Introduction and Theorization of Risk Management on Users with Dementia at Long-term Care Insurance Facilities

我们通过文献研究、访谈和学术会议上的信息交流，就长期护理保险机构(2002-2003财年)痴呆患者的风险实际状况和风险管理进行了全国性的调查，并在了解实际情况和建立干预理论框架的基础上，在4个机构(2004-2005财年)实施了干预研究。尽管干预的细节因设施条件的不同而有所不同，但我们提供了以下共同支持：1)通过增加照顾者的现有信息(包括知识和方法)来增进工作人员之间的相互了解；2)支持通过共享支持案例分析和事件报告来提高对用户安全、舒适、满意度、能力发挥和护理之间关系的理解；3)支持风险管理系统的开发。这样的支撑物是作为c…的基础提供的。干预的效果之一是减少了跌倒、吸入和/或窒息以及感染等事故。即使在没有减少的情况下，工作人员也意识到他们可以防止这样的事故发生，如果发生这样的事故，他们可以采取措施，这样的事故已经不再是无法解决的问题。护理意识的变化也被观察到，更积极的承诺是“实施与风险管理相关的护理”，“照顾痴呆症患者”，以及“成为推动团队的代理人”。研究人员的每一次干预与其效果之间的关系被分析、回顾和阐释为风险管理理论(FY2005)。我们相信，设施管理部门可以有意识地实施此类干预，因为针对痴呆症患者的风险管理活动将有助于提高风险管理质量。较少

We performed a nationwide survey based on documents study, interviews, and information exchange at academic conferences concerning actual status of risks and the risk management related to users with dementia at long-term care insurance facilities (in FY2002-2003), and implemented intervention study in four facilities (in FY2004-2005) after understanding actual status and creating a theoretical framework for the intervention.Though details of the intervention vary depending on the conditions of each facility, we provided following common supports : 1)support to enhance mutual understanding among the staffs by increasing on-hand information (including knowledge, and methodology) of care takers ; 2)support to improve understanding of the relationship between users' safety, comfort, satisfaction, ability exertion and care provided by sharing support case analysis and incident reports, and 3)support for the development of a risk management system. Such supports were provided as basics of c … More aring.One effect of the intervention was reduction of accidents such as falls, aspiration and/or asphyxiation, and infection. Even when no reduction was observed, the staffs realized that they could prevent such accidents ; they can take measures in the event of such accidents, and such accidents are not insoluble issues any more. Changes in care takes' awareness were also observed, with more active commitments to "implementation of care related to risk management", "care for users with dementia", and "becoming an agent to drive the team". We believe that the changes intended by the reserchers were brought about through the interventions.The relationship between each intervention of researchers and its effect were analyzed, reviewed, and illustrated as risk management theory (FY2005). We believe that facility managements can intentionally implement such intervention, as risk management activities for users with dementia and such intervention will contribute to improve risk management quality. Less