## Requirements # 4. Requirements This section specifies the functional and, where available, business and interface requirements for the system, in accordance with ISO-29148. All requirements are derived solely from the provided context. --- ## 4.1 Functional Requirements ### 4.1.1 Home Nursing (訪問看護) - The responsibilities of administrators at home nursing stations must be clarified, and requirements reviewed to ensure both quality of provided home nursing and efficient operation of the station. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272] - The establishment of a system for abuse prevention measures in home nursing is mandatory. Physical restraints and similar measures are, in principle, prohibited. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272], [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] - The requirements and evaluation for frequent visit additions and emergency home nursing additions must be reviewed to ensure appropriate assessment according to patient conditions. [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0], [KB-4be6a015-623d-440c-95dd-a51bf556ebbd] - The requirements and evaluation for 24-hour response system additions must be revised, considering efforts to reduce the burden of nursing work and reviewing the handling of communication systems related to 24-hour response. [KB-06db46ba-7647-483b-9f38-f7fa62a24d77] - The requirements and evaluation for home nursing management medical care fees must be reviewed to strengthen the functions of home nursing stations and ensure high-quality, effective care. [KB-aeb72a17-5d44-4c8e-b3c6-e83c459da003] ### 4.1.2 Abuse Prevention and Physical Restraint Minimization - The system for abuse prevention in home nursing must be established as an obligation, and physical restraints are, in principle, prohibited. [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] - In medical institutions, organizational systems to minimize physical restraints must be established and strengthened. [KB-8445364a-473a-46bc-8207-fb1f2671bde6], [KB-edc81296-4474-4138-a404-f797f293eb19] - For dementia care, the requirements and evaluation for dementia care additions must be reviewed, including the necessity of delirium identification in assessments. [KB-c2bd624b-5c92-413c-be0e-30abb7e64211] ### 4.1.3 Nursing Staff and Assistant Collaboration - The requirements and evaluation for the enhancement of the nursing assistant system must be reviewed to further promote the division and collaboration of duties between nursing staff and assistants, and to encourage efforts to minimize physical restraints. [KB-05c4460e-0933-40a9-962c-fc2be422e060] ### 4.1.4 Medication Management and Guidance - Pharmacists must confirm the medication and storage status, and the presence or absence of side effects for patients prescribed narcotics, and provide necessary pharmaceutical management and guidance. For each instance, 100 points are added to the prescribed score. [KB-24385190-0703-42d1-a834-6854e998b904], [KB-66969593-ac17-45cd-a41d-f335a2406225], [KB-ad7d4dc3-8896-4c1b-92c7-8d969120b377] - When narcotics are dispensed, and the pharmacist confirms the medication and storage status and side effects, 22 points are added to the prescribed score as a narcotics management guidance addition. [KB-10f23eda-03d3-4220-8642-6ff7cbf64700], [KB-31de50ce-f3df-4fb0-a0bd-6a1ce5795463] - For patients requiring special safety management medicines, if the pharmacist confirms the medication status and side effects, and provides necessary guidance, a special drug management guidance addition is applied. [KB-f271747d-fadb-4d69-9ff8-ea0f4702f4f2], [KB-fde2b685-c7c4-44c8-9de7-3a7051dd9005] - For patients with cancer, if the pharmacist confirms the medication status and side effects, and provides necessary guidance, and with patient consent, provides required information to the medical institution in writing, a special drug management guidance addition 2 is applied (once per month, 100 points). [KB-b2731f14-7331-4d15-827d-89f8aed2bcb1], [KB-20775cd7-be3a-4a41-a8e2-53ac409c2538] - For pediatric patients with disabilities as defined by the Child Welfare Act, when necessary information is confirmed directly with the patient or family, guidance is provided, and the content is recorded in a notebook, a pediatric specific addition of 350 points is applied. [KB-6bb697eb-fdad-4cda-a697-9d148e072b9d], [KB-ba91d9ab-b335-4929-9779-694ba115ef39] ### 4.1.5 Medication Information Provision - When necessary, pharmacists must provide information in writing to medical institutions, refill prescription physicians, or care managers, with each instance scored accordingly. [KB-c35807e4-304e-4ba2-b7b8-f7a8be6f4afe] - After dispensing, if the pharmacist recognizes the necessity, and with patient consent, ensures appropriate medication use by monitoring and providing information to the medical institution, this is counted once per month. [KB-37919876-98a0-4fbf-879a-7de2d13e4a0f] - For inhaled drugs, when instruction and management are provided using written materials and training inhalers, and information is provided to the medical institution, an inhaled drug instruction addition is applied once every three months (30 points). [KB-604920cd-689f-4a10-97db-9faeb614d499], [KB-ef609548-ff37-4388-9fd5-c638d8bf6eab] ### 4.1.6 Home Medical Care (在宅医療) - Requirements and evaluation for comprehensive support additions, home medical care transition additions, and terminal care additions must be reviewed to ensure appropriate assessment according to patient conditions and to support patient wishes at the end of life. [KB-09f32992-f81b-4576-aaa4-262f9f8d8579], [KB-75ca8a38-02f4-46be-9a1d-a9f8673d799c], [KB-3e410501-b1b1-45a9-8876-3e7fcf55b2dd] - For emergency situations, pharmacists providing joint guidance with home medical care institutions are scored accordingly. [KB-4fc322f9-642f-4801-89c3-cb70c9af6ab1], [KB-5b2ae222-dd34-4f8c-b2de-0e51e6778c29] - For discharge support, requirements and evaluation for discharge support guidance additions must be reviewed, and joint guidance at discharge is scored. [KB-b375a84b-c77e-4084-a4a2-a2e0f2c22a9a], [KB-44db8f45-e972-47c4-ba46-8ad6a816615e] ### 4.1.7 Medical Safety - For specific intensive care units and laparoscopic surgery, notification of Medical Safety Measures Addition 1 is required. [KB-360b6f6e-0849-4755-9436-c9fda0dba185] ### 4.1.8 ICT and Online Systems - When an online qualification confirmation system is introduced, during the initial visit, the user's 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] --- ## 4.2 Business Requirements - Facility standards notification and electronic submission for claims must be revised to improve efficiency and reduce administrative burden on medical institutions. [KB-b952325d-d264-48ac-afd5-532c6ea95025] - Free issuance of statements by designated home nursing providers is mandatory from June 2024. [KB-7b83826c-4a00-4706-aced-07ac5183c8ff] --- ## 4.3 Interface Requirements - The provision of medical information to external parties (e.g., schools for children with medical care needs) must be reviewed to enhance coordination. [KB-4d2151dc-fa29-4352-91ee-fd6151d0b86c] - The requirements and naming for the Medical Information Coordination Sharing Fee must be reviewed to enable information sharing between dental medical institutions and pharmacies regarding patient medication status. [KB-cf3f3cae-6613-483c-82ec-6394834b6a34] --- ## 4.4 Constraints - For certain home medical care guidance fees, calculation is limited to twice per month, and cannot be claimed by pharmacies specified by the Minister of Health, Labour and Welfare. [KB-473d2d4d-0a06-4fe0-990e-29bef944a7c7] - For joint conferences with home nursing staff and other professionals, calculation is limited to twice per month. [KB-3471e397-bc65-485a-89e4-733c6e99747b], [KB-95340505-f820-4879-9646-0167a0508c15] --- ## 4.5 Gaps - [GAP: Missing data for Requirements] – If further details, such as specific user interface requirements, system performance, or data security requirements are needed, these are not available in the provided context. --- **References:** All requirements are traceable to their respective knowledge base sources as cited above.