## Requirements # 3. Requirements This section specifies the functional and, where applicable, business and constraint requirements for the system, based solely on the provided context. All requirements are traceable to their respective source blocks. --- ## 3.1 Functional Requirements ### 3.1.1 Home Nursing (訪問看護) - The responsibilities of administrators at home nursing stations must be clarified and requirements reviewed to ensure both the quality of provided home nursing and efficient station operation. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272] - Systems must be established to prevent abuse in home nursing, and the use of physical restraints must, in principle, be prohibited. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272][KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] - The requirements and evaluation of frequent visit additions (頻回訪問加算) must be reviewed to ensure appropriate assessment according to patient status. [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0] - The requirements and evaluation of 24-hour response system additions (24時間対応体制加算) must be revised, considering initiatives to reduce nursing workload and reviewing the handling of communication systems for 24-hour response. [KB-06db46ba-7647-483b-9f38-f7fa62a24d77] - The requirements and evaluation of emergency home nursing additions (緊急訪問看護加算) must be reviewed to ensure appropriate provision and to revise the content of home nursing care fee statements. [KB-4be6a015-623d-440c-95dd-a51bf556ebbd] - The requirements and evaluation of home nursing management care fees must be reviewed to strengthen the functions of home nursing stations and ensure high-quality, effective care in response to diverse user and regional needs. [KB-aeb72a17-5d44-4c8e-b3c6-e83c459da003] - The requirements and evaluation of discharge support guidance additions (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] - When an online qualification confirmation system is introduced, at the initial visit, diagnostic and medication information must be obtained and utilized for planned management of designated home nursing, to provide high-quality medical care, and new evaluation must be implemented. [KB-9e53203f-143a-4301-abb8-e7bd7dde87af] ### 3.1.2 Physical Restraint and Abuse Prevention - Organizational systems must be established in medical institutions to minimize the use of physical restraints. [KB-edc81296-4474-4138-a404-f797f293eb19][KB-8445364a-473a-46bc-8207-fb1f2671bde6] - In home nursing, systems for abuse prevention must be mandated, and physical restraint must be prohibited in principle. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272][KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] - The requirements and evaluation of the nursing assistant system enhancement addition (看護補助体制充実加算) must be reviewed to further promote the division and cooperation of duties between nursing staff and assistants, and to promote initiatives to minimize physical restraint. [KB-05c4460e-0933-40a9-962c-fc2be422e060] ### 3.1.3 Dementia Care - The requirements and evaluation of dementia care additions (認知症ケア加算) and delirium high-risk patient care additions must be reviewed, including the necessity of delirium identification in dementia patient assessments. [KB-c2bd624b-5c92-413c-be0e-30abb7e64211] - The requirements and evaluation of the comprehensive medical management addition for dental disease management fees for dementia patients must be reviewed to promote dental care through information sharing and collaboration between primary dental care physicians and other stakeholders. [KB-99f12607-9f08-40a0-abb5-7c958e92d05d][KB-d5f332af-4a8d-4af8-a3a3-8261a8217cb1][KB-6325a096-0775-4575-b189-c388b3fb3707] ### 3.1.4 Discharge Guidance - When a patient designates a pharmacy for post-discharge home medication management, and with patient consent, the designated pharmacist must provide guidance for home care after discharge. [KB-061bef49-5443-4529-80cb-0067c3bedc4f][KB-44db8f45-e972-47c4-ba46-8ad6a816615e][KB-1eebb670-f513-40ab-a8bc-7127863e3404] --- ## 3.2 Business Requirements - The requirements and evaluation of the comprehensive support addition (包括的支援加算) must be reviewed according to the condition of patients receiving home medical care. [KB-09f32992-f81b-4576-aaa4-262f9f8d8579] - Medical institutions must review the requirements for the notification of facility standards and the process for electronic submission of such notifications, to improve operational efficiency and reduce administrative burden. [KB-b952325d-d264-48ac-afd5-532c6ea95025] --- ## 3.3 Constraint Requirements - In-home medical care, when guidance necessary for medical care is provided jointly with relevant professionals, calculation is limited to twice per month. [KB-3471e397-bc65-485a-89e4-733c6e99747b][KB-95340505-f820-4879-9646-0167a0508c15][KB-473d2d4d-0a06-4fe0-990e-29bef944a7c7] --- ## 3.4 [GAP: Missing data for Requirements] - Any requirements not explicitly covered in the above context are not addressed in this section. --- **References:** [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272], [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525], [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0], [KB-06db46ba-7647-483b-9f38-f7fa62a24d77], [KB-4be6a015-623d-440c-95dd-a51bf556ebbd], [KB-aeb72a17-5d44-4c8e-b3c6-e83c459da003], [KB-b375a84b-c77e-4084-a4a2-a2e0f2c22a9a], [KB-9e53203f-143a-4301-abb8-e7bd7dde87af], [KB-edc81296-4474-4138-a404-f797f293eb19], [KB-8445364a-473a-46bc-8207-fb1f2671bde6], [KB-05c4460e-0933-40a9-962c-fc2be422e060], [KB-c2bd624b-5c92-413c-be0e-30abb7e64211], [KB-99f12607-9f08-40a0-abb5-7c958e92d05d], [KB-d5f332af-4a8d-4af8-a3a3-8261a8217cb1], [KB-6325a096-0775-4575-b189-c388b3fb3707], [KB-061bef49-5443-4529-80cb-0067c3bedc4f], [KB-44db8f45-e972-47c4-ba46-8ad6a816615e], [KB-1eebb670-f513-40ab-a8bc-7127863e3404], [KB-09f32992-f81b-4576-aaa4-262f9f8d8579], [KB-b952325d-d264-48ac-afd5-532c6ea95025], [KB-3471e397-bc65-485a-89e4-733c6e99747b], [KB-95340505-f820-4879-9646-0167a0508c15], [KB-473d2d4d-0a06-4fe0-990e-29bef944a7c7]