JP2004302946A - Hospital information system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a hospital information system enabling even one nurse to respond to a situation such as a temporal vital measurement or breakage of an injection bottle while taking notes. <P>SOLUTION: When a temporary input work by a sudden change in state of a patient or an instruction from a doctor or chief nurse (an unscheduled vital measurement and input work of its measurement data) is present (Y in S101) when the nurse logs in a PDA (S100), a temporary button is pressed (S102) to automatically read the identification code of the patient that is the subject of the temporary measurement (S103), a measurement item is selected (S104), the measurement is carried out (S105) after uniting it with an order (S104), and the measurement data are registered in a server. When a bottle breakage occurs during execution of an intravenous drip of general medical treatment (S108), a breakage input button is pressed, when it is before coinjection (Y in S109), to selectively input the broken agent singly (S110), and the broken agent is registered in the server and automatically ordered to a pharmaceutical department. When the occurrence of the breakage is after coinjection (N in S109), all the medical agents are registered as breakage and replaced by new ones. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a hospital information system that can input and output data at a place where a medical practice is performed using a portable terminal, and that supports the medical practice smoothly and easily.
[0002]
[Prior art]
Conventionally, no system has been proposed for accurately recording medical practice records, regardless of the location of the medical practice.
For example, when a place to perform a medical practice such as an endoscopy is decided, and a patient goes to the place to receive a medical practice, a system for recording medical practice is installed at the place. Records of medical activities performed there.
[0003]
However, in cases where the practitioner performing the medical treatment (nurse or doctor) goes to the inpatient's room and goes around each room one after another to perform appropriate medical treatment for each patient, A medical practice is recorded using a paper medium, and a system for recording the medical practice as a database has not been proposed.
[0004]
For this reason, conventionally, in order to collect data on medical treatments that have occurred, it has been necessary to collect the contents recorded on paper. In addition, in order to confirm the status of medical activities, such as the content of medical activities, the degree of progress, and the results, there are other methods besides grasping by looking at the contents of paper records or by transmitting information through human systems. In addition, it took a great deal of effort to grasp the situation of such medical practice.
[0005]
Also, in the past, even if there was some kind of system that records medical actions, after returning to a predetermined place, such as an office or a center waiting room, after performing any medical action, There has only been a method of inputting the contents of the operation after the fact, and no system has been proposed that can record the contents of the medical treatment immediately on the spot.
[0006]
Therefore, it takes a certain amount of time from the execution of the medical practice to the subsequent input of the record, and it has been difficult to grasp the contents, progress, results, and the like of the medical practice in real time.
Also, in such a recording system for performing post-input, there is still a problem that a difference may occur between the executed content and the recorded content, and it is difficult to leave an accurate record. Was.
[0007]
Conventionally, with respect to such a problem, a medical action performed on a patient is input to a movable input terminal (portable terminal), and various data are input by a host computer based on the data indicating the input medical action. Techniques for managing medical services have been proposed. (For example, refer to Patent Document 1.)
In this proposed technique, a recording instruction based on various medical treatments performed by a doctor is performed in real time by a nurse accompanying the doctor, thereby preventing a recording error as in the case of a conventional post-recording. In addition to leaving accurate records, it is also possible to reduce the burden on nurses by enabling direct input and recording of instructions from a doctor on the spot.
[0008]
[Patent Document 1]
JP-A-8-106500 (abstract, FIG. 1)
[0009]
[Problems to be solved by the invention]
However, although the technique of the above-mentioned Patent Document 1 is intended to leave accurate records and reduce the burden on nurses, medical practice is not necessarily performed only by a doctor accompanied by a nurse. In many cases, such as injection (including intravenous drip) or administration of medicines, a nurse performs medical actions alone based on a medical order specified by a doctor in advance. Is not taken into consideration in the above-mentioned Patent Document 1.
[0010]
In addition, especially in the medical field of inpatients, when the patient's condition changes more than expected, such as measurement of body temperature, pulse, respiration, blood pressure, etc. performed as a premise of medical actions to be performed, it occurs temporarily. Nurses alone often need to deal with unforeseen situations, such as measurement and breakage of injection bottles during injection. No proposal has been made for a recording system using a portable terminal in such a case.
[0011]
SUMMARY OF THE INVENTION An object of the present invention is to provide a hospital information system capable of coping with an unexpected situation such as temporary measurement or breakage of an injection bottle while taking a record by a nurse alone, in view of the above-mentioned conventional circumstances. .
[0012]
[Means for Solving the Problems]
The hospital information system of the present invention includes a terminal for inputting and outputting data related to at least medical treatment, a server system for transmitting and receiving the data to and from the terminal, and information in a hospital transmitted and received by the server system. A hospital information management system for centrally managing records and centralized management, wherein the terminal is a medical service which is normally scheduled and transmitted from the server based on a medical order and instructed. And a function of inputting and outputting data for medical services that occur unexpectedly without being transmitted and instructed by the server.
[0013]
The unscheduled medical work is, for example, an extraordinary measurement and input / output of the measurement data as described in claim 2. In this case, the measurement is performed, for example, at least as described in claim 3. , Pulse, respiration, or blood pressure measurements.
The unscheduled medical work is, for example, acquisition of a medicine name of a damaged injection bottle and input / output of the acquired medicine name data, as described in claim 4. The acquisition is performed, for example, by reading and inputting the identification code attached to the injection bottle by the identification code reading device of the terminal, or manually inputting by the user of the terminal.
[0014]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
<One embodiment>
FIG. 1 is a block diagram illustrating an overall configuration of a hospital information system according to an embodiment. As shown in the figure, a hospital information system 1 of the present example is arranged in a hospital, for example, as a medical facility, and records and collectively manages information in the hospital. A plurality of subsystems, such as a first subsystem 4A and a second subsystem 4B, which are connected to the internal information management system 2 by, for example, a wired LAN (Local Area Network) 3, and are capable of transmitting and receiving information via the LAN 3. It is composed of
[0015]
The first subsystem 4A includes a server 5 that performs control and information processing, and a terminal that is a personal computer (hereinafter, abbreviated as a personal computer or a PC) that inputs and outputs data, that is, a PC terminal 6, which is connected to the wired LAN 3. It is connected. The PC terminal 6 is a stationary terminal, and a medical staff such as a nurse or a user performs data input, data reference, and confirmation at a place where the PC terminal is located.
[0016]
In addition, a second subsystem (hereinafter abbreviated as a PDA system because a PDA is used) 4B includes a server 7 that performs control and information processing, and a portable device that can be used by, for example, a nurse as a medical staff. The terminal 7 includes, for example, a PDA (Personal Digital Assistants) 8 as a terminal and an access point 10 which is a data transfer unit that enables access from the PDA 8 via a wireless LAN 9. The server 7 and each access point 10 are connected to a wired LAN 3. Connected.
[0017]
The PDA 8 includes a wireless LAN card 11, which is a data transfer unit that enables wireless communication with the server 7 via the wireless LAN 9, and a reading unit (device) for reading identification information, for example, reading a character or figure expressing an identification code. And an identification code reader 12 that enables the above.
[0018]
FIG. 2 is a diagram showing a hardware configuration of the PDA 8. In FIG. 1, a wireless LAN card 11, an identification code reader 12, a CPU 13, a ROM 14, a RAM 15, a storage unit 16, an operation input unit 17, and a display unit 18 are interconnected via a bus 19, and are managed by the CPU 13. Data can be exchanged below.
[0019]
The wireless LAN card 11 and the identification code reader 12 are as described above. Of these, as the identification code reader 12, for example, an OCR (Optical Character Reader) capable of optically reading characters can be used, but an image scanner that reads characters and graphics as an image or an identification code by wireless communication. May be used.
[0020]
A CPU (Central Processing Unit) 13 is a central processing unit that controls the operation of the entire PDA 8.
A ROM (Read Only Memory) 14 is a memory in which a basic control program executed by the CPU 13 is stored in advance. When the PDA 8 is activated, the CPU 13 executes the basic control program to execute the basic operation of the PDA 8 as a whole. Control is performed by the CPU 13.
[0021]
A RAM (Random Access Memory) 15 is used as a work memory when the CPU 13 executes various application programs stored in the storage unit 16 and is used as a temporary storage area for various data as needed. This memory is also used as a main memory.
[0022]
The storage unit 16 is a memory that stores and holds various application programs and data. As the storage unit 16, a semiconductor memory such as an EEPROM (Electrically Erasable and Programmable Read Only Memory) is suitable. In particular, the EEPROM is suitable in that the stored contents can be electrically rewritten and power is not required for retaining the stored contents.
[0023]
The operation input unit 17 is, for example, a touch panel provided on the display unit 18. The operation input unit 17 is operated by the user of the PDA 8, detects the content of the operation, and transmits the content of the operation to the CPU 13. The CPU 13 recognizes the content of the instruction from the user corresponding to the operation content.
[0024]
The display unit 18 is, for example, a liquid crystal display, and displays various kinds of information sent from the CPU 13 to visually provide various kinds of information to the user.
The above-described identification code reader 12, and the operation input unit 17 and the display unit 18 can input and output various data by executing a predetermined application program of the CPU 13.
[0025]
As described above, since the PDA 8 includes the wireless LAN 9, there is a restriction on the communicable access range depending on the distance from the access point 10, but within the access range, the PDA 8 can access the hospital 7 via the server 7 at an arbitrary location. The information management system 2 is accessed to acquire work schedule data described later, and the acquired work schedule data can be displayed on the display unit of the PDA 8.
[0026]
Also, by enabling the PDA 8 having the identification code reader 12 to read an identification code widely used as identification information, a nurse or the like carrying this PDA 8 can check the practitioner ID and medical practice. Input (or reading) of identification information such as a patient ID and an injection ID can be performed accurately, easily, and quickly.
[0027]
Further, the PDA 8 has a waterproof structure having resistance to a chemical solution, and has a structure that is easy to use in a medical field.
More specifically, the first subsystem 4A and the PDA system 4B described above are used for an outpatient system or a ward system for registering an order such as an injection, and a drug for dispensing a drug in accordance with the registration of an order for an injection or the like. It is provided as a department system, a medical affairs system for performing accounting processing for medical practices, a nurse (station) system for performing co-infusion of drugs by nurses, and the like.
[0028]
Here, especially in a nurse system and a ward system in which a nurse performs a medical practice, each nurse carries a PDA 8 to go to a place where the medical practice is performed, specifically, to the bedside of a hospitalized patient. It is possible to input and output the medical practice information at that place. As a result, the status of medical practice can be recorded and grasped in real time. That is, it is possible to accurately record and grasp the medical practice without causing a delay from the time when the medical practice was performed at the place where the medical practice was performed.
[0029]
In addition, when performing a medical practice at a place where a medical practice is performed, the contents of the work schedule of the medical practice can be confirmed by the PDA 8, and after confirming the contents of the work schedule, the medical practice of the work schedule can be performed. Therefore, the (scheduled) medical action to be performed can be performed accurately and with few errors.
[0030]
In addition, by using the PDA 8, a record of the contents of the medical practice can be input at the place where the medical practice is performed. The recording is performed immediately after the execution. Therefore, the recording can be performed accurately and with less errors.
[0031]
In addition, when performing a medical practice, the use of the portable PDA 8 makes it easy to refer to or confirm the work schedule of the medical practice at almost any place and time, so that the medical practice can be performed smoothly. Easy to proceed. Further, even in the case where the contents of the work schedule are changed, the contents of the work schedule can be confirmed at the place where the work is scheduled immediately before the implementation, so that it is easy to cope with the change of the contents of the work schedule.
[0032]
Further, when the medical practice is performed as described above, the details of the performed medical procedure can be recorded accurately and in real time, so that the system can be more appropriately improved by analyzing the recorded data thereafter.
In FIG. 1, a subsystem in which the components of the first subsystem 4A and the PDA system 4B are mixed may be used. Specifically, for example, the PDA system 4B may further include a stationary PC terminal 6.
[0033]
Next, in the present embodiment, which will be described below, a nursing support function for a medical practice, that is, a nursing operation by a nurse in the hospital information system 1 will be described. The nursing support function is a function for supporting the execution of “injection (including infusion)”, “nursing”, “treatment”, “test sample”, and the like, which are medical activities related to nursing.
[0034]
The above “injection” is a medical practice in which a nurse injects a patient, and “nursing” is a medical practice in which a nurse measures the patient's body temperature, wipes the patient's body, and provides bathing guidance. The "treatment" is a medical practice of a nursing treatment performed by a nurse, such as removing a catheter, and the "test sample" is a medical practice of performing a blood test, a bodily fluid test, and the like by the nurse.
[0035]
Note that there are two types of “injection”, which are called “one-shot injections”, which take almost no time from the start to the end, as described later, and those that take a certain amount of time from the start to the end, such as infusion (injection). .
FIG. 3 is a chart showing the details of the above-mentioned medical treatment of the injection to the test sample and the contents of the scheduled work from the order registration to the execution of the medical treatment. In the above-mentioned medical practice, order instructions of “injection”, “nursing”, “treatment”, and “specimen test” are issued from a doctor, and an order for order registration to the in-hospital information management system 2 is issued by the PC terminal 6. Then, the in-hospital information management system 2 automatically receives the scheduled work data of each step from the order registration to the instruction reception,..., Cancellation as shown in the table of FIG. Generated and automatically generated data are registered in the database of the in-hospital information management system 2.
[0036]
That is, the in-hospital information management system 2 has a function of generating work schedule data, and has a function of registering the generated work schedule data in a database in the in-hospital information management system 2.
Then, the nurse downloads the work schedule data and obtains the work schedule data by accessing the above-mentioned database via the server 7 using the PDA 8 carried by the nurse, and the storage unit in the PDA 8 16 can be stored (recorded).
[0037]
By operating the operation input unit 17 of the PDA 8, for example, a touch panel, the work schedule data recorded in the storage unit 16 can be displayed in a list on a liquid crystal monitor or the like as the display unit 18. It becomes possible to refer to the schedule data and grasp the progress status.
[0038]
The PC terminal 6 can also refer to the contents of the work schedule data and grasp the progress. Usually, order registration is performed by the PC terminal 6 such as an outpatient system.
As shown in the table of FIG. 3, each medical procedure from “injection” to “test specimen” is executed according to steps such as order registration, instruction reception,. For example, as described later, in the medical practice of injection, the order of the injection is registered according to the instruction from the doctor, and thereafter, the instruction for the order registration is received, the medicine is dispensed in preparation for the injection, co-injection, the start of the injection, the end of the injection, In some cases, the injection may be canceled due to breakage of the injection bottle, or the injection may be stopped due to a change in the patient's condition, or the like.
[0039]
In the case of nursing, as shown by the same arrow on the left, nursing order registration and instruction reception are generated in the same manner as in the case of injection shown in the left column.
FIG. 4 is a flowchart showing the contents of the operation procedure at the time of order registration, reference, and execution common to the entire system. 4A shows the operation at the time of order, FIG. 4B shows the operation at the time of reference, and FIG. 4C shows the operation at the time of execution.
[0040]
In FIG. 4A, an order relating to each medical practice is instructed and input by the PC terminal 6 of the outpatient system or, in some cases, the ward system (step S1). The order data is registered in the hospital information management system 2 (step S2). When the order data is registered in the in-hospital information management system 2 in this way, work schedule data of the steps shown in the column direction of the table of FIG. 3 is generated (step S3).
[0041]
The work schedule data is acquired by the first subsystem 4A or the PDA system 4B (Step S6 in FIG. 4B). Then, the instruction content and the schedule content of the order are referred to (step S7). Thereby, a medical practice (medical service) can be performed based on the instructions and schedule of the order.
[0042]
When the implementation of this medical practice is started (step S11 in FIG. 4C), the nurse acquires work schedule data using the PDA 8 carried (step S12). Then, based on the acquired work schedule data, the user goes to a bedside or the like where the medical practice is to be performed, and performs the medical practice on the patient at the performance place (step S13). Then, at the time when the medical practice is performed, the nurse performs an input operation (operation) of the contents of the operation using the PDA 8 carried (step S14), and immediately registers this execution data in the hospital information management system 2. (Step S15).
[0043]
If there is a change in the work schedule data such as the order contents, the change registration is performed, and the changed work schedule data is immediately registered in the in-hospital information management system 2.
The order data, the schedule data to be developed from the order data, and the execution data are configured by, for example, an XML (extensible Markup Language) file defined by a tag having a hierarchical structure. XML is an extension of the function of HTML (Hyper Text Markup Language), and its technology is a well-known technology and will not be specifically described.
[0044]
The order data, the work schedule data, and the execution data can be referred to by the PC terminal 6 or the like of the first subsystem 4A as needed. Can be grasped.
In addition, the portable PDA 8 allows the user to freely grasp the contents of the order, the schedule, the progress status, the execution contents, and the like at any time and any place. In addition, when a medical action scheduled to be performed is performed on a bedside patient who is to be implemented, the contents of the medical action scheduled to be performed are input to the PDA 8 carried by the patient, and the hospital is provided via the PDA system 4B. It can be registered in the local information management system 2 in real time, and can accumulate and update accurate information on medical practice.
[0045]
In this case, not only the time but also information indicating 5W1H (who, where, what, how, and when) is recorded as described later, and the information is analyzed in detail to improve the situation. (E.g., there is little omission of information necessary for analysis later, and detailed analysis is possible).
[0046]
Next, a description will be given of a data input / output mechanism for enabling the first subsystem 4A or the PDA system 4B to ascertain the progress status and the contents of the medical procedure.
FIG. 5 is a diagram showing work schedule data generated according to the order of injection. In the case of injection, when the order is registered, the following work schedule data is generated.
(1) Instruction receiving work in the ward (in FIG. 5, simply indicated as "receiving instruction")
(2) Dispensing operation of the medicine in the medicine section (in FIG. 5, simply indicated as “dispensing”)
(3) Drug co-injection work (mixing work) in the ward (in FIG. 5, simply indicated as "co-infusion")
(4) Work to start injection to the patient in the ward (in FIG. 5, simply indicated as "start injection")
(5) Work to end injection to the patient in the ward (in FIG. 5, simply indicated as "end of injection")
Completion of all these work schedules means that the execution for this injection order is completed.
[0047]
The above respective work schedules are implemented in the first subsystem 4A or the PDA system 4B. Specifically, it proceeds as follows.
"Instruction received" → Nurse implements in ward system.
"Payout"-> Performed by the pharmacist in the drug section system.
"Mixed injection" → performed by nurses in the ward system.
"Injection start" and "injection end" → performed by the nurse in the PDA system 4B.
[0048]
Here, the injection means both a drip injection and a one-shot injection. In the case of drip injection, administration is performed over time, so that the operation of starting and ending administration is usually performed separately. On the other hand, in the case of a one-shot injection, the administration is completed in one action, so that the administration is started and completed almost simultaneously.
[0049]
FIG. 6 is a flowchart showing the contents of the operation procedure of the PDA system when an injection is performed based on the fact that an injection order has been registered. This operation procedure is processed by communication between the server 7 of the PDA system 4B shown in FIG. 1 and the PDA 8 shown in FIGS.
[0050]
In this PDA system 4B, a portable PDA 8 is used, and when a nurse carries this PDA 8 to the bedside and goes out, it is possible to confirm a work schedule on the bedside of a ward or to input a work record. Since it is possible, it is used for inputting the execution data of the injection start and the injection end.
[0051]
Normally, a nurse first obtains a work schedule for a patient in charge of a work zone in which the nurse is in charge, and grasps the schedule and the like for the day. Then, at each scheduled time, the patient goes to the patient's bedside to perform each medical action, and inputs the execution data from the PDA 8. Hereinafter, the operation will be described in detail with reference to FIG.
[0052]
Note that in this operation procedure, a login screen G1, a work schedule list registration screen G2, a patient designation registration screen G3, a work belt ward designation screen G4, a work belt selection screen G5, a work schedule display screen G6 shown in FIGS. The today's business display screen G7 and the executed content display screen G8 are displayed on the display unit 18 of the PDA 8.
[0053]
In FIG. 6, first, the nurse first performs a login process (step S21). When the power of the PDA 8 is turned on in this process, a login screen G1 shown in FIG. 7 is displayed on the display unit 18 of the PDA 8.
On the login screen G1, the nurse inputs an implementer ID and a password for performing the injection. Here, in the login screen G1, when the staff performing the medical practice reads the identification code as the identification information attached to his / her nameplate or the like using the identification code reader 12 provided in the PDA 8, the identification code of the practitioner ID is displayed. The ID data read from the identification code is input in the column. In this way, the identification code reader 12 provided on the PDA 8 allows a simple operation and accurate input of the practitioner ID.
[0054]
The password can be input by touching the touch panel of the PDA 8 on which the screen of the keyboard 20 such as an alphanumeric symbol is displayed with a finger or a pen.
When the input of the practitioner ID and the password is completed and the login button 21 is pressed in this way, the practitioner ID and the password are sent to the in-hospital information management system 2 via the server 7 and the inquiry is sent. If the user ID and the password are correct, the login is completed. When an incorrect password or the like is input, the user can touch the retreat / all delete button 30 to delete the input and input again.
[0055]
When the login is completed, the process proceeds to a process of acquiring a work schedule list (registering in the PDA 8) in FIG. 6 (step S22). When the process proceeds to the process of acquiring the work schedule list, the display of the PDA 8 is switched to a work schedule list registration screen G2 shown in FIG.
[0056]
On the registration screen G2 of the work schedule list, it is displayed whether the patient is specified or registered or the ward is specified (registration is performed on the display screen G2 of the PDA 8 for the sake of simplicity, etc.). List and abbreviation).
That is, the nurse specifies whether to obtain a work schedule list on the PDA 8 by specifying a patient, or obtains a work schedule list of all patients in the ward by specifying a region where the patient is located, for example, a ward. select. In this way, a nurse who performs a medical practice can select or narrow down a work schedule list suitable for himself, thereby providing a user-friendly selection screen. Further, in FIG. 8, the work can be interrupted by pressing (touching) the logout button 23.
[0057]
In FIG. 8, for example, when “register by specifying a patient” is selected, the display screen of the PDA 8 switches to the patient specification registration screen G3 of FIG.
In this patient designation registration screen G3, (1) work zone and (2) patient ID input columns are displayed, and the nurse designates a work zone scheduled to work (in this specific example, a day shift 8:30 to 16: 59), and by reading the identification code of the patient ID, data corresponding to the work schedule list registered in the in-hospital information management system 2 is obtained. Then, on the screen G3, all the acquired target patients are displayed in a list.
[0058]
The patient designation registration screen G3 in FIG. 9 is a work belt (08:30 to 16:59) for three patients (three patients whose patient IDs are 11111111, 22222222, and 3333333). 5 shows a state in which the work schedule list has been acquired. By pressing the confirmation button 24 in this state, the schedule of the medical treatment for the three patients is registered in the PDA 8 properly. Further, the registration of these lists can be canceled by touching the cancel button 22.
[0059]
On the other hand, when the ward is specified and registration is selected on the work schedule list registration screen G2 in FIG. 8, the work zone ward specification screen G4 in FIG. 10 is opened.
On this work zone ward designation screen G4, (1) work zone and (2) ward input fields are displayed, and the nurse specifies the work zone and ward name (for example, 5F north ward) to be acquired, and presses the confirm button 24. By pressing, the schedules of all the patients in the designated ward are acquired in the PDA 8.
[0060]
In the present embodiment, the input column of the work zone in (1) of each of FIGS. 9 and 10 is a work zone button 25. By pressing the work zone button 25, a window for selecting and specifying the work zone is displayed. Open, and a work belt selection screen G5 for selecting and specifying a work belt as shown in FIG. 11 is displayed.
[0061]
In the present embodiment, the working hours are described as 00:00 to 8:29 for the late night hours, 8:30 to 16:59 for the day shift hours, and 17:00 to 23:59 for the midnight hours. However, this time zone can be changed by setting.
In this case, according to the login time, the work zone including the time is displayed in the center in a default (initial) selection state, the other two work zones are displayed before and after that, and the desired work zone is selected. Making it easier.
[0062]
Here, by selecting a work zone and pressing the confirm button 26, it becomes possible to obtain a work schedule list for each of the selected work zones.
In this case, the work schedule data acquired in this case is obtained by adding approximately one and a half hours before and after the work zone time zone to obtain a large work schedule. This takes into account the shift in schedules near the divisions of shifts and the handover of work between staff in each shift.
[0063]
Further, with regard to the work schedule of “end of injection”, the work schedule data is obtained by going back in time up to 24 hours before. This will be described later. In the case of a drip injection in which both the start and end of the injection are performed, there is a state in which the drip injection is being administered. This is because it is necessary when performing the work of terminating the injection in the band.
[0064]
In FIG. 6, when the process of acquiring the work schedule list in step S22 ends, the process proceeds to the process of displaying the work schedule list (step S23). When the process proceeds to the display of the work schedule list, the work schedule display screen G6 shown in FIG.
[0065]
The work schedule display screen G6 in FIG. 12 is a screen for selecting how to display the work schedule list when displaying the work schedule list, and includes a “work list for today” and a “work list for each patient”. , Three selection items 27a, 27b, and 27c of "work list for each item" are displayed.
[0066]
When the selection item 27a of “Today's work list” is selected, all work schedules registered in the PDA 8 are displayed.
When the selection item 27b of “work list for each patient” is selected, only the work schedule list of the designated patient among the work schedules registered in the PDA 8 is displayed.
[0067]
Further, when the selection item 27c of “work list for each item” is selected, only the work schedule list of the type of the specified medical item among the work schedules registered in the PDA 8 is displayed.
As described above, the work schedule data is once registered in the storage unit 16 of the PDA 8 and the form of the list display (list display) of the work schedule data is changed. This has the effect of reducing the frequency of communication and reducing traffic related to communication, and has the effect of reducing processing time.
[0068]
Further, the nurse can selectively display desired work schedule data with power saving by using the work schedule data acquired in the PDA 8. That is, a power saving state in which the database of the in-hospital information management system 2 is not accessed one by one via the server 6, that is, without activating the wireless LAN card 12 and in which the wireless LAN card 12 is in the hibernate state. Then, by performing an operation of designating a work zone, a patient, a work item, and the like from the storage unit 16 in the PDA 8, it is possible to display only work schedule data relating to the designated patient and the like (the CPU in the PDA 8 When it is not necessary to connect to the server 7 in accordance with an operation instruction of the PDA 8, the wireless LAN card 12 is put into a hibernation state to save power).
[0069]
As another modified example, in FIG. 6, after logging in with the PDA 8 in step S21 and accessing the database of the in-hospital information management system 2, the work schedule list in step S23 is not obtained and the work list in step S23 is not obtained. May be displayed.
[0070]
In particular, when it is desired to confirm the information of only the latest certain item, in this way, the desired information can be confirmed in a short time. Further, by expanding the options, the staff using the PDA 8 can display and confirm the work schedule data in a display form more suitable for him / her.
[0071]
As described above, in the present embodiment, the display contents of the work schedule data can be selected. In this case, the display contents can be selected by the work schedule data acquisition unit of the PDA 8 as a portable terminal, and can also be selected by the instruction side of the display unit 18. To accommodate a wide range of users who use the PDA 8.
[0072]
On the work schedule display screen G6 of FIG. 12, when the selection item 27a of the work list of the day is selected, the work display screen G7 of the day shown in FIG. 13 is displayed.
On the work display screen G7 of this day, the “not-yet” button 28 for displaying the work schedule list that has not been (yet) executed and the “done” button 29 for displaying the work schedule list that has been executed are separately pressed. Display.
[0073]
In other words, in the acquired work schedule list, those that have not been executed are displayed by pressing the non-button 28, and those that have been executed are displayed by pressing the done button 29. Among them, what has not been implemented and what has been implemented can be clearly displayed.
[0074]
In addition, at the upper right of the screen, there is a display section called a progress bar 31, and the percentage of how much of the scheduled work has been performed is displayed by a bar gauge. When the bar reaches the far right, you've done all of your work. This gauge displays the calculation result of the ratio between the total number of planned cases and the number of completed cases.
[0075]
Each work schedule is displayed on one line of the list displayed by pressing the non-button 28, and the scheduled time, patient name, and work name are displayed, respectively. By selecting one line of the schedule list, a screen for performing an execution input described later is displayed.
Further, the scheduled list that has been implemented is moved to the list displayed by the done button 29. If one row of the displayed list is selected by pressing this done button 29, the executed content display shown in FIG. As shown in a screen G8, the contents (execution data) that have been executed are displayed in an overlay (on the screen G7 in FIG. 13).
[0076]
The example of the already executed contents in FIG. 14 is an example in which the blood pressure measurement is performed, and the input results of the measured values of the blood pressure (upper) and the blood pressure (lower) are displayed.
In this example, as shown in FIG. 13, an unexecuted work schedule list is displayed. In FIG. 6, one is selected from the work schedule list, and the selected medical practice is performed (step S24). .
[0077]
In this case, the medical practice is performed, and the nurse who has performed the medical practice at the place performs the input of the content of performing the medical practice using the PDA 8 carried. The content of performing this medical practice is input, and when this input operation is completed, the content is also transmitted to the in-hospital information management system 2 via the server 7.
[0078]
Then, the medical practice is registered in the database as the performed medical practice from the work schedule data, and when the registration process is completed, a notification of the completion is returned to the PDA 8.
In this way, the information on the medical practice is accurately stored in the database of the in-hospital information management system 2 in real time. The information registered in the database will be described in detail later, but is not detailed information including only time information but detailed information.
[0079]
In response to the completion notification, the medical action indicated by the input of the non-button 28 on the PDA 8 has been performed, and the contents of the work plan move to the list data displayed by the done button 29.
Thereafter, in FIG. 6, the procedure returns to step S23 again, where one of the remaining work schedules is selected, and the selected medical practice is repeated to perform all unexecuted work scheduled medical practices. become.
[0080]
As described above, in this embodiment, a nurse as a practitioner performing a medical practice carries the PDA 8 to display the work scheduled to be performed on the display unit 18 of the PDA 8 at almost any place and time. Can be confirmed.
In this case, the scheduled work that has not been performed is displayed collectively by inputting the non-button 28, and the scheduled work displayed by the input of the non-button 28 is performed at the execution place, and the details of the execution are input. By performing the operation, the data is registered in the database of the in-hospital information management system 2, and the display form on the PDA 8 is changed from the list displayed by the non-button 28 to the list data to be displayed by the done button 29. , The nurse performs the scheduled work indicated by the non-button 28 in each place where the patient is present, so that the nurse can perform the scheduled work accurately, smoothly and efficiently. it can.
[0081]
The reason why the medical practice can be performed based on the work schedule and the instructions at the time of ordering is that necessary information is set in the work schedule data (XML structured file). Hereinafter, the contents of the work schedule data and the operation at the time of performing the injection will be described.
[0082]
FIG. 15 is a diagram illustrating the structure of work schedule data. The information registered in this database is detailed information, not simply information including only time information. That is, first, information indicating 5W1H (that is, who, where, what, how, and when) necessary for each work is included, and the nurse obtains the work schedule data, so that at the time of ordering, Medical treatment can be performed with reference to the designated instruction contents.
[0083]
In one order, it is possible to register a schedule of a plurality of injections (abbreviated as RP in FIG. 15), and tag data such as <work schedule data><executiondata><instructioncontent><object> may be “multiple occurrences possible”. "(Repeated set) is possible.
The “contents of execution data” column on the right side of FIG. 15 shows the structure of the execution data registered from the PDA 8 through the server 7 by performing the injection.
[0084]
This structure is the same as the work schedule data, and includes information indicating 5W1H performed in each work. Data such as the practitioner that was not set in the work schedule data, the actual execution time, and the dose are set based on the execution content.
An example is shown in the right column of FIG. The shaded portions are the data that has been added or changed based on the implementation details.
[0085]
Change the data of <progress> in the work schedule data from “planned” to “completed”, and add <executor>, <performed time>, and <dosed amount> based on the performed contents to become the performed data. ing. In FIG. 15, the implementer (Hanako Olympus) is abbreviated as ~ Ns for simplicity.
[0086]
Further, as will be described later, the rightmost column of FIG. 15 shows the data structure in the case of discarding, and the shaded portion of the contents of the work schedule data is changed data.
FIG. 16 is a flowchart showing detailed operation contents when an injection is performed (administered) as an example. This operation flow will be described below. Note that, in this operation procedure, the PDA8 is used for the scheduled execution screen G9, the bottle label check screen G10, the warning display screen G11, the wristband check screen G12, the injection execution confirmation screen G13, and the dose input screen G14 shown in FIGS. Is displayed on the display section 18. This operation procedure is also processed by communication between the server 7 of the PDA system 4B shown in FIG. 1 and the PDA 8 shown in FIGS.
[0087]
In FIG. 16, first, a work to be performed (in this case, injection) is selected (step S31). For this purpose, for example, a task list for each item shown in FIG. 12 is selected, and only the work schedule related to injection is displayed based on the selection. FIG. 17 shows an implementation schedule screen G9 in which only the work schedule related to injection is displayed.
[0088]
In the execution schedule screen G9, specifically, taking the schedule of “10:00 on the 5th Olympus Jiro Injection: IV” scheduled for 10:00 on the 5th as an example, the information set in the work schedule data is The data is as shown in the right column of FIG.
If the nurse selects the line "10:00 Olympus Jiro Injection: IV on May 05", a bottle label check process is performed in FIG. 16 (step S32).
[0089]
In this case, a bottle label check screen G10 shown in FIG. 18 is displayed on the PDA 8 of the nurse. On this screen, a message such as "Please input the identification code for the bottle label" is displayed, and all the drugs (drug names and used volumes) mixed and mixed into the injection bottle are displayed.
[0090]
Therefore, the nurse reads the label of the injection bottle on which the identification code is displayed on the PDA 8 carried, and checks whether the read identification code of the label of the injection bottle matches the RP-ID in the work schedule data. I do. If it is determined that the RP-ID matches the RP-ID in the work schedule data, a mixed injection / mixing check is performed in FIG. 16 (step S33).
[0091]
On the other hand, if the read identification code of the label of the injection bottle does not match the RP-ID in the work schedule data, a warning is issued (step S34), and the process returns to step S32.
If the injection bottle is mistaken, etc., the identification code on the label does not match the RP-ID, so an error is detected, and a warning notification can be displayed by displaying a warning message and emitting a warning sound. ing.
[0092]
FIG. 19 shows a warning display screen G11 in this case. In the example of the screen shown in the figure, a warning message such as “The loaded bottle label is not the bottle label of the injection to be performed” is displayed.
In this way, the check of the bottle label is correctly completed, and in the co-injection (mixing) / stop check in step S33,
If the execution input of the mixed injection (mixing) has been completed, the execution data of the mixed injection should have been registered. If the order has been canceled, the execution data of the order cancellation has been registered.
[0093]
Therefore, the co-injection execution data (XML file) is acquired from the in-hospital information management system 2, it is checked whether the tag data of <progress> is "executed", and the data of the order cancellation is displayed. Check whether it has been registered.
If co-injection has not been performed, a warning process of step S34, for example, a warning display indicating that "confirmation of co-infusion has not been performed." Is performed. If the order has been canceled, the warning is displayed. Processing, for example, a warning display “Order has been canceled” is displayed, and the process returns to step S32.
[0094]
Here, the reason for confirming whether or not the confirmation work of the mixed injection (mixing) has been performed and whether or not the order has been canceled is as follows.
The fact that the operation of confirming co-injection (mixing) has not been performed means that the identification code of the label on the bottle and the identification code of each drug to be mixed have not been checked. Therefore, it is necessary to confirm whether or not the mixed injection (mixing) has been checked by the system in order to ensure that the medicine as instructed is mixed and injected into a predetermined bottle.
[0095]
In this system, after the confirmation input of the mixed injection (mixing) is performed, the control is performed so that the correction input of the injection order cannot be performed. This is because it is difficult to cope with the order correction immediately before the administration, even if the order correction can be performed immediately before the administration. Also, if there is a drug change after co-injection (mixing), the drug that has already been co-injected (mixed) is wasted. This can be dealt with by the destruction process.)
[0096]
Therefore, when the identification code of the injection bottle and the code (RP-ID) of the work schedule data can be collated, it can be confirmed that the mixed injection (mixing) has been confirmed and input, and if the order has not been canceled, the work schedule This confirms that the data has not been modified and has not been aborted and is a work to be performed.
[0097]
When the operation to be performed is confirmed by the mixed injection / mixing check, a wristband check process is performed in FIG. 16 (step S35).
FIG. 20 shows a wristband check screen G12 when a wristband check of a patient is performed. When the bottle label check and the co-injection (mixing) / stop check are OK as described above, the display of the PDA 8 transits to the wristband check screen G12. On the wristband check screen G12, for example, a message "Enter the identification code of the patient's wristband." Is displayed.
[0098]
Here, the nurse reads the identification code on the patient wristband using the PDA 8 and checks whether the identification code matches the patient ID in the work schedule data. If they match, the process proceeds to step S36 in FIG. On the other hand, if they do not match, a warning process of step S37 is performed, and the process returns to step S35.
[0099]
As described above, when the target patient is mistaken, the identification code of the wristband does not match the patient ID, so that an error is detected, and a warning display and a warning sound by a warning sound can be performed. .
When the check of the wristband in step S35 is completed, the display of the PDA 8 is switched to the display of the order contents (step S36). Thus, the injection execution confirmation screen G13 shown in FIG. 21 is displayed on the PDA 8.
[0100]
On the injection execution confirmation screen G13, the content of an instruction for an injection is displayed. That is, the patient information, the scheduled date and time, the type / content / route / speed of the injection, the information on the co-administered medicine, and the like are displayed. After confirming the contents of the instruction of this order, injection administration is performed in FIG. 16 (step S38).
[0101]
Then, after the injection is performed, a process of inputting the administered dose is performed (step S39). FIG. 22 shows a dose input screen G14 for inputting the administered dose displayed on the PDA 8 at this time.
The dose input screen G14 is a screen similar to a calculator input, in which a percentage of the administered drug can be input (the default is displayed at 100%, and if there is no change, the confirmation button can be pressed as it is). .
[0102]
By inputting the dose, the registration processing of the execution data is performed in FIG. 16 and registered in the in-hospital information management system 2 from the PDA 8 through the server 7 (step S40).
In addition, since the above injection does not always administer all the injections in the bottle, the dosage can be accurately recorded in this way. This is because only 50% or 75% may be administered due to a change in the patient's condition, instructions at the time of order, or the like. Here, the input is performed in units of%, but the input may be performed in units of ml based on the used capacity.
[0103]
Next, the operation of the bottle label check in step 32 in FIG. 16 will be described in more detail.
FIG. 23 is an operation flowchart of a bottle label check in performing an injection. Note that the operation flowchart shown in the figure shows the operation contents of the bottle check when the contents of the order are changed.
[0104]
Generally, an order such as an injection may be corrected. Specifically, the order correction registration may be performed from the PC terminal 6 or the like of the first subsystem 4A.
If there is a change in the contents of the order, medical practice should be implemented based on the change. In the case where the contents are not corrected, if an attempt is made to execute the correction, it is necessary to check the mistake and display a warning or the like. The bottle label check processing in FIG. 23 corresponds to this.
[0105]
In other words, FIG. 23 is a diagram showing a mechanism for checking even if the contents of the order are corrected. As a specific example, a case will be described in which the type of injection is changed to A ′ (A dash) after ordering injection A.
After the injection A is ordered at the time T1, for example, if the work schedule list is acquired by the PDA 8 at the time T2, if the order is modified at the subsequent time T3, the corrected contents ( A ') has not been registered. However, even in such a state, the hospital information system 1 of the present example has a function capable of preventing an error.
[0106]
When an injection is to be performed in the above state, the following three cases are performed: C1: Injection A before order change reaches the ward, C2: Injection A ′ after order change reaches the ward, C3: There are three possible cases: a completely different injection B reaches the ward. If this hospital information system 1 is used, the check function works in any case. Hereinafter, description will be made sequentially from C1.
[0107]
C1: Injection A before order change arrives in the ward
Usually, at the time of co-injection (at the time of mixing), the identification code on the bottle label and the identification code of each medicine to be co-injected are read and checked by the ward system based on the contents of the work schedule data after the order correction. Therefore, a warning is displayed, and an error is detected (mixing injection confirmation operation).
[0108]
In the PDA system 4B, by checking whether or not the co-injection confirmation work has been performed, it is possible to check whether or not a bottle having correct content has not been delivered.
Further, as shown in FIG. 23, a function for checking the latest work schedule data may be provided so that the order change can be known.
[0109]
In other words, the label check by the PDA 8 is OK, the co-injection check in the next PDA 8 is also OK (if this is NG, a message that "the co-infusion check has not been performed" is displayed), and further, the patient check in the PDA 8 Is OK (if this is NG, a message saying "It is different from the target patient" is displayed), the process of checking the latest work schedule data is performed, and the confirmation result is obtained. Can be NG.
[0110]
Specifically, for example, after processing the patient check on the PDA 8, check the latest work schedule data, and if there is a change, "the order may have been changed. Please check." Is displayed on the PDA 8.
[0111]
For example, referring to the flowchart of FIG. 16, after the wristband check in step S35 is OK, a process for displaying the latest work schedule data on the PDA 8 is performed, and then the order content display in step S36 is performed. It may be.
[0112]
By performing the message display process for checking the latest work schedule data in this way, the practitioner performing the injection obtains and checks the latest work schedule data with the PDA 8 carried, You can know the change of order.
[0113]
C2: Injection A 'after order change arrives in the ward
If the injection A 'after the order correction arrives in the ward, or if the old work schedule data before the correction is registered in the PDA 8, the bottle label check will be inconsistent, and a warning will be displayed by a message.
[0114]
When the order is corrected, the ID (RP-ID) assigned to each injection (RP) is the same up to the middle digit, and the lower digits are incremented. Is determined, it is possible to determine whether or not bottle label inconsistency has occurred due to order correction. Needless to say, a unique number should be given to each injection for the IDs up to the middle digits.
[0115]
As a result of checking the identification code on the bottle label in this way, if the bottle label is inconsistent due to the correction of the order content, the message "The order may have been changed. Please get the business list again. "Is displayed. Here, when the user operates the PDA 8 to reacquire the latest work schedule list, the work schedule data after the change from the injection A to the injection A ′ is registered in the PDA 8. After this, the results of the bottle label check and the wristband check are both OK, so that the injection A 'can be performed.
[0116]
This operation is effective in that the staff who intends to perform the injection can be notified of the new instruction after the order correction, and the injection is not administered without knowing only the old information.
In addition to the warning, furthermore, guidance such as "The order has been corrected, please press the update button" and without issuing NG, "I am getting the latest information because the order has been corrected. Is displayed, the latest work schedule data is acquired and collated, and only when the result of the collation is OK, the procedure may proceed to the patient (wristband) check.
[0117]
C3: When a completely different injection B arrives at the ward
When a completely different injection B arrives at the ward, the identification code on the bottle label and the code (RP-ID) of the work schedule data place are completely different, so that a warning can be clearly given as NG. . Specifically, by giving a warning display indicating that "the bottle is different from the bottle to be used", incorrect administration can be prevented.
[0118]
This technique is particularly effective in the case of one-shot injection, but in the case of infusion, the administration is performed over time. Is input.
In other words, in the case of one shot, work is performed in the order of (1) bottle label check → (2) wristband check → (3) administration → (4) injection end (dose) input, but in the case of infusion. Will have the following two work schedules.
[0119]
Start of infusion: (1) Check bottle label → (2) Check wristband → (3) Start injection,
End of infusion: (1) Check bottle label → (2) End of administration (pull out needle) → (3) End of injection (dose).
[0120]
Explaining with work schedule data, in the case of one shot injection, both the work schedule data of “injection start” and the work schedule data of “injection end” are registered at the same time. “Injection start” (“infusion start”) and “injection end” (“infusion end”) are registered at respective timings.
[0121]
FIG. 24 is a flowchart showing the operation contents when performing medical treatment of infusion. FIG. 24 (a) shows the operation contents when the infusion is started, and FIG. 24 (b) shows the operation contents when the infusion is completed. Is shown.
As shown in FIG. 24A, the process of bottle label check in step S41 is performed when the infusion is started. The bottle label check (the same applies to the following mixed injection / stop check and wristband check) is actually NG if the check is not correctly performed as described with reference to FIG. 16, and a warning is issued and the process returns to step S41. The process is performed. Here, for simplicity, a simplified description will be given assuming that the bottle label check has been correctly performed.
[0122]
If the bottle label check is correctly performed, the process proceeds to the next mixed injection / stop check in step S42. If the mixed injection / stop check is correctly performed, the process proceeds to the wristband check process in step S43. Then, the process proceeds to the process of displaying the order contents in step S44.
[0123]
After the processing for displaying the order details, the injection (needle) is started in step S45. In other words, the medical practice of drug administration set by inserting a drip needle into the patient checked by the wristband is started. Further, at that time (at the timing), the nurse who has performed the action performs an input operation of infusion start by the PDA 8 as shown in step S46, transmits the information to the in-hospital information management system 2, and transmits the in-hospital information. Infusion management start data is registered in the database of the management system 2. Then, the scheduled drug is started to be administered to the patient by infusion.
[0124]
After the start of the infusion, at the time when the administration of the medicine by the infusion ends, the nurse performing the medical practice of the end of the infusion performs the bottle label check shown in step S51 in FIG. The operation of ending the administration (needle removal) is performed by removing the needle pierced, and the dosage is input by the PDA 8 in step S54 to complete the infusion.
[0125]
By the input of the dose, the information of the end of the infusion is transmitted from the PDA 8 to the in-hospital information management system 2 as shown in step S55, and the data of the end of the infusion is registered in the database of the in-hospital information management system 2.
Even in the case of such a time-consuming medical practice, detailed information at the start of the medical practice is accurately registered in the database of the in-hospital information management system 2 and detailed information at the end of the medical practice. Is registered correctly.
[0126]
In the case of such a time-consuming medical practice, detailed information is registered at the start time and detailed information is also registered at the end time, so that more appropriate support can be provided as follows. .
For example, in the case where the time at which the work for actually starting the infusion is shifted from the scheduled work time for the start of the infusion, the time at which the drip end is scheduled is also shifted. The in-hospital information management system 2 refers to the time at which the time at which the work for actually starting the infusion is actually shifted, and changes the scheduled work time at which the corresponding drip end work is performed in the database.
[0127]
Due to this change, when a nurse who sets the drip-ending operation as work schedule data downloads the work schedule data from the database of the in-hospital information management system 2 using the PDA 8 and references or browses the work schedule data, Since the scheduled work time for performing the drip ending operation has been changed, it is possible to respond quickly.
[0128]
In this case, the nurse who actually performed the operation of starting the infusion often performs the operation of ending the infusion, and the nurse can more accurately know the scheduled time at which the operation of ending the infusion will end. Therefore, it is easy to cope with subsequent scheduled work.
In addition, if the time required to administer the drug from the start to the end of the infusion is long and the nurse does not need to be at that place from the start to the end of the infusion, other scheduled work can be performed efficiently during that time. can do. Also in this case, it is possible to more accurately know the scheduled time at which the drip ending operation is to be completed, so that it is easy to perform another operation scheduled operation.
[0129]
In addition, the nurse who actually performed the work to start the drip will perform the work to start the drip near the end time of the working zone, for example, and will take over the work of the drip end to another nurse Even if is set, the other nurse accesses the database with the PDA 8 and refers to or browses the work schedule data. It is possible to quickly know that the scheduled end time of the work shifts, and it is easy to take measures.
[0130]
For example, by performing another scheduled medical operation during the time lag as described above, the influence on the subsequent scheduled operation can be reduced, and the medical treatment can be smoothly performed. It can be carried out.
In such a time-consuming medical practice, even if a situation where the scheduled start time and the actual start time deviate occurs, the information can be quickly grasped, so that the effect of performing the subsequent medical practice can be reduced. It is possible to reduce the number of medical treatments and to support medical treatments smoothly (or to provide an environment that facilitates medical treatments smoothly).
[0131]
Further, by performing detailed analysis of such information later from the database, it is possible to investigate the cause of the deviation of the medical practice, and to improve the situation more appropriately.
In other words, in this case as well, not only the time but also the information including 5W1H described above is registered in detail in the database at the start and end of the infusion. Information is available and detailed analysis can be performed.
[0132]
For example, the information registered at the start and the end of the infusion includes the data of the executor, the practicing place, the practicing content, the practicing patient, and the like, in addition to the data of each performing date and time. More specifically, it corresponds to that shown in the column of the contents of the implementation data in FIG. FIG. 15 shows an outline of what the work schedule data will be due to the execution of the work or the abandonment of the work schedule. FIG. 15 shows (start and end) (It is almost the same time as the above.) One-shot injection is shown.
[0133]
Therefore, when the start of the infusion in the case of the infusion that takes a long time, the data of <progress> is changed from the schedule in the work schedule data to the execution in the execution data (more specifically, the start of the infusion is completed), As for the data of <instruction content>, the administration data shown in the hatched area in FIG. Shading of this administration will be performed by completing the drip.
[0134]
In addition, in response to the registration of the infusion start execution data, the in-hospital information management system 2 sets the <execution scheduled date> data in the contents of the drip end work schedule data paired with the infusion start data as the infusion start date. It changes according to the date and time of the implementation data, and builds a more accurate database so that the referring user can be provided with accurate information.
[0135]
Since the information is recorded in detail in this manner, it can be used not only for analysis to further improve the system program, but also for grasping the abilities, burdens, and the like of each nurse performing medical work.
In the above description, an example in which accurate information is recorded and stored in the database has been described. However, in the case of a medical practice that takes a long time from the start of work to the end of work (such as in a drip), the start of work is not required. At the stage where the information on the actual start of the work has been registered from the scheduled time, the CPU (not shown) of the in-hospital information management system 2 determines whether or not the deviation time exceeds a preset time. If it is determined that the infusion is completed, a process of notifying the PDA 8 carried by the practitioner performing the infusion that the scheduled work time of the infusion has been changed may be executed.
[0136]
It is easy to understand that the notification process is information for notifying that the scheduled work time at the end of the infusion has been changed, but the present invention is not limited to this, and a message that simply obtains the latest work schedule data may be used. . If such a message is used, it can be used in other cases, and the program can be simplified.
[0137]
In addition, when the operator performing the start and end of the infusion was different, the mail function of the PDA 8 was used to confirm that the scheduled time of the end of the infusion was shifted because the time of the start of the infusion was shifted. It may be made to notify the person who carries out the termination from the person.
[0138]
Further, in the above description, the case of intravenous drip is described as a time-consuming medical practice, but the present invention can also be applied to other medical practices, for example, a medical practice for obtaining an electrocardiogram.
<Other embodiments>
Next, processing of unscheduled medical work will be described as another embodiment. The unscheduled medical work occurs temporarily or urgently, and includes a temporary input work for inputting the result of measurement of vitals and the like, and a loss / damage input for inputting data of a damaged bottle.
[0139]
Vital input is the task of inputting the results of vital measurements of body temperature, pulse, respiration, and blood pressure. For example, assuming that the vital measurement performed at 6:00, 10:00, and 12:00 in the morning is a business order of a normal vital measurement scheduled to be performed according to an instruction previously input to the server 7 by the doctor, the time other than that is assumed. In some cases, such as sudden changes in the patient's condition, verbal instructions from a doctor or nurse, or requests from the patient, urgent or unscheduled vital measurements and input of the resulting data may occur. . Hereinafter, this is referred to as a temporary input operation.
[0140]
Also, if the injection bottle is damaged for some reason during the co-injection preparation work or after going to the hospital room, data may have to be input in response to the damage. Hereinafter, this is referred to as a damage input operation.
FIG. 25 is a flow chart of the operation contents showing the unscheduled medical work such as the temporary input work or the damage input work and the medical practice work based on the normal order described up to FIG. 25 together. . This operation procedure is also processed by communication between the server 7 of the PDA system 4B shown in FIG. 1 and the PDA 8 shown in FIGS.
[0141]
25, first, the user logs in to the PDA 8 (step S100).
FIG. 26 is a medical execution schedule screen which is a normal scheduled operation to be executed in the current work day and is displayed on the display screen of the PDA 8 upon the above-mentioned login. The scheduled execution screen G15 has a display format substantially similar to that of the scheduled execution screen G9 illustrated in FIG. 17, but is slightly different in this example.
[0142]
In the execution schedule screen G15 of this example, the PDA 8 is taken out from the PDA storage location in the display section of the topmost operator name and the built-in rechargeable battery remaining amount, as in the implementation schedule screen G9 shown in FIG. You can see the display of "Test nurse (1234)" which is the name of the nurse who registered his / her own ID, and the display of "Battery: 80%" which is the remaining amount of the rechargeable battery. "Today's work" is displayed in place of the name of the work to be performed, and an update button 32 is displayed on the right side thereof instead of the item change button. Further, in this example, a temporary button 33 is added to the right side in addition to the left return button in the button display area at the bottom of the screen so that the temporary input can always be performed.
[0143]
Then, since this implementation schedule screen G15 is immediately after login, the latest medical practice data is displayed in the central medical practice instruction column when the update button 32 is pressed. In the medical practice instruction column, instructions for performing intravenous injection as a scheduled task at 8:00 on the 16th of today are displayed as measurement tasks of body temperature and blood pressure at 8:00 on the 16th.
[0144]
Here, it is determined whether or not a temporary input operation has occurred (step S101).
This judgment is made by the test nurse (1234). Then, when the test nurse (1234) tries to execute an unscheduled vital measurement medical treatment, for example, due to a sudden change in the patient's condition, a verbal instruction from a doctor or a nurse, or a request from the patient, The test nurse (1234) determines that a temporary input operation has occurred (Yes in S101).
[0145]
Then, in this case, the processing of steps S102 to S107 is performed. In the processing procedure of steps S102 to S107 described below, following the scheduled execution screen G15 shown in FIG. 26 described above, the temporary input screen G16 shown in FIGS. The screen G18, the selection item confirmation screen G19, the order string selection screen G20, the body temperature data input screen G21, the pulse data input screen G22, and the blood pressure data input screens G23a and G23b are sequentially displayed on the display unit 18 of the PDA 8.
[0146]
First, the temporary button 33 is selected and touch-inputted on the implementation schedule screen G15 shown in FIG. 26 (step S102).
As a result, the temporary input screen G16 shown in FIG. 27A is displayed on the display unit 18 of the PDA 8. The temporary input screen G16 is a temporary business selection input screen. In the example shown in the figure, the operator name at the top and a built-in rechargeable battery remaining amount display unit (hereinafter, display of the rechargeable battery remaining amount). (Illustration is omitted), and the lower display has been changed to a temporary input screen except for the display. That is, there is a display of "temporary input" immediately below the uppermost operator name display section, and a nursing (inspection) button 34 is displayed slightly above the large display section below it.
[0147]
In addition, in the same figure (a), only “nursing (advisory)” representing the measurement of vitals etc. is displayed as an extraordinary inspection in the extraordinary operation, but actually “treatment” and other extraordinary operations are also selected. A button appears. However, here, only the "inspection" will be described.
[0148]
First, the identification code of the patient for whom the temporary input is performed is read (step S103).
In this process, when the nursing (examination) button 34 on the temporary input screen G16 shown in FIG. 27A is pressed, the display screen is switched to the patient selection screen G17 shown in FIG.
[0149]
In the identification code reading screen G17, "Patient selection" is displayed immediately below the uppermost operator name display section, the background color of the large display section below the display changes, and "Patient's name" is displayed in the center of the screen. Please enter the identification code of the wristband. "Is displayed. Thus, the display of the PDA 8 instructs to read the identification code from the patient's wristband. The identification code reading screen G17 shown in FIG. 27B has the same configuration as the wristband check screen G12 shown in FIG.
[0150]
Here, the identification code of the patient's wristband is read by the identification code reader provided in the PDA 8. After the identification code of the patient is read by the PDA 8, a process of selecting an item for which the temporary input is to be performed and linking the selected execution item to an order is performed (step S104).
[0151]
In this process, a measurement item selection screen G18 shown in FIG. 28A is displayed on the display unit 18 of the PDA 8. On the measurement item selection screen G18, the ID of the patient that has just been read is displayed as “ID: 95005635” immediately below the uppermost operator name display area, and below this is input related to nursing (admission). The text of "temporary input nursing (advisory)" indicating that it is a temporary input is displayed, under which it is divided into two steps, "observation / measurement" and medical practice contents are displayed, and "measurement" is displayed below Please select an item "is displayed.
[0152]
The measurement items to be selected and input are displayed on the lower four lines as body temperature, pulse, respiration, and blood pressure, respectively. Here, the test nurse (1234) selects items to be examined, for example, body temperature, pulse, and blood pressure, by touching the display lines.
[0153]
Then, as shown in FIG. 13B, the background color of the display row of the selected item is sequentially changed, and the screen is sequentially changed to the selection item confirmation screen G19. As described above, the selected item is displayed on the selection item confirmation screen G19 so that the selected item can be easily confirmed by eyes. If the user presses the wrong button, the user can press the cancel button 22 to go back to the previous selection and restore the background color, cancel the selection, and make a correct selection.
[0154]
Here, if the input of the measurement data by the on-site examination is not associated with the order, there is no record of when and for what purpose the measurement was performed, which is not useful for prognostic medical care. Therefore, in the hospital information system 1, the inspection data and the order can be linked.
[0155]
That is, when the selection of the item is completed on the measurement item selection screen G18, the selection item is confirmed on the selection item confirmation screen G19, and the confirm button 24 is pressed by the test nurse (1234), the result is shown in FIG. An order linking selection screen G20 is displayed on the display unit 18 of the PDA 8.
[0156]
In the order linking selection screen G20, the display of the operator name display section at the top of the measurement item selection screen G18 and the selection item confirmation screen G19 and the display of the selection item line to be measured are changed. The uppermost operator name display section is changed to display the patient name and the patient name "A" is displayed, and the selection item line to be measured is changed to the display of the order name to be linked and four order names are displayed. "Patient sudden change", "Doctor's instruction", "Master's instruction", and "Patient request" are displayed.
[0157]
If this visit is due to a sudden change in the condition of the patient "Mr. A", the test nurse (1234) selects the "item sudden change in the patient condition" of the selection item and presses the confirm button 24 to execute the temporary examination. It is started (Step S105).
In the execution of the temporary inspection, the display method of the screen is different from that of the normal inspection. That is, in the case of the normal examination, the body temperature is measured, the measured body temperature is input, and when the confirm button 24 is pressed, the screen returns to the first screen (the execution schedule screen G15 in FIG. 26) and the completed body temperature examination line is executed. Is gone. Therefore, the inspection is repeated for the next line (which is changed to the top line in the screen display).
[0158]
However, in the on-site inspection, the inspection of the selected item can be performed continuously. That is, in accordance with the measurement item confirmed and input in the selection item confirmation screen G19, the body temperature data input screen G21 shown in FIG. The pulse data input screen G22 and the blood pressure data input screens G23a and G23b shown in (c) and (c) are sequentially and sequentially displayed as the measurement data is input.
[0159]
In these data input screens, only the display in the central display area excluding the upper two display areas and the lower button display area of the display of the order linking selection screen G20 is changed. In the center display area, in the case of the body temperature data input screen G21, "body temperature" is displayed at the top, "degree" is displayed on the right side of the input data display section 35 thereunder, and a calculator is displayed on the entire remaining surface. Type input operation buttons are displayed.
[0160]
In the example shown in FIG. 30A, the test nurse (1234) measures the body temperature of the patient "Mr. A" on the input data display section 35 and inputs the result from the calculator-type input operation button. The body temperature data “36.5” is displayed.
In the case of the pulse data input screen G22, "pulse" is displayed at the top, "times / minute" is displayed on the right side of the input data display section 35 thereunder, and a calculator-type input operation button is provided on the entire remaining surface. Is left as it is.
[0161]
In the example shown in FIG. 30B, the test nurse (1234) measures the pulse of the patient "Mr. A" in the input data display section 35, and inputs the result from the calculator-type input operation button. Pulse data “55” is displayed.
In the case of the blood pressure data input screen G23a, "blood pressure (upper)" is displayed at the top, and in the case of the blood pressure data input screen G23b, "blood pressure (lower)" is displayed. "MmHg" is displayed on the right side of the input data display section 35 below them, and the display of the calculator-type input operation buttons is left as it is on the remaining entire surface.
[0162]
In the example shown in FIG. 30C, the test nurse (1234) measures the blood pressure of the patient "Mr. A" on each input data display section 35, and outputs the result from a calculator-type input operation button. The input blood pressure data is displayed as "120" for blood pressure (upper) and "75" for blood pressure (lower).
[0163]
When the input of the blood pressure data “75” to the input data display unit 35 on the blood pressure data input screen G23b, which is the final data input screen of these data input screens, is completed, the test nurse (1234) presses the confirm button 24. Then, data registration to the server is started (step S106).
[0164]
In this process of registering data in the server, data indicating nursing (examination), data indicating the identification code of the patient's wristband, and data indicating the selected item to be measured are sequentially input from the temporary input screen G16. , And data indicating the order associated with this nursing (visit) are output from the PDA 8 to the server 7 and stored in a predetermined storage area of the server 7. The data is transferred from the server 7 to the hospital information management system 2 and stored in a predetermined database of the hospital information management system 2.
[0165]
It should be noted that the execution of the measurement work is immediately executed by delaying the order link input of the inspection on the order link selection screen G20 shown in FIG. 29, and the data registration (temporary registration in this case) to the server in step S106 is completed. After that, if necessary, an inspection order linking input may be performed from the PC terminal 6 of the first subsystem 4A (step S107).
[0166]
FIGS. 31 (a), (b), and (c) are tables showing an example of a data configuration in which the vital measurement data of the inspection is registered in the normal scheduled vital measurement data by the subsequent order linking. .
First, FIG. 7A shows a normal scheduled nursing order of a patient A. As shown in FIG. 7A, the data of the nursing order of patient A is vertically divided into three lines, morning, noon, and night, and horizontally, one day, two days, and three days. The order is shown in three columns, three times a day for three days. In each case, four types of vital measurement, namely, (1) body temperature, (2) pulse, (3) blood pressure, and (4) respiration are performed in one order, and the measured data is as shown in FIG. Is registered in the data file of the database of the hospital information system 1 as data. As described above, the order information is issued three times a day for three days.
[0167]
On the other hand, when an extraordinary inspection is required, additional registration of inspection data can be performed by pressing the temporary entry button 33 on the execution schedule screen G15 shown in FIG. 26 from the terminal of the PDA 8 as described above. It has become.
For example, when the temporary input of breathing and blood pressure is performed after noon on the first day, if an item is selected in the selection of the temporary input item, the breathing and blood pressure are measured, and the temporary input of the measurement data is performed. The input value is registered as data in the database.
[0168]
FIG. 7B shows the data contents of the data file when the inspection is carried out on the first day. However, FIG. 7B shows a case where the inspection input is performed without linking the order. In this case, as shown in FIG. 8B, the inspection is simply performed between the first day and the second day. , Breathing and blood pressure data are only registered in an emergency.
[0169]
In any case, when the inspection is performed and the temporary input is executed, the input value is stored in the data file of the database of the hospital information system 1 together with the data of the normal scheduled nursing order. Registered as
Here, as described above, if the measurement data input by the inspection is not associated with the order, there is no record of when and why the inspection was performed, and it is not useful for the medical treatment of prognosis. Therefore, in the above case, it is necessary to associate the inspection data with the order.
[0170]
Therefore, the data file shown in FIG. 11B is opened by the PC terminal 6 of the first subsystem 4A, and an input screen having the same format as the order-linking selection screen G20 is displayed, for example, in an overlay manner. When an item is selected and input and the order is linked to the inspection input value, as shown in FIG. In the meantime, a new data row is generated, and the “respiration” data and “blood pressure” data of the inspection input values are recorded in the data area corresponding to the first day of the data row, and correspond to the column indicating the time zone. In the data area, "due to sudden change in condition" is recorded as the order name (factor).
[0171]
In this manner, in FIG. 4B, the inspection input values that were only recorded immediately between the first day and the second day are changed according to the time period during which the inspection was performed and the order in which the inspection was performed. The name is linked as clear data of the medical environment and recorded in the database. This clarifies when and for what purpose, and makes it possible to understand the fluctuation of the result value in more detail when referring to the measurement result.
[0172]
In addition, associating the inspection data with the inspection data as described above is used not only when the inspection is urgent, but also when it is necessary to additionally register detailed contents that cannot be input in the PDA 8. .
The temporary button 33 on the screen G15 in FIG. 26 may be similarly displayed on the screens in FIGS. 8, 12, 13, and 17, and may be configured to enable a temporary input from each screen.
[0173]
Except for the on-site examination, data input for normal medical practice is all performed by doctors based on orders registered in the in-hospital information management system 2 in advance. Even in the case of implementation, if the doctor is too busy to operate the PC terminal 6 and cannot register the order in the hospital information management system 2 in advance, the order may be orally instructed to the nurse. is there. Even in such a case, in the hospital information system 1 of the present example, it is possible to use the PDA 8 to input medical practice data based on the order.
[0174]
FIG. 32 shows an example of a medical instruction screen of the oral instruction displayed on the PDA 8 when the order of the normal scheduled medical instruction issued by such an oral instruction is executed. The medical instruction screen G24 of the verbal instruction shown in the figure is almost similar to the today's business display screen G7 shown in FIG.
[0175]
However, in the case of the medical instruction screen G24 of the verbal instruction, there is no order that follows before and after because it is not a planned normal medical order. Therefore, the display of the button to the previous page and the button to the next page is invalid. The character "oral instruction" is displayed in the margin of the display area of the return button.
[0176]
The name of the nurse who has received the verbal instruction is displayed as "test nurse (1234)" in the uppermost display area for the name of the handler, and below that is the target of the medical treatment of the order given the verbal instruction. The patient name is displayed as "test patient 2".
In the central medical treatment schedule display area, the medical treatment schedule input based on the verbal instruction by the test nurse (1234) who received the verbal instruction indicates the body temperature at 8:00 and the blood pressure at 8:00. , And at 10:00, a drip is displayed. That is, the measurement of the body temperature and the blood pressure of the test patient 2 is specified at 8:00, and the infusion is specified at 10:00.
[0177]
Based on this instruction, the test nurse (1234) completes the measurement of the body temperature and blood pressure of the test patient 2 at 8:00, and then returns to the ward at the time of infusion at 10:00. .
Note that the name data of the test nurse (1234), the name data of the test patient 2, and the data indicating that this order is an oral instruction are input to the PDA 8 after the medical treatment scheduled in the medical treatment schedule described above. Is recorded in the database together with the input data of
[0178]
Thus, the doctor who has issued this order by verbal instruction can access the in-hospital information management system 2 via the server 7 with the PC terminal 6 later, open the corresponding file in the database, and check the contents.
In addition, although the input of the vital measurement result was mainly described as the temporary input work, the present invention is not limited to this, and it is possible to input blood glucose level, SpO2 (oxygen saturation concentration of blood), heart sound of child, meal volume, urine volume, and the like. May be configured.
[0179]
Next, when it is determined in the step S101 in FIG. 25 that the temporary input operation has not occurred, the test nurse (1234) executes a normal scheduled order (step S108). The data input each time the execution of the execution item is completed is registered in the server 7, and is registered in the in-hospital information management system 2 via the server 7.
[0180]
Subsequently, in the process of executing the normal scheduled order in step S107, it is assumed that the medical treatment is the infusion performed at 10:00, and the test nurse (1234) injects the test patient 2 into the test patient 2 ( The following describes a case in which an injection bottle (hereinafter simply referred to as a bottle, which is a flexible bag made of a transparent resin instead of a glass bottle as in the past) occurs when an attempt is made to perform an infusion.
[0181]
Bottles can be damaged before co-injection (when one of the individual drugs to be mixed leaks from the container or the container itself is damaged) and after co-injection (after mixing the individual drugs to be mixed, If the bottle is dropped and the medicine inside leaks out, etc.).
[0182]
Usually, a co-infusion operation of an infusion bottle is performed by a nurse, in which case there is a separate nursing practice system dedicated to co-infusion to prevent errors. If a single drug is found to be damaged before entering the work in the nursing practice system dedicated to co-infusion, it will be the damage input before co-infusion. In the case of bottle damage after the completion of the co-infusion operation in the co-infusion dedicated nursing implementation system, the damage input after co-infusion is input.
[0183]
In the case of damage during injection (for example, when a mild patient walks around while injecting into the hospital and accidentally falls down the bottle stand, and the medicine inside leaks out), as shown in FIG. In this case, the infusion is terminated in step S55. In this case, the dose input screen G14 shown in FIG. 22 is displayed on the display unit 18 of the PDA 8 of the nurse in charge.
[0184]
However, in this case, the “infusion amount” is displayed instead of the “one-shot execution amount”, and the infusion amount from the start of infusion to the occurrence of damage is estimated to be, for example, 55 (%) from the progress of damage. Is entered. This record is confirmed by the attending physician, the remaining 45% of the underdose is prescribed again as a new order, the dose is instructed to the nurse, and the remaining infusion is performed based on the new order. The same processing as described above is performed in the case where the needle has come off in the middle of a drip in a hospital room.
[0185]
In the case of the above-described bottle damage before or after co-injection, the user inputs broken data on the bottle label check screen G25 shown in FIG. The input of the damaged data is performed in steps S109 to S111 and S106 in FIG.
In the processing of steps S109 to S111, in addition to the bottle label check screen G25 of FIG. 33, a damaged bottle label check screen G26 or a damaged bottle confirmation screen G27 of FIG. 34 and a broken bottle label manual input screen G28 Is displayed on the PDA 8.
[0186]
As shown in FIG. 33, on the bottle label check screen G25, a nurse in charge of “test nurse (1234), battery: 80%” is displayed at the top, and “test patient 2” is displayed in the next row. The patient name is displayed, and below it, "2002/04/16 10:00 administration method 1", the date and time of the injection medical treatment and the method of execution are displayed, and the instruction message display area 36 below the display shows the "bottle label identification code". Please enter. "And the instructions to the nurse are displayed.
[0187]
Then, in the bottle content display area 37 below, “used medicine” is displayed above, and below this, the medicines used (or to be used) for this bottle are “medicine 001” and “medicine 002”. , "Drug 003", and the usage amounts of those drugs are displayed as "10", "1 bag", and "2 bags" in the right column.
[0188]
Here, if the bottle is damaged before the identification code of the bottle label is input, in that case, first, the damage input button 39 displayed to the right of the bottom button display area 38 on the bottle label check screen G25. push. Then, the display screen is switched to a damaged bottle label check screen G26 shown in FIG.
[0189]
In the damaged bottle label check screen G26, the message "Enter damage!" Is displayed above the instruction message "Enter the bottle label identification code" in the instruction message display area 36 of the bottle label check screen G25. The display is additionally displayed, and the display of the bottle content display area 37 remains unchanged, and the button display is changed to the “manually input bottle label” button 41 in the bottom button display area 38.
[0190]
Here, when the test nurse (1234) reads the identification code of the bottle label using the reading device of the PDA 8, the display of the PDA 8 switches to the display of the damaged bottle confirmation screen G27 in FIG.
In the damaged bottle confirmation screen G27, the indication message display area 36 displays data related to the medical treatment, including the patient name and its ID code, and the display of the bottle content display area 37 is unchanged and the bottom button is displayed. In the display area 38, the button display on the right side is switched from a “manual input of bottle label” button 41 to a “confirm” button 42.
[0191]
Here, in FIG. 25, it is determined whether the damage of the bottle occurred before or after the co-infusion (step S109).
If it is before the co-infusion (Yes in S109), the user touches and selects the damaged drug name from the drug names displayed in the bottle content display area 37 (step S110).
[0192]
In this case as well, although not particularly shown, the background color of the selected drug name display line changes to another color, and it can be visually confirmed that the selected drug name has been selected. When all the damaged medicines have been selected while checking in this manner, the test nurse (1234) presses the "OK" button 42, and the damaged medicine is registered in the server 7 (step S111).
[0193]
When the damaged drug is input and registered in the server 7 in this manner, although not shown in FIG. 25, the order of reissue of the damaged drug is added to the drug unit, and a new drug is received from the drug unit. Automatically sent. Thus, the co-infusion is input and registered again, and the co-infusion is restarted.
[0194]
In the restart of co-injection, when the execution button (not shown) is pressed, the execution of co-infusion is registered in the server 7.
If it is after co-injection (No in S109), it is not known what and how much medicine has been lost due to damage, and what kind of foreign matter has entered. When the "" button 42 is pressed, the damage of all the medicines is determined and registered. Also in this case, a new medicine is automatically sent from the medicine part, and the input and registration of all the medicines for the co-infusion are performed again, and the co-infusion is restarted.
[0195]
In this case as well, when the execution button (not shown) is pressed in the restart of the co-infusion, the co-infusion is registered in the server 7.
As described above, in the system according to the present embodiment, it is possible not only to immediately shift to the damage input from the injection (drip) execution screen, but also to input the damage as a single drug in the case of the damage before the co-injection. .
[0196]
In the damage input, the recognition code of the damaged bottle is read by the PDA reading device. In this way, if the recognition code of the damaged bottle is readable, the reading can be performed as described above and the damage can be input. If it cannot be read by the reading device, the recognition code must be input manually.
[0197]
In the system of this example, although not shown in FIG. 25, when such automatic reading is not possible, the “bottom bottle label manual input” in the lower right is displayed when the damaged bottle label check screen G26 in FIG. 34 is displayed. When the "" button 41 is pressed, the screen switches to the display of the broken bottle label manual input screen G28 in FIG.
[0198]
On the broken bottle label manual input screen G28, in addition to numeric keys, operation keys required for manual input of the recognition code are displayed. The test nurse (1234) manually inputs the recognition code using the numeric keys and other operation keys, and presses the enter key.
Thus, in any case, a recognition code for a damaged bottle can be input.
[0199]
If the identification code cannot be read even by the eyes of a nurse, appropriate data such as mixed-injection charts and collation data of the server should be taken into account and restored and input from them. Instead of being performed by the hospital information system 1, it is taken into account each time by people at the site.
[0200]
By the way, in general, when displaying the data measured as described above on a monitor screen and observing a patient's condition, a reference value is displayed together with the measured value, and the difference between the reference value and the measured value is observed. To monitor the patient's condition. The reference value is determined to be a fixed value. For example, the upper blood pressure according to international standards is 140 mmHg. In many cases, the body temperature, pulse, respiratory rate, and the like are also fixed values.
[0201]
However, for example, in the case of the above blood pressure, there is a person who does not cause any abnormality even at 170 mmHg at all times, and a person causes an abnormality in the body when the pressure slightly exceeds 140 mmHg.
Also, some people have an average fever of 36 degrees or higher, while others have a temperature lower than 36 degrees. For a person with an average heat of 36 degrees or more, 37 degrees is a slight fever, but for a person with an average heat of less than 36 degrees, 37 degrees is in a high heat category, so it is not safe to say that the measured value is 37 degrees.
[0202]
In addition, those who train their bodies in sports generally have a low pulse and respiratory rate, but those who do not normally exercise and do not train their bodies generally have a high pulse and respiratory rate. Therefore, when the pulse and respiratory rate of a person who is training in sports are sick and the pulse and respiratory rate are increased, the increased pulse and respiratory rate are the same as the pulse and respiratory rate of a person who is not physically trained and sick Even so, you have to think that your condition is worse than someone who has not trained.
[0203]
Thus, the data obtained by vital measurement varies from person to person and is by no means fixed. In general, all vital values increase after surgery such as surgery.
Therefore, conventionally, when the measured value is displayed together with the reference value and observed as described above, when the measured value deviates from the reference value and exceeds the reference value, attention is paid such as coloring the excess portion. Although it is displayed, this is used as a guide to understand the deterioration of the condition, because there is individual difference between individuals as described above, when compared with the fixed reference value, the acceptable value for the patient himself Even within the range, the measured value often exceeds the reference value on the monitor display.
[0204]
Therefore, it is correct if you do not read the measured values together with factors other than the reference value, such as whether the condition has really deteriorated, whether it is bad for the post-operative period, whether the reference value is exceeded due to the patient's constitutional characteristics, etc. I can't judge. In other words, when the measured value is displayed together with the reference value for observation, the reading judgment requires experience and skill, and it cannot be easily determined by anyone.
[0205]
However, in the hospital information system of this example, it is possible to perform a monitor display method in which the measured value is displayed together with the reference value so that anyone can easily determine the symptoms.
FIG. 37 (a) is a diagram showing a monitor display method of this example, and FIG. 37 (b) is a diagram showing a conventional monitor display method for reference. In FIGS. 7A and 7B, the horizontal axis indicates the lapse of time after the operation, and the vertical axis indicates the vital measurement values. The vital value is representative of one of a patient's temperature, pulse, blood pressure, and respiration.
[0206]
In FIG. 6B, the reference value is fixed and displayed regardless of the post-operative state or the patient's personal characteristics. The display shows an example in which the measured value is displayed exceeding the reference value.
On the other hand, in this example, as shown in FIG. 9A, the reference value is raised upward at the end of the operation. As described above, in this example, the doctor in charge changes the reference value upward in consideration of, for example, that the vital measurement value increases after surgery. Further, the fluctuation range is adjusted up and down in consideration of the constitutional characteristics of the patient. In any case, the reference value is changed to be higher than usual.
[0207]
In this way, the measurement data (measurement value) output from the PDA 8 to the server 7 is registered in the server in association with the reference value set by changing the measurement data for the patient. Then, this is displayed on the monitor.
In this way, the reference value is changed and displayed according to the medical environment and the constitution of the patient, so if the condition is good, unnecessary measurement value over will not occur, and the measurement value of the patient indicates the reference value. It fluctuates within the allowable range. Therefore, anyone can easily determine whether the condition of the patient indicated by the measured value is good or not simply by visually checking whether the measured value exceeds the reference value.
[0208]
If the measured value exceeds the reference value, it can be understood that the condition has really deteriorated. On the other hand, it is easy to see if it is recovering more than expected. In addition, if the setting of the reference value can be changed from the PC terminal 6 or the PDA 8 as needed based on the condition, the monitor display with the reference value always in the correct allowable range can be realized.
[0209]
【The invention's effect】
As described above, according to the present invention, not only the execution and recording of a normal medical practice by the portable terminal at the place where the medical practice by one nurse is performed, but also the measurement that occurs temporarily and the damage of the injection bottle and the like can be performed. Since the unexpected situation can be dealt with by the mobile terminal, the burden on the nurse is greatly reduced, and this is convenient.
[0210]
In addition, for the medical treatment (examination) that occurred temporarily, the association of the inspection performed for what purpose or by whom can be entered and registered as necessary from the mobile terminal side. Is easy and convenient.
[Brief description of the drawings]
FIG. 1 is a block diagram showing an overall configuration of a hospital information system according to an embodiment of the present invention.
FIG. 2 is a diagram showing a hardware configuration of the PDA shown in FIG.
FIG. 3 is a table showing details of medical procedures of injections to test specimens and contents of scheduled work from order registration to implementation of the medical procedures.
FIG. 4 is a flowchart showing the contents of an operation procedure at the time of order registration, reference and execution.
FIG. 5 is a diagram showing scheduled work contents generated by injection order registration.
FIG. 6 is a flowchart showing an operation procedure of the PDA system when an injection order is registered.
FIG. 7 is a diagram illustrating an example of a login screen of a PDA.
FIG. 8 is a diagram illustrating an example of a registration screen of a work schedule list.
FIG. 9 is a diagram showing an example of a screen on which all target patients in a designated work zone are displayed in a list when a patient is designated in FIG.
FIG. 10 is a diagram showing an example of a ward selection screen when a ward is designated in FIG. 8;
FIG. 11 is a diagram showing an example of a work band selection screen when a button for a work band is operated in FIG. 9;
FIG. 12 is a diagram showing an example of a selection display screen of a work schedule list.
FIG. 13 is a diagram showing an example of a screen displayed when a selection item of the work list of the day is selected in FIG.
FIG. 14 is a diagram illustrating an example of a display screen when a list that has been executed in the work schedule list is selected.
FIG. 15 is a diagram showing the structure of work schedule data.
FIG. 16 is a flowchart showing a detailed operation content when performing an injection (administration).
17 is a diagram showing an example of a screen when an injection item is selected from a task list for each item on the screen of FIG. 12;
FIG. 18 is a diagram illustrating an example of a bottle check screen.
FIG. 19 is a diagram showing an example of a display screen of a warning message when an injection bottle is read by mistake.
FIG. 20 is a diagram illustrating an example of a display screen when a wristband check of a patient is performed.
FIG. 21 is a diagram showing an example of a display screen when an injection is performed.
FIG. 22 is a diagram showing an example of a screen for inputting a dose after performing an injection.
FIG. 23 is a diagram illustrating an operation content of the bottle check when the content of the order is changed.
FIG. 24 is a flowchart showing an operation content when performing medical treatment of infusion.
FIG. 25 is a flowchart of an operation content showing an unscheduled medical operation and a medical execution operation based on a normal order collectively.
FIG. 26 is a medical practice schedule screen of a normal schedule operation to be performed in the work zone of the day, which is displayed on the display screen of the PDA upon login.
27A is a diagram showing a temporary input screen displayed on the display screen of the PDA, and FIG. 27B is a diagram showing an identification code reading screen.
28A is a diagram showing a measurement item selection screen displayed on the display screen of the PDA, and FIG. 28B is a diagram showing a selection item confirmation screen.
FIG. 29 is a diagram showing an order linking selection screen displayed on the display screen of the PDA.
30A is a view showing a body temperature data input screen displayed on the display screen of the PDA, FIG. 30B is a view showing a pulse data input screen, and FIG. 30C is a view showing an upper and lower blood pressure data input screen; is there.
FIGS. 31 (a), (b), and (c) are tables showing an example of a data configuration in which vital measurement data for an inspection is registered in an order linking manner after the normal planned vital measurement data.
FIG. 32 is a diagram showing an example of a medical instruction screen of an oral instruction displayed on a PDA when an order for a normal scheduled medical instruction issued by an oral instruction is executed.
FIG. 33 is a view showing a bottle label check screen displayed on the display screen of the PDA.
FIG. 34 is a view showing a damaged bottle label check screen displayed on the display screen of the PDA.
FIG. 35 is a view showing a damaged bottle confirmation screen displayed on the display screen of the PDA.
FIG. 36 is a view showing a broken bottle label manual input screen displayed on the display screen of the PDA.
FIG. 37 (a) is a diagram showing a monitor display method of the present hospital information system, and FIG. 37 (b) is a diagram showing a conventional monitor display method for reference.
[Explanation of symbols]
1 hospital information system
2 Hospital information management system
3 LAN
4A First Subsystem
4B Second subsystem (PDA system)
5 server
6 PC terminal
7 Server
8 PDAs
9 Wireless LAN
10 access points
11 Wireless LAN card
12 Identification code reader
13 CPU
14 ROM
15 RAM
16 Storage unit
17 Operation input section
18 Display
19 bus
20 keyboard
21 Login button
22 Cancel button
23 Logout button
24 Confirm button
25 Shift button
26 Confirm button
27a, 27b, 27c Selection items
28 Not button
, 29 button
30 Back / Erase All button
31 Progress bar
32 Update button
33 Extra button
34 Nursing (inspection) button
35 Input data display section
36 Instruction message display area
37 Bottle content display area
38 Button display area
39 Damage input button
41 Bottle label manual input button
42 Confirm button
G1 login screen
G2 Work schedule list registration screen
G3 Patient registration screen
G4 work zone ward designation screen
G5 work zone selection screen
G6 Work schedule display screen
G7 Today's business display screen
G8 Implemented content display screen
G9 Implementation Schedule Screen
G10 Bottle label check screen
G11 Warning display screen
G12 Wristband check screen
G13 Injection execution confirmation screen
G14 Dosage input screen
G15 Implementation Schedule Screen
G16 Temporary input screen
G17 Patient selection screen
G18 Measurement item selection screen
G19 Selection item confirmation screen
G20 Order string selection screen
G21 Body temperature data input screen
G22 Pulse data input screen
G23a, G23b Blood pressure data input screen
G24 medical practice screen
G25 Bottle label check screen
G26 Damaged bottle label check screen
G27 Damaged bottle confirmation screen
G28 Damaged bottle label manual input screen

Claims (5)

A terminal for inputting and outputting at least data relating to medical practice, a server system for transmitting and receiving the data to and from the terminal, and recording and centrally managing information in a hospital transferred by the server system A hospital information system comprising: an in-hospital information management system;
The terminal is
A function of inputting and outputting data of a medical service that is normally scheduled and transmitted and instructed from the server based on a medical order,
A function of performing data input and output of medical services that occur unscheduled without being transmitted and instructed from the server,
A hospital information system comprising: 2. The hospital information system according to claim 1, wherein the unscheduled medical work is temporary measurement and input / output of the measurement data. 3. The hospital information system according to claim 2, wherein the measurement includes at least measurement of body temperature, pulse, respiration, or blood pressure. 2. The hospital information system according to claim 1, wherein the unscheduled medical work is acquisition of a medicine name of a damaged injection bottle and input / output of the acquired medicine name data. The acquisition of the medicine name is performed by reading and inputting an identification code attached to the injection bottle by an identification code reading device of the terminal, or manually inputting by a user of the terminal. The described hospital information system.

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