Fact-finding Survey on the Incidence of Medical Procedure and Ventilation Therapy Accidents and Safety Measure Initiatives at Home-visit Nursing Stations in Gunma Prefecture

目的：群馬県訪問看護事業所における医療処置及び人工呼吸器装着者の事故発生状況，安全対策への取組を明らかにし，地域における安全対策の体制整備を検討する．方法：群馬県の訪問看護事業所の管理者421人を対象に自記式質問紙調査を実施した．有効回答は67人（15.9％），記述統計量を算出し，自由記述は類似性に基づき整理した．結果：医療処置の事故は訪問看護提供時間内に14件（n＝31），影響度はレベル3以下，人工呼吸療法に関する事故は介護者在宅時が11件（n＝25），影響度はレベル4が1件（4.0％），レベル5が3件（12.0％）であった．発生時の対応は，介護職のケア時間に発生した事故の検討47.4％，地域の多機関で話し合う30.6％であった．結論：人工呼吸器装着者の安全対策は，介護者のみの時間の療養者・家族が行う対策が重要であり，支援チーム，地域の多機関での事故に関する情報共有・検討が課題である．
Purpose: This study examined the development of local safety measure systems by clarifying the incidence of accidents in medical procedures and among users of ventilators, as well as initiatives for safety measures at home-visit nursing stations in Gunma Prefecture.Methods: A self-administered questionnaire was distributed to 421 administrators of home-visit nursing stations in Gunma Prefecture and valid responses were obtained from 67 respondents (15.9％). Each item was subject to descriptive statistics and open-ended answers were organized based on similarities.Results: The respondents reported 14 (45.2％) medical procedure accidents that occurred during home-visit nursing hours with an impact level on patients of 3 or lower, and 11 (44.0％) ventilation therapy accidents that occurred while the caregiver was home, one of which had an impact level of 4 (4.0％) and three of which had an impact level of 5 (12.0％). Measures taken to address accidents were investigations into accidents that occurred during care hours by care workers in 47.4％ of cases and discussions among various local agencies in 30.6％ of cases.Conclusions: Regarding safety measures for users of ventilators, measures carried out by the patient and their family while only the caregiver was home were important. In the future, it is necessary to address the sharing and review of information on accidents among support teams and various local agencies.
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