This study aimed to clarify the relationship between nosocomial infection control and medical safety management in Japan. Administrative documents issued up until the end of March 2019 and concerning nosocomial infection control and medical safety management were analyzed with a focus on Medical Care Act regulations and additional medical fees. Today, nosocomial infection control is regarded as a part of medical safety management by medical law. However, when the concept of medical safety was introduced in Japan, the concept was unclear. This is considered to be one of the factors that made it difficult for healthcare professionals to have a common understanding of tackling nosocomial infection control as a part of medical safety management. Therefore, it is important to send clear and easy-to-understand messages to healthcare professionals and the public in promoting awareness of drug resistance, which is required in healthcare settings.

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Patients who have had their spleen removed need to be vaccinated and educated to prevent overwhelming post splenectomy infection. We provide patient education on infection prevention after splenectomy during hospitalization. In this study, we conducted an interview survey of two patients who had undergone patient education and asked about their awareness and behavior regarding prevention of overwhelming post splenectomy infection at least one year after discharge. The patients and their families were aware that the spleen had been removed, and shared information about splenectomy with their family doctor and school using the tools provided. It is suggested that it is necessary to educate patients including the family to prevent overwhelming post splenectomy infection and to consider practical education.

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Owing to the need for interaction between community healthcare and hospital care, interventions utilizing hospital pharmacist outpatient care are recommended; however, there are no reports of seamless inpatient intervention continuing after discharge. We evaluated the utility of seamless intervention in follow-up outpatient care after discharge. Subjects were patients who received pharmacist outpatient services from October 2017 to August 2018. We performed objective and subjective evaluations and compared the medical economic effects between a group that received continued intervention even after discharge (seamless group) and a group that received intervention only from the outpatient care stage (outpatient group). The seamless group comprised 91 patients, and the outpatient group comprised 149 patients; pre-avoid was noted in 143 (41.3%) and 56 cases (19.2%), respectively, which was significantly higher in the seamless group (P < 0.001). The medical economic benefit was calculated as 39,288 yen and 15,088 yen per case, respectively. This seamless intervention from admission to outpatient care led to more pre-avoid and was useful for improving the safety and quality of healthcare and for conferring medical economic benefits.

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