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

本研究的目的是调查家庭护理中的医疗事故，从法律的角度分析探访护士的义务，调查家庭护理中探访护士和家政服务人员发生的事件和事故的数量。我们在1999年9月至10月期间，向247名到访护士进行了问卷调查，并在2000年7月至8月期间，向479名家务助理进行了问卷调查，到访护士发生事故及意外的个案数目分别为264宗及62宗。大多数事故都是与用药有关的错误。此外，家务助理发生事故及意外的数字分别为720宗及547宗。家政服务人员存在一些违法行为，根据修订后的《医疗法》，推定患者的家为就医场所。这就需要风险管理来保障患者在家中的医疗事故。厚生劳动省公平地承认了来访护士的自由裁量权。如果出访护士发生了医疗事故，就要承担责任。开展居家护理的关键是要更好地滋养和鼓励来访护士精益求精的服务意识，确保患者的生命安全。

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.