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[null,null,"　  産後ケア施設（　宿泊型　　　アウトリーチ型　　　デイケア型）"]
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[null,null,"　 電話　　  教室・講座　　その他"]
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[null,null,"　  産後多量出血　　　産褥熱　　　感染対策不備　　　新生児ケアに関すること"]
[null,null,"　  指導時の対応や指導内容に関すること　　　接遇へのクレーム"]
[null,null,"　  その他"]
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[null,null,"※３a以上については、都道府県助産師会担当者から日本助産師会に報告する"]
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[null,null,"　　技術の誤り　　　報告不足　　　身体の健康管理（体調不良等）　"]
[null,null,"　　心理的状態（イライラ、慌てていた、思い込み、緊張等）"]
[null,"当事者に影響を及ぼした因子","　　教育訓練の不足　　　マニュアルの不備　　　連絡・報告システムの不備　"]
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[null,null,"　　機器の誤操作　　　施設・設備の管理不適切　　　薬剤管理の不備"]
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["予後",null,"　  良　　不良（障害を残した　死亡）  　　不明"]
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["事例検討",null,"　  済　　  未（予定あり）　　　未（予定なし）"]
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["再発防止策"]
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["≪都道府県助産師会使用欄≫"]
["都道府県助産師会",null,null,null,null,null,null,null,null,"日本助産師会"]
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[null,null,null,null,null,null,null,null,null,"（西暦",null,"年",null,"月",null,"日　 受理）"]
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[null,null,"北海道"]
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[null,null,"福島県"]
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[null,null,"栃木県"]
[null,null,"群馬県"]
[null,null,"埼玉県"]
[null,null,"千葉県"]
[null,null,"東京都"]
[null,null,"神奈川県"]
[null,null,"新潟県"]
[null,null,"富山県"]
[null,null,"石川県"]
[null,null,"福井県"]
[null,null,"山梨県"]
[null,null,"長野県"]
[null,null,"岐阜県"]
[null,null,"静岡県"]
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[null,null,"三重県"]
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[null,null,"愛媛県"]
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[null,null,null,null,null,null,"ｲﾝｼﾃﾞﾝﾄ･ｱｸｼﾃﾞﾝﾄ報告用紙",null,null,null,null," 2021.7\n日本助産師会安全対策委員会"]
["タイトル",null,"生後1か月児の転落"]
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["報告者",null," 都道府県：",null,"東京都"]
[null,null," 氏名：※無記名可",null,null,"安全　ケア子",null,null,null,"　","当事者　・　　発見者　"]
[null,null," 年齢：　",null,45,"歳"]
[null,null," 開業届：　　有　　　",null,null,2012,"年届出　・　無",null,null,null,null,0]
[null,null," 保険加入：　　有　・　無"]
[null,null," 助産師経験年数：",null,null,null,27,"年"]
[null,null," 勤務形態：　　 開業 ・　 勤務　・　その他"]
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[null,null,"　 電話　　  教室・講座　　その他"]
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[null,null,"　  産後多量出血　　　産褥熱　　　感染対策不備　　　新生児ケアに関すること"]
[null,null,"　  指導時の対応や指導内容に関すること　　　接遇へのクレーム"]
[null,null,"　  その他"]
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[null,null,"※３a以上については、都道府県助産師会担当者から日本助産師会に報告する"]
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[null,null,"　　技術の誤り　　　報告不足　　　身体の健康管理（体調不良等）　"]
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[null,"当事者に影響を及ぼした因子","　　教育訓練の不足　　　マニュアルの不備　　　連絡・報告システムの不備　"]
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[null,null,"　　勤務状況（多忙、人員不足、夜勤等）　　　交通手段（遅延・事故等）"]
[null,"医療用具（機器）・薬剤・設備","　　環境の不備（照明、段差、滑りやすい等）　　　衛生材料・器具の不備"]
[null,null,"　　機器の誤操作　　　施設・設備の管理不適切　　　薬剤管理の不備"]
[null,"説明・対応に\n関すること","　　説明が不足　　　説明の誤り　　　対象者や家族の理解が不十分"]
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["具体的な内容\n時系列で記入\n状況　判断　対応",null,"　自宅訪問にて乳房ケア中、生後32日目の男児が、高さ約30ｃｍのソファーの座面より転落した。すぐに啼泣し、外傷は見られなかった。助産師が母親をケアしている間、在宅であった父親が児の面倒を見ていたが、ソファーに児を寝かせてトイレに行ってしまった。そのことに助産師も母親も気づかず、「ゴン」という音と、児の鳴き声で落下したのを発見した。\n　すぐに啼泣し、外傷がないこと、その後授乳の様子を確認し、児の状態に変わった様子がないことから、両親に注意すべき症状を伝え、経過観察とした。"]
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["予後",null,"　  良　　不良（障害を残した　死亡）  　　不明"]
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["事例検討",null,"　  済　　  未（予定あり）　　　未（予定なし）"]
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["再発防止策",null,"両親への注意喚起。養育環境において注意すべきことについての情報提供。"]
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["≪都道府県助産師会使用欄≫"]
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[null,"（西暦",2021,"年",4,"月",1,"日　受理）"]
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[null,null,null,null,null,null,null,null,null,"（西暦",null,"年",null,"月",null,"日　 受理）"]
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[null,null,"　\n両親は経過観察で良いことについて、納得していたか?\n　　⇒父親は自分の不注意をひどく反省していた。心配な様子ではあったが、すぐに泣いて、哺乳にも問題が無い様子を一緒に見て頂き、受診が必要な注意すべき症状についてお伝えした所、理解され納得した。"]
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[null,null,"北海道"]
[null,null,"青森県"]
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[null,null,"愛知県"]
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[null,null,"香川県"]
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