Top > ご連絡など > ケアマネジャーの介護保険NEWS > 【介護支援専門員 NEWS】介護職の医行為、2012年実施へ
【介護支援専門員 NEWS】介護職の医行為、2012年実施へ
公表された案では、前回までの内容の再掲に加え、対象となる場所にデイサービスとショートステイが加わったほか、たんの吸引、経管栄養とそれぞれ個別に複数の類型の研修を設けることや、たんの吸引などの医行為を介護福祉士が業務として行えるよう、養成カリキュラムにその内容を追加することが明記された。
【介護職員等によるたんの吸引等の実施のための制度について骨子(案)】
■対象とする範囲
【介護職員が実施できる行為の範囲】
●たんの吸引(口腔内と鼻腔内、気管カニューレ内部)
●口腔内については、咽頭の手前まで。
●経管栄養(胃ろう・腸ろう・経鼻)
胃ろう・腸ろうの状態確認や、経鼻経管栄養のチューブ挿入状態の確認は、看護職員が行う。
・たんの吸引のみ、あるいは経管栄養のみといったように、実施可能な行為及び実施のための研修に複数の類型を設ける。
・まずは、たんの吸引及び経管栄養を対象として制度化を行うが、将来的な拡大の可能性も視野に入れた仕組みとする。ただし、その際には、関係者を含めた議論を経て判断することが必要である。
【実施できる職員の範囲】
●介護福祉士
介護の専門職である介護福祉士が、その業務としてたんの吸引等を行うことができるようにし、養成カリキュラムに基本研修及び実地研修を含むたんの吸引等に関する内容を追加する。
この場合、既に介護福祉士の資格を取得している者については、一定の追加的研修を修了することにより、たんの吸引等の行為を行うことができることとする。
●介護福祉士以外の介護職員等
介護福祉士以外の介護職員等(訪問介護員等の介護職員、保育所の保育士、特別支援学校等教職員を含む)については、一定の条件下でたんの吸引等の行為を行うことができることとする。
【実施できる場所の範囲】
●介護関係施設(特別養護老人ホーム、老人保健施設、グループホーム、有料老人ホーム、通所介護、短期入所生活介護等
●障害者支援施設(通所施設及びケアホーム等)
●在宅(訪問介護、重度訪問介護(移動中や外出先を含む)等)
●特別支援学校
・医療機関の取扱いについては、所定の看護職員が配置されているなど介護職員等によるたんの吸引等を積極的に認める必要がないことから、対象外とする。
※なお、この問題については、医療・介護の在り方に関する根本的な論点を含むものであり、別途、検詞する必要があると考えられ、今後の検討課題とすることが適当である。
・介護職員等がたんの吸引等を行う上での安全確保に関する基準を設け、医師、看護職員と介護職員等の連携・協働の確保等、基準の遵守について指導監督の仕組みを設ける。
・医師、看護職員と介護職員等との具体的な連携内容や安全確保措置の具体的内容については、現在行われている「試行事業」の結果等を踏まえてさらに検討する。
【制度の実施時期】
●介護保険制度等の見直しの時期も踏まえ、平成24年度の実施を目指す。
ただし、介護福祉士の位置付けについては、介護福祉士養成課程の体制整備や新カリキュラムでの養成期間等を踏まえた実施時期とする。現在、一定の条件の下にたんの吸引等を実施している者が、新たな制度の下でも実施できるよう、必要な経過措置を設ける。
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