Accident Report at Nursing Care Service Facilities

In the event of an accident occurring during the provision of nursing care services

Long-Term Care Insurance designated Business Operators are required to take appropriate action to protect the life and body of users in the event of an accident during the provision of care services, as well as to contact the user's family and the relevant home care support office. They are also obligated to record the circumstances of the accident and the actions taken, and report this to the insurer.

Flow of Accident Reporting

1. Accident Occurred
2. Contact for family members of users and home care support business operators contracted with users
3. Submit the accident report in writing to the Senior Welfare Division Long-Term Care Insurance Section within approximately 5 days (however, in the case of fatal accidents or other urgent or serious incidents, report by phone immediately and then submit the accident report)
4. If the business operator or facility is located in a municipality other than Inagi City, and the user's insurer is also not Inagi City, a report must be made to the respective municipality.
5. Submit the final accident report when all relevant accident handling is complete (however, if the accident handling is complete at the time of the first report, it is not necessary).

• Note 1: Please submit the documents in paper format by hand, by mail, or as electronic data.
• Note 2: When submitting electronic data, please contact the address below to report an incident (please include "Incident Report (Business Operator Name)" in the email subject. In the email body, please include the name of the person in charge, phone number, and business operator email address. Please do not attach the incident report to this email. After that, we will reply with the URL and password to upload the electronic data of the incident report, so please upload the electronic data of the incident report to the specified URL.
  Senior Welfare Division email address: koureifukushi@city.inagi.lg.jp

Accident Report Subject

1. In the event that a user dies or is injured due to an accident during the provision of services (including accidents during medical treatment within the facility, transportation, or outpatient visits, as well as unauthorized outings),
2. In the event of an outbreak of food poisoning, infectious diseases (as defined in the "Law on the Prevention of Infectious Diseases and Medical Care for Patients with Infectious Diseases", including Class 1 to Class 5 infectious diseases (excluding Class 5 designated infectious diseases), novel influenza and other infectious diseases, designated infectious diseases, and new infectious diseases.)
3. If the provision of services is affected due to disaster damage or machinery failure at the business establishment
4. In the case of occurrences such as pica, aspiration, or medication errors
5. If there are any illegal acts or scandals by staff (such as loss of personal information, loss of deposits, etc.) that affect the treatment of users
6. Other cases deemed necessary

Note: Please report regardless of the presence or absence of negligence and responsibility of the Business Operators.

Items that do not require an accident report

1. In the case of relatively minor injuries such as abrasions or bruises
2. In the case of natural death or death due to illness from old age

Note: Even in the above cases, items requested for reporting by the Mayor of Inagi City are considered to require a report.

Report Items

As per the attached accident report
(On March 19, 2021, the Ministry of Health, Labor and Welfare notified that a new reporting format for accidents in Long-Term Care Insurance facilities was introduced in Long-Term Care Insurance Latest Information Vol. 943. Accordingly, Inagi City has also created a format based on the accident report format recommended by the national government as a new format, so please download and use it from the link below. Please ensure that there are no omissions in the items "Person in Charge of Reporting", "Contact Information", "Location of Medical Institution", "Name of Administrator" that are not included in the national format.)

• Note 1: Please fill in all items of the report, including those that are undecided.
• Note 2 Regarding the "Future Measures for Preventing Recurrence," please discuss prevention of recurrence in a meeting attended by the facility manager or administrator of the business operators, and record the results of the discussion.
• Note 3: Please fill out without leaving any blanks.
• Note 4: There may be inquiries from the person in charge regarding the contents of the report.

• Download Various Forms (For Business Operators)

Overview of the Accident Report Summary for Fiscal Year 2021

• The number of accident reports for the 2021 fiscal year was 195, which is a increase of 59 from the previous year.
• The top reported cases by service type were "paid elderly homes" with 52 cases (an increase of 3 from the previous year), "special nursing homes for the elderly" with 40 cases (an increase of 17 from the same period), and "dementia group homes" with 34 cases (an increase of 19 from the same period).
• The main causes of accidents reported were: 94 cases (an increase of 46 from the previous year) attributed to "physical disabilities", 55 cases (an increase of 12 from the previous year) due to "staff negligence, etc.", and 31 cases (an increase of 24 from the previous year) related to "infectious diseases, etc.".
• Of the 55 cases of "staff negligence, etc.," 33 cases were related to "medication errors or missed doses," and all 31 cases of "infectious diseases, etc.," were related to COVID-19.

About Medication Errors and Missed Doses

The number of reports of "medication errors and missed doses" is increasing. The main factors include insufficient confirmation by staff, assumptions, and anxiety due to overlapping tasks. "Medication errors and missed doses" can lead to fatal accidents in the worst cases. Please make efforts to prevent accidents from occurring, and if an accident does happen, be sure to implement recurrence prevention measures in a meeting attended by the facility manager or administrator of the business operators.

Here are some good examples of measures to prevent recurrence, so please refer to them.

• Do not leave the person until the swallowing confirmation is complete.
• Adjustments are made to allow multiple staff members to double-check the confirmation of dates and medication times such as morning and evening.
• Do not rely on verbal confirmation for the type of medication; use the instruction manual or similar resources, and if the issue is not resolved, consult a nurse or the facility director.
• Change the assignment of duties so that it is handled by employees who are relatively less fatigued right after arriving at work, rather than those who are about to leave.
• The checklist should be filled out individually for each user, not all at once.
• Before and after administering medication, confirmation will be conducted by two staff members each, establishing a system that allows for double-checking and cross-checking.
• Staff administering medication will not provide other assistance, and if the need for additional assistance arises, they will request support from other staff.