## Requirements # 5. Requirements This section outlines the functional and, where available, business and constraint requirements for the system, strictly based on the provided context. All requirements are referenced to their source for traceability. --- ## 5.1 Functional Requirements ### 5.1.1 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 home nursing services and efficient operation of the station. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272] - A system for abuse prevention measures in home nursing must be mandated, and physical restraints must be prohibited in principle, 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 the patient's condition. [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 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 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 home nursing care fee statements must be revised. [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. [KB-aeb72a17-5d44-4c8e-b3c6-e83c459da003] - Abuse prevention measures in home nursing must be systematized, and physical restraints must be prohibited in principle. [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525] ### 5.1.2 Physical Restraint Minimization - Medical institutions must establish an organizational system to minimize the use of physical restraints, strengthening initiatives to reduce physical restraint in both general and dementia care settings. [KB-edc81296-4474-4138-a404-f797f293eb19], [KB-8445364a-473a-46bc-8207-fb1f2671bde6] - The requirements and evaluation for the dementia care addition (認知症ケア加算) must be reviewed to promote minimization of physical restraints and to include delirium identification in the assessment of dementia patients. [KB-c2bd624b-5c92-413c-be0e-30abb7e64211] ### 5.1.3 Nursing Staff Collaboration - The requirements and evaluation for the enhancement addition for the nursing assistant system (看護補助体制充実加算) must be reviewed to further promote task sharing and collaboration between nursing staff and nursing assistants, and to encourage efforts to minimize physical restraints. [KB-05c4460e-0933-40a9-962c-fc2be422e060] ### 5.1.4 Medication Management and Guidance - Pharmacists must provide necessary guidance to patients, especially for drugs requiring special safety management, and document such guidance. [KB-08289384-33b4-4060-8531-77d29c0895ef], [KB-f271747d-fadb-4d69-9ff8-ea0f4702f4f2], [KB-fde2b685-c7c4-44c8-9de7-3a7051dd9005] - For patients prescribed narcotics, pharmacists must confirm the status of use and storage, check for side effects, and provide necessary pharmaceutical management and guidance. A narcotics management guidance addition (麻薬管理指導加算) of 100 points per instance is applied. [KB-24385190-0703-42d1-a834-6854e998b904], [KB-ad7d4dc3-8896-4c1b-92c7-8d969120b377], [KB-66969593-ac17-45cd-a41d-f335a2406225], [KB-08876a43-c1e4-4b7f-8517-0cd67e273533] - For patients with malignant tumors, pharmacists must confirm the treatment plan and provide pharmaceutical management and guidance, with additional documentation to the medical institution as required. [KB-b2731f14-7331-4d15-827d-89f8aed2bcb1], [KB-20775cd7-be3a-4a41-a8e2-53ac409c2538] - For patients with multiple medications or those unable to self-administer, pharmacists must support medication management, including one-dose packaging and necessary guidance, and provide information to the prescribing physician. [KB-07f1aee1-1797-47ce-a5e9-b2462436b453], [KB-2f8bb1e8-7cd1-4808-802d-61cbf1dea96e], [KB-ff3ce6e4-b5ec-4058-afe5-c24124781336] - For pediatric patients with disabilities as defined by the Child Welfare Act, pharmacists must confirm necessary information directly with the patient or family, provide required guidance, and record the guidance in a notebook. A pediatric specific addition (小児特定加算) of 350 points is applied. [KB-6bb697eb-fdad-4cda-a697-9d148e072b9d], [KB-ba91d9ab-b335-4929-9779-694ba115ef39] - For inhalation drugs prescribed to asthma or COPD patients, pharmacists must provide necessary management and guidance using documents and practice inhalers, and provide written information to the medical institution. An inhalation drug guidance addition (吸入薬指導加算) of 30 points is applied once every three months. [KB-604920cd-689f-4a10-97db-9faeb614d499], [KB-ef609548-ff37-4388-9fd5-c638d8bf6eab] ### 5.1.5 Discharge Support and Home Medical Care - For patients discharged from a medical institution, if a designated pharmacy pharmacist is responsible for post-discharge home medication management, and with patient consent, a joint discharge guidance fee (退院時共同指導料) of 600 points is applied. [KB-061bef49-5443-4529-80cb-0067c3bedc4f], [KB-44db8f45-e972-47c4-ba46-8ad6a816615e], [KB-1eebb670-f513-40ab-a8bc-7127863e3404] - For emergency situations in home care, pharmacists may provide urgent joint guidance, with a fee of 700 points applied. [KB-4fc322f9-642f-4801-89c3-cb70c9af6ab1] - For home care patients, the requirements and evaluation for comprehensive support addition (包括的支援加算) must be reviewed to better reflect patient conditions. [KB-09f32992-f81b-4576-aaa4-262f9f8d8579] ### 5.1.6 Information Management and Security - Medical institutions must establish a management system for medical records (診療録管理体制) that includes cyber security measures for emergencies, in accordance with the "Guidelines for the Safe Management of Medical Information Systems." [KB-f2add61c-f758-48b5-bf48-6956eec6aa8a] ### 5.1.7 Other Functional Requirements - The requirements and evaluation for outpatient tumor chemotherapy management fee (外来腫瘍化学療法診療料) must be reviewed, including new evaluation when pharmacists confirm and assess medication status before consultation and provide information or proposals to physicians. [KB-ae822bb5-db0a-4310-9d78-651887df1be2], [KB-f700221a-650f-4f32-ada0-aff43c6a8ba9] - Requirements and evaluation for the use of ICT in home palliative care must be reviewed to ensure high-quality care and information sharing among healthcare professionals during patient emergencies. [KB-ef95bdaa-ef0b-4848-bf4b-a5c073be5ba9], [KB-fa0fdacb-f933-4296-8d0b-ac501b9102a5] --- ## 5.2 Business Requirements - Facility standards notification and electronic submission for claims and facility standards must be promoted to improve efficiency and reduce administrative burden on healthcare workers. [KB-b952325d-d264-48ac-afd5-532c6ea95025] --- ## 5.3 Constraint Requirements - For certain additions (e.g., 麻薬管理指導加算), calculation is limited to twice per month, and for some pharmacies as defined by the Minister of Health, Labour and Welfare, calculation may not be permitted. [KB-473d2d4d-0a06-4fe0-990e-29bef944a7c7] - For joint conferences and guidance involving home care, calculation is limited to twice per month. [KB-95340505-f820-4879-9646-0167a0508c15], [KB-3471e397-bc65-485a-89e4-733c6e99747b] --- ## 5.4 [GAP: Missing data for Requirements] - Any requirements not explicitly covered in the provided context are not addressed in this section. [GAP: Missing data for Requirements] --- **End of Section**