## Requirements # 3. Requirements ## 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] - The establishment of systems for abuse prevention measures in home nursing is mandatory, and physical restraints are, in principle, prohibited to promote proper abuse prevention and restraint minimization. [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 based on patient condition. [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0] - The requirements and evaluation for 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 the contact system for 24-hour response. [KB-06db46ba-7647-483b-9f38-f7fa62a24d77] - The requirements and evaluation for emergency home nursing visit additions (緊急訪問看護加算) must be reviewed, and the content of home nursing care fee statements revised to ensure appropriate provision of emergency designated home nursing. [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] - Abuse prevention measures and the proper handling of physical restraints in home nursing must be systematized and made mandatory, with physical restraints generally prohibited. [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] ### 3.1.2 Physical Restraint Minimization - Medical institutions must establish organizational systems to minimize physical restraints, strengthening initiatives to reduce their use. [KB-edc81296-4474-4138-a404-f797f293eb19] [KB-8445364a-473a-46bc-8207-fb1f2671bde6] - In nursing, requirements and evaluation for the enhancement of the nursing assistant system must be reviewed to further promote task sharing/collaboration between nursing staff and assistants, and to encourage efforts to minimize physical restraints. [KB-05c4460e-0933-40a9-962c-fc2be422e060] ### 3.1.3 Dementia Care - The evaluation of the dementia care addition (認知症ケア加算) must be reviewed to further promote minimization of physical restraints for dementia patients, and the requirements for both dementia care addition and delirium high-risk patient care addition must be revised to include the identification of delirium during assessment. [KB-c2bd624b-5c92-413c-be0e-30abb7e64211] - The scope of patients eligible for the dental disease management comprehensive medical management addition (歯科疾患管理料総合医療管理加算) must be reviewed to promote dental care through information sharing and collaboration between primary dental practitioners and physicians for dementia patients. [KB-99f12607-9f08-40a0-abb5-7c958e92d05d] ### 3.1.4 Medical Safety - The requirements for medical safety measures addition 1 (医療安全対策加算１) must be revised to require notification for specific intensive care units and laparoscopic surgeries where enhanced medical safety measures are necessary. [KB-360b6f6e-0849-4755-9436-c9fda0dba185] ### 3.1.5 Pharmaceutical Management - For patients prescribed multiple oral medications or those who have difficulty opening packages themselves, the necessity and support for medication management must be confirmed with the prescribing physician, and medication support (such as one-dose packaging and necessary guidance) must be provided, with calculation based on the number of days the medication is administered. [KB-07f1aee1-1797-47ce-a5e9-b2462436b453] - When duplicate prescriptions are identified through centralized management of medications, the pharmacist must propose solutions to the prescribing physician in writing, and the prescribed points can be calculated once every three months. [KB-50d4fc2a-962d-4820-a105-6ba75b15cf4c] [KB-f2bbf07b-2196-40f3-9da7-66b45e6dd128] - When medication management is performed upon request from the patient, family, or medical institution, and the results are provided to the medical institution, the prescribed points can be calculated. [KB-2f8bb1e8-7cd1-4808-802d-61cbf1dea96e] - For patients requiring special safety explanations (e.g., based on pharmaceutical risk management plans), the pharmacist must provide the relevant safety management materials at the first use, with additional points calculated. [KB-9720cc93-fb47-4376-9506-fbb4d8f61048] - When a pharmacist provides necessary guidance on the use and storage of narcotics, and checks for side effects, additional points are calculated per instance. [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] ### 3.1.6 Discharge Guidance - For patients discharged from medical institutions, if the designated pharmacy pharmacist provides home medication management guidance after obtaining patient consent, the discharge joint guidance fee is calculated. [KB-061bef49-5443-4529-80cb-0067c3bedc4f] [KB-1eebb670-f513-40ab-a8bc-7127863e3404] [KB-44db8f45-e972-47c4-ba46-8ad6a816615e] ### 3.1.7 Other Functional Requirements - [GAP: Missing data for Requirements] ## 3.2 Business Requirements - [GAP: Missing data for Requirements] ## 3.3 Interface Requirements - [GAP: Missing data for Requirements] ## 3.4 Performance Requirements - [GAP: Missing data for Requirements] ## 3.5 Security and Quality Requirements - [GAP: Missing data for Requirements] --- **References:** [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272] [KB-05c4460e-0933-40a9-962c-fc2be422e060] [KB-06db46ba-7647-483b-9f38-f7fa62a24d77] [KB-07f1aee1-1797-47ce-a5e9-b2462436b453] [KB-10f23eda-03d3-4220-8642-6ff7cbf64700] [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0] [KB-24385190-0703-42d1-a834-6854e998b904] [KB-31de50ce-f3df-4fb0-a0bd-6a1ce5795463] [KB-44db8f45-e972-47c4-ba46-8ad6a816615e] [KB-50d4fc2a-962d-4820-a105-6ba75b15cf4c] [KB-61bef49-5443-4529-80cb-0067c3bedc4f] [KB-66969593-ac17-45cd-a41d-f335a2406225] [KB-8445364a-473a-46bc-8207-fb1f2671bde6] [KB-99f12607-9f08-40a0-abb5-7c958e92d05d] [KB-c2bd624b-5c92-413c-be0e-30abb7e64211] [KB-d3ab3b3c-2eb6-483e-a1be-0ccada2baa4d] [KB-edc81296-4474-4138-a404-f797f293eb19] [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] [KB-f2bbf07b-2196-40f3-9da7-66b45e6dd128] [KB-fde2b685-c7c4-44d8-9de7-3a7051dd9005] [KB-ff3ce6e4-b5ec-4058-afe5-c24124781336]