## Requirements

# 3. Requirements

This section outlines the functional and business requirements for the system, as derived solely from the provided context. Each requirement is referenced with its corresponding source block ID for traceability.

## 3.1 Functional Requirements

### 3.1.1 Home Nursing (訪問看護)

- The responsibilities of administrators must be clarified and requirements revised to ensure both the quality of home nursing services and efficient operation of home nursing stations. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272]
- Measures for the prevention of abuse and the proper management of physical restraints in home nursing must be institutionalized. The establishment of an abuse prevention system is mandatory, and physical restraints are, in principle, prohibited. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272][KB-e14d657a-8970-4e3e-9ccb-5662af7d6525]
- The requirements and evaluation criteria for frequent visit add-on (頻回訪問加算) and emergency home nursing add-on (緊急訪問看護加算) must be reviewed to ensure appropriate assessment according to patient condition and to support efficient station operation. [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0][KB-4be6a015-623d-440c-95dd-a51bf556ebbd]
- The requirements for the 24-hour response system add-on (24時間対応体制加算) must be revised, including the evaluation system considering initiatives to reduce nursing workload and the handling of communication systems for 24-hour response. [KB-06db46ba-7647-483b-9f38-f7fa62a24d77]
- The requirements and evaluation for home nursing management medical fee (訪問看護管理療養費) must be revised to strengthen the functions of home nursing stations and ensure high-quality, effective care. [KB-aeb72a17-5d44-4e89-9640-f4c1995c3d49]
- Abuse prevention measures and the proper management of physical restraints must be institutionalized, with physical restraints being fundamentally prohibited. [KB-e14d657a-8970-4e3e-9ccb-5662af7d6525]

### 3.1.2 Physical Restraint Minimization

- Medical institutions must establish organizational systems to minimize the use of physical restraints. [KB-8445364a-473a-46bc-8207-fb1f2671bde6][KB-edc81296-4474-4138-a404-f797f293eb19]
- The requirements and evaluation for the nursing assistant system enhancement add-on (看護補助体制充実加算) must be reviewed to further promote the division and collaboration of duties between nursing staff and assistants, and to minimize physical restraints. [KB-05c4460e-0933-40a9-962c-fc2be422e060]

### 3.1.3 Medication Management and Guidance

- Pharmacists must provide necessary guidance to patients, especially for drugs requiring special safety management, and document the guidance provided. [KB-1a041fdb-9f3f-4485-887a-113bbc6d3aa7][KB-5398730a-d7b5-4d8b-830e-5282b5bf61c8][KB-f271747d-fadb-4d69-9ff8-ea0f4702f4f2][KB-fde2b685-c7c4-44c8-9de7-3a7051dd9005]
- For patients prescribed narcotics, pharmacists must confirm the status of use, storage, and side effects, and provide necessary pharmaceutical management and guidance. Narcotic management guidance add-on (麻薬管理指導加算) is to be calculated per instance. [KB-24385190-0703-42d1-a834-6854e998b904][KB-66969593-ac17-45cd-a41d-f335a2406225][KB-ad7d4dc3-8896-4c1b-92c7-8d969120b377][KB-31de50ce-f3df-4fb0-a0bd-6a1ce5795463]
- For patients with malignant tumors, pharmacists must confirm medication status and side effects, provide necessary pharmaceutical management and guidance, and report to the medical institution in writing. [KB-b2731f14-7331-4d15-827d-89f8aed2bcb1][KB-20775cd7-be3a-4a41-a8e2-53ac409c2538]
- For pediatric patients with disabilities, pharmacists must confirm necessary information directly with the patient or family, provide required guidance on medication, and record the guidance in a notebook. Pediatric-specific add-on (小児特定加算) is to be calculated. [KB-6bb697eb-fdad-4cda-a697-9d148e072b9d][KB-ba91d9ab-b335-4929-9779-694ba115ef39]

### 3.1.4 Medication Information Provision

- Pharmacists must provide necessary medication information to medical institutions, care managers, and, where applicable, patients, in writing. [KB-c35807e4-304e-4ba2-b7b8-f7a8be6f4afe][KB-37919876-98a0-4f81-879a-7de2d13e4a0f][KB-0dc6dd3d-3ecc-4685-9f43-b8bcb2ab8ce4]
- For refill prescriptions, pharmacists must provide necessary information to the prescribing physician in writing. [KB-c35807e4-304e-4ba2-b7b8-f7a8be6f4afe]
- For patients with multiple medications or those who have difficulty managing their medication, pharmacists must support medication management and provide information to medical institutions. [KB-2f8bb1e8-7cd1-4808-802d-61cbf1dea96e][KB-ff3ce6e4-b5ec-4058-afe5-c24124781336]

### 3.1.5 Discharge Support and Home Medical Care

- Pharmacists must participate in joint discharge guidance for patients transitioning to home care, with appropriate documentation and information sharing. [KB-061bef49-5443-4529-80cb-0067c3bedc4f][KB-1eebb670-f513-40ab-a8e2-7127863e3404][KB-44db8f45-e972-47c4-ba46-8ad6a816615e]
- For home medical care, pharmacists must respond to urgent changes in patient condition and provide necessary guidance and information to the attending physician or related medical institutions. [KB-4fc322f9-642f-4801-89c3-cb70c9af6ab1][KB-5b2ae222-dd34-4f8b-b2de-0e51e6778c29][KB-d1dea226-c0ae-4dfe-b0ce-d6cb90c165fb]

### 3.1.6 ICT Utilization

- For home nursing, the introduction of online qualification confirmation systems must be leveraged to obtain and utilize patient medical and medication information for high-quality care planning during initial visits. [KB-9e53203f-143a-4301-abb8-e7bd7dde87af]

## 3.2 Business Requirements

- The requirements and evaluation for various add-ons and management fees (e.g., frequent visit add-on, emergency home nursing add-on, home nursing management medical fee, pediatric-specific add-on, narcotic management guidance add-on, specific drug management guidance add-on) must be reviewed and revised to ensure appropriate compensation based on patient condition and care provided. [KB-17ac1ec0-b2d4-4910-9884-a2e46ea25ce0][KB-4be6a015-623d-440c-95dd-a51bf556ebbd][KB-aeb72a17-5d44-4e89-9640-f4c1995c3d49][KB-6bb697eb-fdad-4cda-a697-9d148e072b9d][KB-ba91d9ab-b335-4929-9779-694ba115ef39][KB-24385190-0703-42d1-a834-6854e998b904][KB-66969593-ac17-45cd-a41d-f335a2406225][KB-ad7d4dc3-8896-4c1b-92c7-8d969120b377][KB-31de50ce-f3df-4fb0-a0bd-6a1ce5795463][KB-5398730a-d7b5-4d8b-830e-5282b5bf61c8][KB-f271747d-fadb-4d69-9ff8-ea0f4702f4f2][KB-fde2b685-c7c4-44c8-9de7-3a7051dd9005]
- The documentation and reporting of guidance and management activities must be standardized and submitted as required for reimbursement and quality assurance. [KB-1a041fdb-9f3f-4485-887a-113bbc6d3aa7][KB-c35807e4-304e-4ba2-b7b8-f7a8be6f4afe][KB-37919876-98a0-4f81-879a-7de2d13e4a0f][KB-0dc6dd3d-3ecc-4685-9f43-b8bcb2ab8ce4][KB-20775cd7-be3a-4a41-a8e2-53ac409c2538][KB-b2731f14-7331-4d15-827d-89f8aed2bcb1]

## 3.3 Constraints

- Physical restraints are, in principle, prohibited in home nursing and must be minimized in all medical institutions through organizational measures. [KB-01a2d77c-a20a-47e5-ae19-16ab2c89e272][KB-e14d657a-8970-4e3e-9ccb-5662af7d6525][KB-8445364a-473a-46bc-8207-fb1f2671bde6][KB-edc81296-4474-4138-a404-f797f293eb19]
- The calculation of certain add-ons (e.g., narcotic management guidance add-on, specific drug management guidance add-on, pediatric-specific add-on) is limited to specified frequencies (e.g., per instance, per month, or per quarter) as defined in the requirements. [KB-24385190-0703-42d1-a834-6854e998b904][KB-5398730a-d7b5-4d8b-830e-5282b5bf61c8][KB-f271747d-fadb-4d69-9ff8-ea0f4702f4f2][KB-fde2b685-c7c4-44c8-9de7-3a7051dd9005][KB-6bb697eb-fdad-4cda-a697-9d148e072b9d][KB-ba91d9ab-b335-4929-9779-694ba115ef39]

## 3.4 [GAP: Missing data for Requirements]

- Any requirements not explicitly covered in the provided context are marked as gaps and require further clarification or source material.