CN111445981A - Cancer patient nutrition management system - Google Patents
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- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
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Abstract
The invention provides a cancer patient nutrition management system, which relates to the technical field of cancer nutrition treatment, and comprises a patient basic information module, an enrollment information module, a nutrition evaluation module, a medication monitoring module, a patient follow-up module and a treatment management log module; the system automatically marks the patients in a grading way to realize quick grouping; the pharmacist carries out nutrition assessment on the patient every day, wherein the subjective overall assessment of the patient adopts a modified PG-SGA method; the system comprehensively generates a nutrition prescription recommendation suggestion according to the nutrition evaluation record, the nutrition prescription recommendation suggestion is adjusted by a pharmacist and then pushed to a doctor for examination, and the nutrition recommendation prescription is obtained after the doctor examines the nutrition prescription recommendation suggestion. The system can simultaneously realize the functions of automatic grading marking, online nutrition evaluation, linkage examination and verification of nutrition prescriptions by doctors and pharmacists, online communication, regular follow-up table, storage and retrieval of treatment files in the past and the like of cancer nutrition treatment patients, saves a large amount of time for medical workers, and improves the working efficiency.
Description
Technical Field
The invention relates to the technical field of cancer nutrition treatment, in particular to a nutrition management system for cancer patients.
Background
Malnutrition is a common clinical problem and a lethal factor faced by tumor patients. The international authoritative institution survey shows that the incidence rate of malnutrition of malignant tumor patients reaches 15-80%. The nutritional status of tumor patients not only directly affects the clinical decision of tumor treatment, but also increases the incidence and mortality of complications and affects the clinical outcome of patients. Therefore, the nutrition treatment of the tumor becomes an important component of multidisciplinary comprehensive treatment of the tumor, and the reasonable and effective nutrition treatment has important significance for improving the prognosis and the life quality of patients.
A large amount of literature data show that reasonable and normative nutrition treatment can obviously shorten the hospitalization time of patients, improve the life quality of the patients, reduce the incidence rate of complications and the fatality rate of patients and improve the bed turnover rate of sickrooms. However, at present, the malnutrition of the tumor patients is not paid enough attention in clinic or even in the patient group, and the proportion of the patients with cancer cachexia at the later stage of the tumor is as high as 80%.
With the popularization and generalization of nutrition treatment concepts, a plurality of domestic researches explore nutrition treatment paths, and the influence of medical care or doctor-patient cooperative management or whole-course nutrition management modes on the comprehensive treatment of patients is discovered, and the researches find that individualized and refined nutrition management has positive significance on the treatment of patients. However, all researches have the defects of single service mode, incapability of combining with comprehensive treatment information of patients, no formation of a standardized service system and the like, and comprise a multidisciplinary nutrition diagnosis and treatment mode without a system and a multi-direction and whole-course management mode for medical care, wherein the multidisciplinary nutrition diagnosis and treatment mode cannot be in butt joint with a Hospital Information System (HIS), no effective automatic grouping means and management are available. Meanwhile, a supportable high-efficiency platform is not established, so that the maximum utilization of limited hospital pharmacist resources cannot be realized, and the high-efficiency and homogeneous management of the nutrition treatment of patients cannot be realized.
At present, only partial mobile phone end PN calculator APPs exist in China, such as parenteral and enteral nutrition assistants of Huarui corporation and PNtools of Baiteqiao light, partial EXCE L version calculator in hospital reports or parenteral and enteral nutrition preparation calculation or review module embedded in prescription system, all the APPs or software programs in hospital focus on review or general prescription recommendation, individual information of patients cannot be connected to a hospital HIS system or effectively utilized, and individual and whole-course nutrition treatment management is not mentioned.
In some developed countries, even if the pharmaceutical service experience is mature at present, there are perfect working assessment systems, including perfect recording systems of pharmacists participating in clinical treatment, such as epic system of Nebraska Medicine, but there is no personalized nutrition treatment system for tumor patients participated in by the pharmacists all the time.
Disclosure of Invention
The invention aims to solve the problem that the existing nutrition treatment of cancer patients lacks participation of pharmacists, provides a nutrition management system for cancer patients, and the pharmacists participate in the nutrition treatment scheme of the cancer patients in the whole process, and can realize personalized nutrition treatment and improve the treatment effect of the cancer patients.
The invention provides a cancer patient nutrition management system, which comprises a patient basic information module, an enrollment information module, a nutrition evaluation module, a medication monitoring module, a patient follow-up module and a treatment management log module, wherein the patient basic information module is used for storing basic information of patients;
the patient basic information module comprises medical record, inspection, examination and medical advice information;
the group information module comprises basic information, nutrition condition evaluation, personal history and supplementary information;
the nutritional condition evaluation comprises nutritional risk screening, subjective overall evaluation of patients, admission routine detection indexes, liver function evaluation, whether fasting exists, whether the risk of refeeding syndrome exists, nutritional ways and special supplement;
the nutrition evaluation module comprises weight recording, nutrition risk screening, subjective overall evaluation of patients and recommendation opinions;
the subjective overall evaluation of the patients adopts a modified PG-SGA method, and the nutrition evaluation result of the modified PG-SGA method comprises the following steps:
if the total PG-SGA is 0-1, the PG-SGAA grade is obtained, the nutrition evaluation is 'good nutrition', and the system gives out the advices of pharmacists that 'no intervention measure is needed, and the routine follow-up diagnosis and evaluation are kept';
if the PG-SGA is 2-3 in total, the PG-SGA is in grade B, the nutrition evaluation is suspicious malnutrition, and the system gives out a pharmacist suggestion of 'performing patient or patient family education and performing drug intervention according to patient symptoms and laboratory examination results';
if the total PG-SGA score is 4-8, the grade is PG-SGA grade B, the nutrition evaluation is moderate malnutrition, and the system gives out a pharmacist suggestion of 'performing nutrition intervention jointly according to the severity of symptoms';
if the total PG-SGA score is more than or equal to 9, the grade is PG-SGA C, the nutrition evaluation is 'severe malnutrition', and the system gives out the advice of pharmacists as 'urgent need for symptom improvement and (or) simultaneous nutritional intervention';
the drug treatment monitoring module comprises a pharmacist daily pharmacy ward-visit record and a pharmacy monitoring record;
the patient follow-up visit module comprises discharge education, discharge education records, discharge follow-up visits and discharge follow-up visits records;
the treatment management log automatically generates a cancer patient nutrition treatment management log according to the operation of the system;
after the data of the patient basic information module is imported, the system marks the grading of the patients according to the record of the patient basic information module and automatically enters the group;
the system comprehensively generates corresponding nutrition prescription recommendation suggestions according to weight records, nutrition risk screening and patient subjective overall evaluation in the nutrition evaluation module, the nutrition prescription recommendation suggestions are adjusted by pharmacists and then are pushed to doctors for examination, and after the doctor examines the nutrition prescription recommendation suggestions, the nutrition prescription recommendation is obtained and pushed to the patients;
and after the patient is discharged, the patient follow-up module is started, the system regularly pushes the follow-up table to give out the patient to the hospital, and the patient is given out of the hospital with nutrition treatment guidance according to the filled follow-up table.
Preferably, the system is cooperable with a hospital information system.
Preferably, the basis for the rating marks comprises patient nutritional orders and nutritional risk assessments.
Preferably, the nutritional formula recommendation includes a patient energy requirement, a recommended nutritional support regimen, a recommended preparation, a list of parenteral nutritional formula and a formula specification.
Preferably, after the review by the doctor, the system automatically performs energy, liquid amount, nutrient ratio, ion concentration and formula integrity review on the nutrition recommended prescription obtained after the review by the doctor, and if the review does not pass, the nutrition recommended prescription is fed back to the doctor.
Preferably, the grouping information module can be filled in by a pharmacist.
Compared with the prior art, the technical scheme provided by the invention has at least the following advantages:
1. the cancer patient nutrition management system provided by the invention forms a standardized nutrition treatment service mode based on nutrition screening-evaluation-diagnosis-treatment, and is not developed at home and abroad at present.
2. The cancer patient nutrition management system provided by the invention can realize multiple functions of intelligent grouping of patients, system nutrition evaluation, individual medical advice pushing, prescription auditing, real-time drug therapy monitoring, out-of-hospital tracking follow-up visit, comprehensive drug therapy log generation and the like, and has the advantages of standardized technical content and strong quality control repeatability.
3. The cancer patient nutrition management system provided by the invention enables a pharmacist to comprehensively participate in the nutrition treatment process of a tumor patient, greatly improves the working efficiency and quality of the pharmacist, and can provide better personalized nutrition treatment service for the patient.
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FIG. 1 is a schematic flow diagram of a cancer patient nutrition management system according to the present invention.
Detailed Description
The invention provides a cancer patient nutrition management system, which comprises a patient basic information module, an enrollment information module, a nutrition evaluation module, a medication monitoring module, a patient follow-up module and a treatment management log module, wherein the patient basic information module is used for storing basic information of patients;
the patient basic information module comprises medical record, inspection, examination and medical advice information. The content of the patient basic information module is filled in by the patient after the patient is admitted, and medical staff help to fill in or call other system patient information. The system of the present invention is preferably usable with a hospital information system (HIS system) from which basic information of a patient is directly imported.
The grouping information module comprises basic information, nutrition condition evaluation, personal history and supplementary information. The basic information includes the patient's name, sex, age, height, weight, BMI value, date of admission, diagnosis of admission, etc. The personal history comprises smoking history, drinking history, allergy history and the like, the health condition of the patient is fully known, and a personalized nutrition scheme is formulated by combining the personal history. The supplemental information includes patient medication habits and compliance. The nutritional condition evaluation comprises nutritional risk screening, subjective overall evaluation of patients, admission routine detection indexes, liver function evaluation, whether fasting exists, whether the risk of refeeding syndrome exists, nutritional ways and special supplement; the nutrition risk screening preferably adopts the NRS2002 method; the subjective overall evaluation of the patients adopts a modified PG-SGA method;
in the present invention, the modified PG-SGA method differs from the conventional PG-SGA method in the judgment of the nutrition evaluation results, which are shown in Table 1. According to the nutrition evaluation result of the improved PG-SGA method, 4-8 scores of the total score are judged as moderate malnutrition, 2-3 scores of the total score are judged as suspicious malnutrition, so that the evaluation result is further refined, corresponding pharmacist suggestions are preset according to different nutrition evaluation results, and a system can automatically give recommended nutrition suggestions conveniently.
TABLE 1 determination of nutrient evaluation results by modified PG-SGA method
The drug therapy monitoring module comprises a pharmacist daily pharmacy ward-visit record and a pharmacy monitoring record; the nutritional assessment of the patient is updated and validated against daily pharmaceutical ward rounds to ensure that a personalized nutritional regimen is provided for each cancer patient's nutritional status.
The patient follow-up module comprises discharge education, discharge education records, discharge follow-up visits and discharge follow-up records; preferably, after the cancer patient is discharged from the hospital, the patient follow-up module periodically pushes the follow-up table to the patient, and the doctor periodically monitors the nutrition treatment condition of the patient after the patient is discharged from the hospital by feeding back the follow-up table, so that the interruption of the nutrition treatment after the patient is discharged from the hospital is avoided. Preferably, after the patient is discharged from the hospital, the doctor can be asked on line through the system disclosed by the invention, so that the patient can conveniently consult.
The treatment management log of the invention automatically generates a cancer patient nutrition treatment management log according to the operation of the system. The medical record (grouping, nutrition evaluation, monitoring result, medical advice intervention, nutrition treatment and the like) of the pharmacist, the doctor, the nurse and the patient in the system is automatically integrated into a treatment management log by the system and is updated at any time, so that the doctor, the pharmacist and the nurse can follow up the treatment change of the patient, the communication time is shortened, and the cancer nutrition treatment efficiency is improved.
After the data of the patient basic information module is imported, the system marks the grading of the patients according to the record of the patient basic information module and automatically enters the group. Preferably, the grading mark comprises the basis of nutrition medical orders and nutrition risk evaluation of patients, and the grading mark can enable doctors and pharmacists to know the nutrition condition of the patients more intuitively and apply medicines according to symptoms. The system provided by the invention automatically marks the patients in a grading way, reduces the work of screening by pharmacists, quickly finishes grouping and reduces the work of the pharmacists. To further prevent system loss, the grouping is preferably provided with manual supplementary information for the pharmacist in addition to the system rating indicia.
After the group is entered, a pharmacist carries out nutrition evaluation on the patients every day, evaluation results are recorded into the system, the system comprehensively generates corresponding nutrition prescription recommendation suggestions according to weight records, nutrition risk screening and subjective overall evaluation of the patients in the nutrition evaluation module, the nutrition prescription recommendation suggestions are personalized and adjusted by the pharmacist for each patient and are pushed to a doctor for review, and after the doctor reviews the nutrition prescription, the nutrition recommendation prescription is obtained and pushed to the patients. Preferably, medical care can also consult medication questions via the system of the present invention.
The nutrition prescription recommendation suggestion is generated after calculation according to a program preset in the system, and the disease condition and the nutrition of the patient can be comprehensively considered. The nutritional status of the patients is comprehensively evaluated by adopting indexes or scales such as weight, NRS2002, PG-SGA and the like according to the demographic data, the primary tumor status, the treatment status, the anthropogenic indexes, the clinical biochemical indexes and the like of the patients. Can be used for early discovery and early treatment of patients with nutritional risk or malnutrition.
Preferably, the nutritional prescription recommendation includes the energy requirement of the patient, a recommended nutritional support mode, a recommended preparation, a parenteral nutrition formula list and a formula instruction. More preferably, after the review by the doctor, the system automatically performs the review on the energy, liquid amount, nutrient ratio (such as glycolipid ratio, heat and nitrogen ratio, and amino acid supply), ion concentration, and formula integrity of the nutrition recommended prescription obtained after the review by the doctor, and if the review fails, the result is fed back to the doctor. Furthermore, the system is arranged for auditing and feeding back auditing opinions in real time, so that the clinical use safety and effectiveness of the nutrition treatment scheme can be fully guaranteed.
After the patient is discharged, the patient follow-up module in the system is started, the system regularly pushes the follow-up table to give out the patient to the hospital, and the patient outside the hospital is provided with the out-of-hospital nutrition treatment guidance according to the filled follow-up table, so that the continuity of out-of-hospital nutrition treatment management of the tumor patient is ensured
The system of the invention can generate a comprehensive drug treatment log: and automatically generating a drug treatment log according to all work records and medical advice change conditions of the pharmacist in the system. And combining the follow-up records outside the patient hospital to finally form a continuous and complete pharmaceutical record.
The system can also be used as a basis for performance assessment and drug administration service charging of hospitals, and has certain social and economic benefits from the viewpoints of patient benefit, hospital benefit and pharmacist occupational value.
Example 1
The cancer patient nutrition management system is butted with a hospital information platform (HIS system), and an APP (application) of 'online collaboration and medical care' is embedded, wherein the APP comprises a patient basic information module, an enrollment information module, a nutrition evaluation module, a drug therapy monitoring module, a patient follow-up module and a therapy management log module. The patients were evaluated for nutrition once after admission and entered into patient information (as shown in table 3).
TABLE 3 patient grouping information Table
The system of the invention is operated to carry out intelligent grading marking on the patient information from the hospital information platform, and the patients are automatically grouped according to the grading marking, and a pharmacist can supplement information in the grading marking so as to ensure the accuracy of the grading marking.
After the patients marked intelligently by the system are confirmed to be grouped, basic information of the patients, including cases, medical advice, examination and examination of the patients, can be checked by clicking 'patient information' in the main interface, and the basic information is updated at any time, so that pharmacists, doctors and nurses can master the conditions of the patients in time.
For cancer patients who entered the cohort, the pharmacist performed at least one nutritional assessment of the patient daily and filled in promptly. At the same time, the system records the patient's pharmacy monitoring and other treatment monitoring daily. Wherein the nutritional condition assessment comprises nutritional risk screening, subjective overall patient assessment, admission routine test indicators, liver function assessment, whether to fast, whether to risk a refeeding syndrome, nutritional pathways, and special supplements; the nutrition risk screening adopts an NRS2002 method; the subjective overall evaluation of the patients adopts a modified PG-SGA method; the modified PG-SGA method differs from the conventional PG-SGA method in the judgment of the nutrition evaluation results, and the nutrition evaluation results of the modified PG-SGA method are shown in Table 1.
After the group is entered, a pharmacist carries out nutrition evaluation on the patients every day, evaluation results are recorded into the system, the system comprehensively generates corresponding nutrition prescription recommendation suggestions according to weight records, nutrition risk screening and subjective overall evaluation of the patients in the nutrition evaluation module, the nutrition prescription recommendation suggestions are personalized and adjusted by the pharmacist for each patient and are pushed to a doctor for review, and after the doctor reviews the nutrition prescription, the nutrition recommendation prescription is obtained and pushed to the patients. Preferably, medical care can also consult medication questions via the system of the present invention.
The nutrition prescription recommendation suggestion is generated after calculation according to a program preset in the system, and the disease condition and the nutrition of the patient can be comprehensively considered. The nutritional status of the patients is comprehensively evaluated by adopting indexes or scales such as weight, NRS2002, PG-SGA and the like according to the demographic data, the primary tumor status, the treatment status, the anthropogenic indexes, the clinical biochemical indexes and the like of the patients. Can be used for early discovery and early treatment of patients with nutritional risk or malnutrition. The nutritional prescription recommendation includes the patient's energy needs, recommended nutritional support regimens, recommended preparations, a list of parenteral nutritional formula, and formula instructions. After the doctor audits, the system automatically audits the energy, the liquid amount, the nutrient proportion (such as glycolipid ratio, heat nitrogen ratio and amino acid supply), the ion concentration and the formula integrity of the nutrition recommended prescription obtained after the doctor audits, and if the audit does not pass, the nutrition recommended prescription is fed back to the doctor.
After the patient is discharged, the patient follow-up module in the system is started, the system regularly pushes the follow-up table to give out the patient to the hospital, and the patient outside the hospital is provided with the out-of-hospital nutrition treatment guidance according to the filled follow-up table, so that the continuity of out-of-hospital nutrition treatment management of the tumor patient is ensured
And automatically generating a drug treatment log according to all work records and medical advice change conditions of the pharmacist in the system. And combining the follow-up records outside the patient hospital to finally form a continuous and complete pharmaceutical record.
The foregoing is only a preferred embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and decorations can be made without departing from the principle of the present invention, and these modifications and decorations should also be regarded as the protection scope of the present invention.
Claims (6)
1. A cancer patient nutrition management system is characterized by comprising a patient basic information module, an enrollment information module, a nutrition evaluation module, a medication monitoring module, a patient follow-up module and a treatment management log module;
the patient basic information module comprises medical record, inspection, examination and medical advice information;
the group information module comprises basic information, nutrition condition evaluation, personal history and supplementary information;
the nutritional condition evaluation comprises nutritional risk screening, subjective overall evaluation of patients, admission routine detection indexes, liver function evaluation, whether fasting exists, whether the risk of refeeding syndrome exists, nutritional ways and special supplement;
the nutrition evaluation module comprises weight recording, nutrition risk screening, subjective overall evaluation of patients and recommendation opinions;
the subjective overall evaluation of the patients adopts a modified PG-SGA method, and the nutrition evaluation result of the modified PG-SGA method comprises the following steps:
if the total PG-SGA is 0-1, the PG-SGA grade is obtained, the nutrition evaluation is 'good nutrition', the system gives out the advices of pharmacists that 'no intervention measures are needed, and the routine follow-up diagnosis and evaluation are kept';
if the PG-SGA is 2-3 in total, the PG-SGA is in grade B, the nutrition evaluation is suspicious malnutrition, and the system gives out a pharmacist suggestion of 'performing patient or patient family education and performing drug intervention according to patient symptoms and laboratory examination results';
if the total PG-SGA score is 4-8, the grade is PG-SGA grade B, the nutrition evaluation is moderate malnutrition, and the system gives out a pharmacist suggestion of 'performing nutrition intervention jointly according to the severity of symptoms';
if the total PG-SGA score is more than or equal to 9, the grade is PG-SGA C, the nutrition evaluation is 'severe malnutrition', and the system gives out the advice of pharmacists as 'urgent need for symptom improvement and (or) simultaneous nutritional intervention';
the drug treatment monitoring module comprises a pharmacist pharmacy ward-visit record and a pharmacy monitoring record;
the patient follow-up visit module comprises discharge education, discharge education records, discharge follow-up visits and discharge follow-up visits records;
the treatment management log automatically generates a cancer patient nutrition treatment management log according to the operation of the system;
after the data of the patient basic information module is imported, the system marks the grading of the patients according to the record of the patient basic information module and automatically enters the group;
the system comprehensively generates corresponding nutrition prescription recommendation suggestions according to weight records, nutrition risk screening and patient subjective overall evaluation in the nutrition evaluation module, the nutrition prescription recommendation suggestions are adjusted by pharmacists and then are pushed to doctors for examination, and after the doctor examines the nutrition prescription recommendation suggestions, the nutrition prescription recommendation is obtained and pushed to the patients;
and after the patient is discharged, the patient follow-up module is started, the system regularly pushes the follow-up table to give out the patient to the hospital, and the patient is given out of the hospital with nutrition treatment guidance according to the filled follow-up table.
2. The system of claim 1, wherein the system is cooperable with a hospital information system.
3. The system of claim 1, wherein the basis for the rating mark comprises a patient nutritional order and a nutritional risk assessment.
4. The system of claim 1, wherein the nutritional prescription recommendation includes a patient energy requirement, a recommended nutritional support regimen, a recommended preparation, a list of parenteral nutrition formulas, and a formula specification.
5. The system according to claim 1 or 4, wherein after the review by the doctor, the system automatically performs energy, liquid amount, nutrient ratio, ion concentration and formula integrity review on the nutrition recommended prescription obtained after the review by the doctor, and if the review is not passed, the energy, liquid amount, nutrient ratio, ion concentration and formula integrity review are fed back to the doctor.
6. The system of claim 1, wherein the grouping information module is supplementarily fillable by a pharmacist.
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| CN112489761A (en) * | 2020-11-19 | 2021-03-12 | 华中科技大学同济医学院附属协和医院 | Liquid and energy management system |
| CN112652377A (en) * | 2020-12-24 | 2021-04-13 | 广东钜元营养科技有限公司 | Business system of nutrition inquiry internet hospital |
| CN112669993A (en) * | 2021-02-20 | 2021-04-16 | 温州市人民医院 | System and method for evaluating adverse reaction tendency of medicine |
| CN113642386A (en) * | 2021-07-02 | 2021-11-12 | 广州金域医学检验中心有限公司 | Method, device, equipment and medium for evaluating nasopharyngeal carcinoma treatment effect based on deep learning |
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| CN114496166A (en) * | 2022-02-16 | 2022-05-13 | 上海楚动智能科技有限公司 | Tumor patient nutrition prescription system |
| CN115274053A (en) * | 2022-07-01 | 2022-11-01 | 南方医科大学珠江医院 | Nutritional follow-up management method and system for disabled elderly based on ICF nutritional management |
| CN116564486A (en) * | 2023-02-03 | 2023-08-08 | 上海市同仁医院 | Radiation therapy information management system |
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