Practical Report on the Development of Medical Care System in Special Needs Schools: From the Perspective of Eliminating the Accompaniment to Their Children on Ventilators

令和３年９月に「医療的ケア児及びその家族に対する支援に関する法律」が施行され、改めて各学校に在籍する医療的ケア児に対する適切な支援環境・医療的ケア実施体制の整備が求められている。そこで、著者が担当した人工呼吸器の管理を要する児童が在籍する学級の事例を基に、保護者付添い解消という課題解決に至るまでの教員・看護師・保護者間での連携から、特別支援学校における医療的ケア実施体制の在り方について明らかにすることを目的とした。教員・看護師・保護者間での具体的な連携手段や取組を整理し、保護者付添いの段階的な移行の過程についてまとめた。その結果、特別支援学校における医療的ケア実施体制の整備に向けて、医療的ケア児の学校生活を支える視点に基づき、教育・看護それぞれの視点から教員・看護師間で実態を共有し、適切な支援を検討・実施する必要があると考えられる。With the enforcement of the Act on Support for Children with Medical Care and Their Families in September 2021, establishment of an appropriate support environment and medical care implementation system for children with medical care in each school is even more required. Therefore, based on the author’s case study of a class with a child requiring ventilator management, the purpose of this research is to clarify the ideal system for implementing medical care in special needs schools, based on the cooperation between teachers, nurses, and parents to solve the problem of parental accompaniment to their children. This report summarizes the process of the gradual transition of parental accompaniment by organizing the specific cooperation and efforts among teachers, nurses, and parents. As a result, to improve the system of medical care implementation in special needs schools, based on the perspective of supporting the school life of children with medical care, it is necessary to share the actual situation from the perspectives of education and nursing, and consider and implement appropriate support. For that, it is important to strengthen the cooperation between teachers and nurses