2006 OPEN FORUM Abstracts
Multidimensional Community Systems for ALS with Home Mechanical Ventilation
Konishi, K.,
PhD, RN, Showa University, Japan, Kawamura, S., PhD RN, Aomori University of
Health and Welfare, Japan, Ogura, A., PhD RN, Ishii, M. MA, RN, Itagaki, Y.
MA, RN, Tokyo Metropolitan Institute for Neuroscience, Japan
Background: Medical
treatment including suctioning must be given by MDs and RNs in Japan.
However, family members of ALS with Home Mechanical Ventilation (HMV) have to
take medical care under their charge at their home. To lighten the
burden imposed on the family, home
help services (non-medical staff) have been accepted to do suctioning with
qualifications since 2005 in Japan.
Objectives: To identify
actual state of home care services and multidimensional community systems for
ALS with HMV in Japan.
Methods: All of ALS
patients in Japan through a registration system were given an informed
consent letter and interviewed by public health nurses belonging to public
health centers. Five thousand seven hundred seventy one subjects (88.6%) were
participated this study.
Results: The results
are presented in the table.
| ALS | n=5,771 | ||||||||
| ALS | with HMV n=1,530 (26.8%) | ||||||||
| Home care | Acute Hospital | Long-term Hospital | Others | ||||||
| 665 | (43.5%) | 109 | (7.1%) | 333 | (21.8%) | 423 | (27.6%) | ||
Among 774 (665 home
care + 109 acute hospital) examinees, 740(95.6%) were TIPPV, mean years from
diagnosis to TIPPV were 3.0(±3.65),
745(97.3%) were regularly provided home visiting nursing service.
Mostly(91.5%) using by day on weekday, mean hours of nursing service were
5.2(±3.86) hours par week.
Regarding to home help service (non-medical staff), 664(85.8%) were regularly
provided the service, 63.3% were using by day on weekday, however, night
service is finding increasing use, mean hours of home helping service were
11.8(±13.84) hours per week,
240(30.8%) were regularly doing suctioning not under medical management.
Conclusions: Home help
service was given to provide for long hours and by night under medical
insurance system and care insurance system in Japan. The roles of each staff
in home care team have to be clarified for patients' safety, and educational
systems need to be developed.