KB-b375a84b-c77e-4084-a4a2-a2e0f2c22a9a], [KB-b952325d-d264-48ac-afd5-532c6ea95025], [KB-c35807e4-304e-4ca5-8e86-e1404c20a9fd], [KB-cf3f3cae-6613-483c-82ec-6394834b6a34], [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525], [KB-edc81296-4474-4138-a404-f797f293eb19], [KB-f1d3144f-e414-47c2-b233-445b8886c38b], [KB-f271747d-fadb-4d69-9ff8-ea0f4702f4f2], [KB-fde2b685-c7c4-44d8-9de7-3a7051dd9005]