Analysis of visiting nurses' obligation from medical accidents in home health care

本研究目的在探讨居家照护中的医疗事故，并从法律的观点分析护理人员在居家照护中的责任，探讨护理人员在居家照护中因护理人员及家庭帮工所发生的医疗事故及意外事件。在1999年9月至10月期间，曾向247名探访护士及在2000年7月至8月期间向479名家务助理员进行问卷调查，结果显示探访护士所涉及的事故及意外分别为264宗及62宗。大多数事故都是与药物有关的错误。此外，家务助理员所涉及的事故和意外数目分别为720宗和547宗。家庭佣工的执业行为存在一定的违法性，根据《医疗法》的修改，家庭佣工的执业行为被推定为以病人的家为医疗场所。这需要风险管理来保障患者在家中的医疗事故。卫生，劳动和福利部公平地承认出诊护士的自由裁量权。如果是巡诊护士造成的医疗事故，巡诊护士要承担责任，做好家庭护理工作的关键是要培养和鼓励巡诊护士的服务意识，确保病人的安全。

The purpose of this study was to investigate the medical accidents in home health care, and to analyze the obligation of visiting nurses from the legal point of view.We investigate the number of incidents and accidents by visiting nurses and home-helpers in home health care. A questionnaire surveys were conducted from September to October in 1999 for 247 visiting nurses and from July to August in 2000 for 479 home-helpers.The numbers of incidents and accidents by visiting nurses were 264 and 62 respectively. Most of the accidents were mistakes that related to medication. Also the numbers of incidents and accidents by home-helpers were 720 and 547 respectively. There are some illegal practice by home-helpers.According to revision of the Medical Law, it is presumed that the patients' home are the place of medical treatment. That need the risk management to indemnify against medical accidents for the patients at home.The visiting nurses are admitted their discretion fairly by The Ministry of Health, Labor and Welfare. If the medical accidents are occurred by visiting nurses, they have to be liable to their negligence.The key of performing home health care is that visiting nurses are more nourished and encouraged to have sophisticated sense of their services to insure patients' safety.