Difficulties and Necessity of Introducing ICT-based Death Certification in the Tokyo Metropolitan Area

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K19226
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58080:Gerontological nursing and community health nursing-related
• Research Institution: Tokyo Health Care University
• Principal Investigator: SHIRASE SANAE 東京医療保健大学, 医療保健学部, 助教 (70827435)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Keywords: ICTを利用した死亡診断 / 在宅看取り / 死後診察 / 訪問看護ステーション / 看護管理者 / 訪問看護師

Outline of Final Research Achievements

This research conducted a questionnaire survey on the interest in the introduction of the system of the ICT-based Death Certification answered by nursing managers of home-visit nursing stations in the Tokyo metropolitan area, in order to clarify their needs, expectations, and possible difficulties. The survey revealed that few nursing managers were interested in the system but understood the details of the system and considered its immediate introduction necessary. They predicted difficulties because of uncertain needs for the use of the system. On the other hand, it became clear that they expected the system would not keep family members waiting. This research suggested that it would be necessary to take measures in a super-aging society where an increasing number of aged people die, through providing opportunities to make all those who are concerned aware of the system and allowing them to choose how they would like to spend their last days.

Free Research Field

看護管理学

Academic Significance and Societal Importance of the Research Achievements

在宅での穏やかな看取りが困難な状況に対応するために、2017年に情報通信機器（ICT）を利用した死亡診断等ガイドラインが公表されたが導入が進んでいない背景がある。しかし、2022年度診療報酬改定で訪問看護ターミナル療養費に遠隔死亡診断補助加算が新設され、導入を推進していく動きがある。本研究では、ICTを利用した死亡診断に関する困難や必要性を明らかにし、多死時代を見据えた対応として、それぞれが穏やかな最期を迎えらえるよう選択できる必要性があると示唆を得られたことに意義がある。また、ガイドライン改訂時や訪問看護ステーションのマニュアル作成時の基礎資料を得ることができ、制度を推進していく一助となる。