JP2007179346A - Empty bed management device and empty bed management method - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To implement empty bed management considering the degree of loads on nursing staff inside a medical institution. <P>SOLUTION: When requirement of empty bed retrieval is performed, a use patient of a sickbed is specified in each unit in reference to a sickbed DB 130 wherein sickbeds, units to which the sickbeds belong, and use patients of the sickbeds are associated and managed, the load degree of the nursing staff to the sickbed use patient is specified in reference to an instruction DB 140 wherein the patients and the degree of loads on the nursing staff are associated and managed, and a ward candidate having an empty bed is outputted to a client terminal 200. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a vacant floor management apparatus that manages the allocation of vacant beds (unused hospital beds) to a new patient who is hospitalized or a moving patient who moves on a sick bed (beds or beds for sick persons), and The present invention relates to an empty floor management method in which a computer performs the same processing.

  The technique regarding the empty floor management apparatus for allocating an empty floor is also disclosed in the conventional patent documents.

  For example, characteristics of patients who use the beds around the vacant beds (disease name, medical condition, preference, personality) so that the medical staff can allocate vacant beds considering the compatibility between new inpatients and surrounding hospitalized patients. The technology of the vacant floor management apparatus that displays a screen of a family structure etc. is disclosed (Patent Document 1).

Or, based on the doctor's schedule, the treatment profile in which the treatment date is defined for the standard hospitalization period for each treatment, and the hospitalization reservation status, the surgeon works on the treatment day and there is room for the standard hospitalization period A technique for searching for a bed is disclosed (Patent Document 2).
JP 09-153097 JP2004-038898

  However, these vacant floor allocation methods do not take into account the burden of nurses' assistance generated according to the physical movement ability of hospitalized patients and the burden of nurses generated by treatments or examinations directed by doctors.

  Normally, a single nursing staff must handle multiple patients. Alternatively, a group of nursing staff is determined for each ward and floor, and that group needs to care for all inpatients in the area in charge.

  On the other hand, the shortage of nursing staff has become a chronic problem as hospitalized patients rapidly increase in an aging society. Therefore, the nursing burden that one nursing staff should bear is increasing more and more. In this situation, vacant floor allocation considering only the position of the patient or doctor creates an unequal nursing burden among nursing staff and creates the risk of creating patients who cannot enjoy healthy hospital services. Yes.

  An object of the present invention is to realize vacant floor management in consideration of the nursing burden of nursing staff.

  The present invention is an empty floor management device for managing the operation status of hospital beds of hospitalized patients, a load table that is managed in association with a load level indicating the degree of load generated on a patient and a nurse, a bed, It is provided with a bed table in which the unit to which the bed belongs and the patient using the bed are associated and managed, and when there is a request for empty bed search, the bed bed is identified for each unit by referring to the bed table and the load By referring to the table and identifying the load of the nurse on the patient using the bed, the unit load is calculated for each unit by totaling the load of the nurse on all the beds used by the unit. Based on the degree of load, the vacant floor information regarding the vacant floor is output.

  Furthermore, the present invention includes a unit table in which the unit to which the bed belongs and the number of nurses in charge of the unit are managed in association with each other, and the calculation means includes a nurse table for all bed-use patients for each unit. The load level is totaled and the unit load level is calculated by dividing the total load level for each unit by the number of nurses after referring to the unit table and specifying the number of nurses corresponding to each unit. Features.

  In addition, the present invention is a vacant floor management method in which a computer performs the same processing content as the vacant floor management apparatus.

  According to the present invention, in consideration of the nurse's nursing load, each physical unit such as a ward / floor, physical unit such as a nursing group, organizational unit such as a nursing group, personnel unit such as a doctor in charge, etc. It becomes possible to provide floor information.

  Furthermore, according to the present invention, it is possible to provide vacant bed information in consideration of the nursing load per nurse who is responsible for the unit to which the above-mentioned bed belongs. Thereby, it can avoid that the nursing load of the nurse of a specific unit becomes extremely large.

  In the present embodiment, it is assumed that a plurality of nursing staff members are arranged for each ward, and all the arranged nursing staff members care for all patients in the ward.

  In order to clarify the features of the present invention, in this embodiment, general categories in vacant floor management such as clinical department type, patient age group, private room and shared room type are omitted. In this embodiment, only patient sex is a typical condition of a general category. That is, in this embodiment, vacant floor information is output for a patient who is in charge of the same department and does not need to pay attention to the age group.

  It should be noted that any changes may be made to the present embodiment as long as the same effects as the present embodiment are produced.

  The system configuration in the present invention is shown in FIG. The present invention includes an empty floor management apparatus 100 and a plurality of client terminals 200 (200_1 to 200_n).

  The vacant floor management apparatus 100 and the client terminal 200 exchange data with each other via a wired cable such as a LAN or wireless communication.

  The vacant floor management apparatus 100 further includes a management program 110, a ward DB (database) 120, a hospital bed DB 130, an instruction DB 140, a care load DB 150, an operation load DB 160, and an instruction load DB 170.

  When the management program 110 receives a vacant floor search request from the client terminal 200, the operation load level that is the usage rate of the bed for each ward, the assistance load level according to the physical motion limit of the inpatient for each ward, and the ward Calculates the degree of instruction load (including care load on the patient and work load of the treatment / inspection itself) calculated by each doctor's instructions, and based on these various degrees of load, there is a vacant floor suitable for allocation. A certain ward is output to the client terminal 200.

  The ward DB 120 manages the number of beds for each ward, the number of nursing staff in charge for each ward, and the sex of patients who can be hospitalized for each ward. A ward table 300 stored in the ward DB 120 is shown in FIG.

  In the hospital bed DB 130, various information related to the hospital bed is managed. As shown in FIG. 4, the bed table 400 stored in the bed DB 130 includes a bed ID (identification information), a ward in which the bed exists, a ward in which the bed exists, a patient ID using the bed, and the bed. The data item includes a start time when the patient starts to use and an end time when the patient finishes using the bed.

  In the bed table 400, no data is set for a patient ID, a start time, and an end time for a bed that is not currently used and is not scheduled to be used (indicated by “−”). Further, if the end time is not yet determined for a hospital bed in use, temporary data of “9999/99/99” (meaning that it will continue to be used in the future) is set as the end time.

  In this embodiment, the start time and end time are set to the date, but the date and time may be added for management.

  In the instruction DB 140, care load caused by patient exercise ability, or nursing load caused by various treatments and examinations of doctor instructions for the patient are managed. As shown in FIG. 5, the instruction table 500 stored in the instruction DB 140 includes, for example, a patient ID, self-care content indicating patient exercise ability, a care load level indicating the degree of assistance load corresponding to the self-care content, Consists of data items such as clean instruction contents, measurement instruction contents, nursing treatment instruction contents instructed by a doctor, and each instruction load indicating the degree of assistance load and work load according to these three types of instructions Is done.

  The doctor staff operates the client terminal 200 as appropriate for the instruction contents, and the nursing staff appropriately inputs the self-care contents, and the client terminal 200 transmits the input information to the vacant floor management apparatus 100. The management program 110 of the vacant floor management apparatus 100 writes the received instruction content or self-care content into the instruction table 500. Further, the management program 110 refers to the instruction load DB 170 for the correspondence relationship between the instruction content and the instruction load degree, and refers to the care load DB 150 for the correspondence relationship between the self-care content and the care load degree, and indicates the corresponding load degree to the instruction table 500. Write to.

  In the care load DB 150, information on the correspondence between the self-care contents and the care load degree is managed. As shown in FIG. 6, the care load table 600 stored in the care load DB 150 includes data items such as a care load level indicating the care load level of the nursing staff and a self-care content indicating the physical exercise ability of the patient. The In this example, the degree of care load is set at equal intervals, but the weighting for each self-care content may be changed in consideration of the current situation.

  The operation load DB 160 manages information that associates the range of operation rates indicating the bed usage rate in the ward with the operation load level. A care load table 700 stored in the operating load DB 160 is shown in FIG. In this example, the corresponding operating load level is set to be the same with the same operating rate range setting in all wards. However, the operating rate width and the corresponding operating load may be set for each ward according to the ability of the nursing staff, the medical device or the assisting device installed in the ward, and the like.

  The instruction load DB 170 manages the correspondence between the contents of treatments and examinations that are instructed or approved by medical care and the instruction load degrees indicating the degree of assistance / work load for performing the procedures. An instruction load table 800 stored in the instruction load DB 170 is shown in FIG.

  In the example of FIG. 8, the instruction load corresponding to the clean instruction content for cleaning the patient's body, the measurement instruction content that is a test for measuring the patient's medical condition, and the treatment content that is necessary care for the patient, respectively. The degree is set. However, in addition to this, if there are treatments that require nursing staff's assistance and work load, they can be additionally set as needed. Also, the instruction content and the instruction load frequency in FIG. 8 are merely examples, and may be set in consideration of the actual situation of the medical institution facilities and nursing staff qualities.

  In addition, the number of executions converted per day may be managed together with the instruction content item. If the instruction load degree per patient is calculated by multiplying the instruction load degree by the number of executions converted per day, the instruction load degree in consideration of the instruction contents and the execution number can be calculated.

  Note that the instruction load table 800 is provided with remark items for explaining the contents of each treatment and examination. This is used to display the contents of the instruction item on the input screen when the terminal operator inputs an instruction on the client terminal 200. This remark item may be omitted because it is not essential for the vacant floor search process.

  The client terminal 200 exchanges data with the vacant floor management apparatus 100 via a wired or wireless network, and transmits input information regarding instruction contents and self-care contents or input information regarding vacant floor search requests to the vacant floor management apparatus 100. At the same time, a screen of a vacant floor management application transmitted from the vacant floor management apparatus 100 (such as a search condition input screen or a search result screen) is displayed on the display.

  As the client terminal 200, for example, a WS (workstation), a PC (personal computer), a mobile phone, a PDA (Personal Data Assistant) terminal, and the like are assumed. It is not limited to products.

  Next, the vacant floor search processing flow executed by the management program 110 of the vacant floor management apparatus 100 will be described with reference to FIG.

  In S <b> 1, the management program 110 receives search condition data transmitted from the client terminal 200. The search condition data includes the date of hospitalization of a new patient or the date of movement of a patient who moves on a bed and the patient's sex.

  Incidentally, FIG. 9 shows a search condition input screen 900 displayed on the client terminal 200. The terminal operator (doctor or nursing staff) directly enters the hospitalization date or bed movement date in the hospitalization date input field, and selects the radio button corresponding to the sex of the target patient. Then, when the terminal operator presses the “search” button at the bottom of the screen, the client terminal 200 transmits the input search condition data to the vacant floor management apparatus 100.

  In S2, the management program 110 refers to the ward table 300, extracts the ward corresponding to the patient characteristics of the search condition data received in S1, and temporarily saves the vacant floor management apparatus 100 (not shown) such as a work memory. Save to For example, in the example of FIG. 9, since the patient sex is designated as “male”, the management program 110 extracts the A building, the B building, and the C building as wards that can be accommodated by the target patient.

  In S3, the management program 110 counts the number of beds used for each ward extracted in S2 while referring to the bed table 400 using the date of the search condition data as a key, and stores it in the temporary save area.

  In the example of FIG. 9, since the condition date is designated as “September 30, 2005”, this condition date is included in the bed records in which the ward item is set to A building, B building, and C building. The number of bed records that contain within the period from the start time to the end time is counted for each ward.

  In the example of the bed table 400 of FIG. 4, the first record is not counted because the condition date is not included in the period between the start time and the end time. The third record is not counted because neither start time nor end time is set. Since the second record and the fourth record are to be counted, and the ward item is set to “A”, the management program 110 uploads the bed count data for A in the temporary evacuation area. To do.

  In S4, the management program 110 refers to the number of beds in the ward table 300 with respect to the number of beds used for each ward counted in S3, and indicates that the number of both of the wards matches (the number of all beds is in use). If yes, the data for this ward is deleted from the temporary save area.

  In S5, the management program 110 calculates an operating rate indicating the usage rate of the ward of each ward based on the number of used beds stored in the temporary evacuation area, and saves it in the temporary evacuation area. The occupancy rate is calculated by referring to the number of beds in the bed table 300 and obtaining the percentage of the number of beds used in the number of beds for each ward.

  In S6, the management program 110 reads the operating rate for each ward stored in the temporary save area, specifies the operating load level corresponding to each operating rate while referring to the operating load table 700, and this operating load level. Is saved in the temporary save area.

  In S7, the management program 110 calculates the total care load level of all patients for each extracted ward. That is, the management program 110 reads the ward stored in the temporary evacuation area and refers to the bed table 400 while searching for the search condition date in the period between the start time and the end time of the bed in the corresponding ward. And a patient ID associated with the bed record is identified. Then, referring to the instruction table 500, the presence / absence of the corresponding patient ID record is determined, and if there is, the corresponding care load degree is identified. Then, for each identified patient ID record, the identified care load level is sequentially added to the care load level of the corresponding ward in the temporary evacuation area.

  In S8, the management program 110 calculates the total instruction load level of all patients for each extracted ward. This processing is almost the same processing operation as the above S7, but instead of identifying the care load degree of the instruction table 500, the three kinds of instruction load degrees already described for the corresponding patient ID are added and this is added. The addition processing is sequentially performed as the instruction load degree of the corresponding patient ID.

  The reason why the three types of instruction loads are added is that, as shown in FIG. 10, in the search result screen 1000 of this embodiment, the instruction load degrees are grouped into one item. If each type of instruction load degree is displayed on the search result screen 1000, an addition process may be performed for each type of instruction load degree.

  In S9, the management program 110 adds the operation load, care load, and instruction load stored in the temporary save area for each extracted ward, and saves the total load in the temporary save area.

  In S10, the management program 110 edits screen data such as the search result screen 1000 while reading the operation load level, care load level, instruction load level, and total load level for each ward stored in the temporary save area. create. At this time, the management program 110 sorts the wards in ascending order using the total load level as a key, and then edits the vacant floor candidate table. By doing so, it is possible to display in order of wards with a low load.

  In S <b> 11, the management program 110 transmits the created screen data of the search result screen 1000 to the client terminal 200. In the search result screen 1000 shown in FIG. 10, the data “B” is input in the input field of the selected ward, but is left blank at the time of transmission in S11.

  The above is the vacant floor search processing flow executed by the management program 110 of the vacant floor management apparatus 100 in the present embodiment. In this example, nursing staff is assigned to each ward, and the feature is that the ward is selected by presenting the load situation that takes into account the load situation of the nursing staff. Description of the processing of the portion is omitted.

  However, if the outline of the process of this omitted part is described, after the process of S10, the selected ward ("B" ridge in the example of FIG. 10) input from the client terminal 200 on the search result screen 1000 is empty. The vacant floor management apparatus 100 is transmitted to the floor management apparatus 100. The vacant floor management apparatus 100 further extracts a vacant floor in the corresponding ward while referring to the ward bed table 400 based on the transmission data, and then a specific vacant floor. Candidates are displayed, and a screen that accepts specific patient information such as the final decision vacant floor and patient ID is created and transmitted.

  In this example, the nursing staff is managed in association with the ward. However, for example, each floor other than the ward is associated with each other, or if multiple hospitals are affiliated, the nursing staff is associated with each hospital. This can be achieved by managing nursing staff in association with any physical area unit. Alternatively, management may be performed in association with an organizational unit such as a nursing group or a personnel unit such as a doctor in charge, instead of a physical area unit.

  Specifically, the ward item of the ward table 300 and the ward bed table 400 may be changed to the unit item to be changed, and the degree of load for each changed unit may be calculated in the processing flow of FIG.

  Alternatively, the nursing staff may be directly associated with each patient or hospital bed, and the patient and the nursing staff, or the hospital bed and the nursing staff may be managed in a one-to-one relationship. In this case, each nursing staff is a staff unit.

  In this case, the number of nurses is not managed in the ward table 300, and the ward item in the ward bed table 400 is changed to the nursing staff ID to be associated.

In addition, in this example, in order to consider the effective use of the bed, the vacant bed candidate was searched in consideration of the bed operating load for each ward, but without considering this, only the care load degree and the instruction load degree, In other words, the vacant floor search process may be performed in consideration of only the load of the nursing staff.
(Appendix 1) An empty floor management device for managing the operation status of hospital beds of hospitalized patients,
A load table in which a load level indicating a load level generated by a patient and a nurse is associated and managed;
A bed table in which a bed, a unit to which the bed belongs, and a patient using the bed are associated and managed;
An accepting means for accepting a request for an empty floor search;
With reference to the bed table, the patient who uses the bed for each unit is specified, and the load level of the nurse for each patient using the bed is specified with reference to the load table. A calculation means for calculating a unit load level that is a total of the load levels of nurses for all bed use patients;
An empty floor management apparatus comprising: output means for outputting empty floor information relating to empty floors based on the unit load degree. (1)
(Appendix 2) An empty floor management apparatus according to appendix 1,
further,
It has a unit table in which the unit to which the bed belongs and the number of nurses in charge of the unit are managed in association with each other,
The calculation means, for each unit, sums the load of the nurse on all bed use patients of the unit, further refers to the unit table, specifies the number of nurses corresponding to the unit, unit A vacant floor management apparatus that calculates a unit load degree by dividing a total load degree for each nurse by the number of nurses. (2)
(Supplementary note 3) The empty floor management apparatus according to supplementary note 1,
In the bed table, a use period in which the use patient uses the bed is further managed,
The accepting means accepts the request including a bed use start time,
The calculation means refers to the bed table, specifies the bed use patient for each unit at the time of the use start time, and calculates the unit load degree. (3)
(Appendix 4) An empty floor management apparatus according to appendix 1,
The load generated in the nurse includes a load caused by treatment or examination performed on a patient according to a doctor's instruction.
(Additional remark 5) It is the vacant floor management method which manages the operating condition of the hospitalized patient's bed,
Computer
A reception step for receiving a request for an empty floor search;
Refers to the bed table managed by associating the bed, the unit to which the bed belongs, and the patient using the bed, and identifies the patient using the bed for each unit and indicates the degree of load generated on the patient and nurse Referring to the load table in which the load level is managed in association with each other, the load level of the nurse for each bed use patient is specified, and for each unit, the load of the nurse on all bed use patients of the unit A calculation step for calculating a unit load degree that is a sum of degrees;
An empty floor management method comprising: an output step of outputting empty floor information relating to an empty floor based on the unit load degree.
(Supplementary note 6) The vacant floor management method according to supplementary note 5,
The vacant floor management method characterized in that the load generated on the nurse includes a load caused by a treatment or examination performed on a patient according to a doctor's instruction.

It is a figure which shows the system configuration example of this invention. It is a figure which shows the empty floor search processing flow of this invention. It is a figure which shows the ward table 300 of this invention. It is a figure which shows the bed table 400 of this invention. It is a figure which shows the instruction | indication table 500 of this invention. It is a figure which shows the care load table 600 of this invention. It is a figure which shows the working load table 700 of this invention. It is a figure which shows the instruction | indication load table 800 of this invention. It is a figure which shows the search condition input screen 900 of this invention. It is a figure which shows the search result screen 1000 of this invention.

Explanation of symbols

100 Vacant floor management device 110 Management program 120 Ward DB (database)
130 Bed DB (database)
140 Instruction DB (database)
150 Care load DB (database)
160 Operating load DB (database)
170 Instruction load DB (database)
200 client terminals

Claims (3)

An empty floor management device for managing the operation status of hospital beds of hospitalized patients,
A load table in which a load level indicating a load level generated in a patient and a nurse is associated and managed;
A bed table in which a bed, a unit to which the bed belongs, and a patient using the bed are associated and managed;
An accepting means for accepting a request for an empty floor search;
With reference to the bed table, the patient who uses the bed is specified for each unit, and the load level of the nurse for each bed use patient is specified with reference to the load table. A calculation means for calculating a unit load that is a total of the load of nurses on all bed-use patients;
An empty floor management apparatus comprising: output means for outputting empty floor information relating to empty floors based on the unit load degree. The vacant floor management apparatus according to claim 1,
further,
A unit table in which the unit to which the bed belongs and the number of nurses in charge of the unit are managed in association with each other is provided.
The calculation means, for each unit, sums the load of the nurse on all the bed use patients of the unit, further refers to the unit table, specifies the number of nurses corresponding to the unit, unit A vacant floor management apparatus, wherein a unit load degree is calculated by dividing the total load degree for each nurse by the number of nurses. An empty bed management method for managing the operation status of hospital beds of hospitalized patients,
Computer
A reception step for receiving a request for an empty floor search;
Refers to the bed table managed by associating the bed, the unit to which the bed belongs, and the patient using the bed, and identifies the patient using the bed for each unit and indicates the degree of load generated on the patient and nurse Referring to the load table managed in association with the load level, the load level of the nurse for each bed use patient is specified, and the load of the nurse for all bed use patients of the unit is specified for each unit. A calculation step for calculating a unit load degree that is a sum of degrees;
An empty floor management method comprising: an output step of outputting empty floor information relating to an empty floor based on the unit load degree.

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