CN111863195A - Newborn infant enteral and parenteral nutrition medical advice management system based on hospital information system - Google Patents
Newborn infant enteral and parenteral nutrition medical advice management system based on hospital information system Download PDFInfo
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/60—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to nutrition control, e.g. diets
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
- G16H20/17—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients delivered via infusion or injection
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Epidemiology (AREA)
- General Health & Medical Sciences (AREA)
- Medical Informatics (AREA)
- Primary Health Care (AREA)
- Public Health (AREA)
- Chemical & Material Sciences (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Medicinal Chemistry (AREA)
- Nutrition Science (AREA)
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Abstract
The invention relates to a neonatal parenteral nutrition order management system based on a hospital information system, which specifically comprises: an enteral nutrition order generation module: obtaining the water and milk type and dosage parameters of the newborn according to the determined daily required nutrition formula of the newborn so as to generate an enteral nutrition doctor advice column interface; a parenteral nutrition order generation module: deducting and subtracting various nutrition and energy parameters to generate an parenteral nutrition advice column interface, and converting the intravenous injection preparation in the generated parenteral nutrition advice column interface into a volume unit; the evaluation module: and judging the generated parenteral nutrition advice, so that an operator modifies the nutrition parameters or resets the nutrition formula according to the judgment conclusion. Doctor advice transmission module: and respectively transmitting the generated enteral nutrition medical advice and the generated parenteral nutrition medical advice to the transmission through a hospital information system. The management system saves doctor's advice and pharmacist's dispensing efficiency, and ensures the timeliness of patient's medication.
Description
Technical Field
The invention relates to the technical field of intelligent whole-course management for monitoring when a newborn medical advice formula is automatically generated, in particular to a newborn intra-intestinal and extra-intestinal nutrition medical advice management system based on a hospital information system.
Background
Neonates refer to infants from umbilical cord ligation to 28 days after birth, and can be classified into premature infants, term infants and overdue infants according to gestational age at birth; the low birth weight, normal birth weight and giant birth weight are classified according to the birth weight. Due to experience from intrauterine to intrauterineThe mortality and morbidity of the extra-uterine environment in the transition stage are at the first of life, especially within 24 hours after birth[1]. With the improvement of newborn resuscitation and life support technology, new technologies such as continuous vital sign monitoring, mechanical ventilation, application of lung surfactant, nitric oxide inhalation therapy, extracorporeal membrane pulmonary oxygenation (ECMO) and the like enable more and more high-risk newborns, especially premature babies and very low living body weight babies (VLBWI) to survive, and during the process of newborn smooth rehabilitation and healthy growth, reasonable enteral and parenteral nutrition support provides material basis and power source for the newborns[2]。
The annual birth rate of the newborn in China is 1.228 percent, the newborn in China is 1598 thousands of the infants, more than 150 thousands of the infants need to be treated in the early postnatal period, and most of the infants need the support of enteral and parenteral nutrition. The immature function of each organ, attack of diseases and various treatment measures of the low birth weight infant can cause insufficient nutrient intake, and the nutritional support becomes one of the basic means for guaranteeing the survival of the infant in addition to the requirement of 'catching up growth' after the infant. The nutrition support is the only way to provide nutrition after congenital digestive tract malformation operation for children. Insufficient nutrition directly leads to the increase of complication incidence and fatality rate of the newborn, and influences the future brain development and health condition of the children patients. In developed countries, insufficient nutrient intake for critical neonates and premature neonates is also a significant problem that is not overlooked[3]。
The neonatal care unit (NICU) receives neonates who need to perform respiratory management, shock, poisoning, asphyxia, low weight, severe septicemia or necrotic enteritis, and has the characteristics of light weight, small size, severe disease, incomplete organ function development and the like. The measures for newborn management such as treatment of primary diseases, advanced life support, prevention of secondary infection, and supply of nutrition are important factors for determining survival or reduction of sequelae, and the importance of newborn nutrition supply is recognized, and sometimes it is called "newborn nutrition management" and includes liquid treatment, enteral nutrition, parenteral nutrition, and the like. Compared with the parenteral nutrition of adults, the parenteral nutrition of neonates requires more precise calculation of liquid volume and energy, requires the use of compound amino acids (lactic acid is not contained in the preparation) and medium-long chain fat emulsion for children, requires osmotic pressure less than or equal to 900mOms/L (less than or equal to 1200mOms/L for adults) during peripheral infusion, and introduces the concept of 'sugar speed'. The difference of the enteral nutrition is mainly reflected in the nutritional preparation, the enteral nutritional preparation for the newborn mainly comprises world standard premature milk, full-term milk, breast milk and the like, the newborn is fed in different forms according to the sucking capacity and disease conditions of the newborn, and part of the newborn even needs to extract and measure the residual milk in the stomach. At present, when (after) a NICU doctor makes a ward round, the NiCU doctor converts the liquid amount, the energy and the ratio of each nutrient of a newborn into nutrition orders by using a calculator and inputs the nutrition orders into a Hospital Information System (HIS), which is time-consuming, complex and easy to make mistakes. Therefore, a set of neonatal enteral and parenteral nutrition advice software is needed to be developed based on the HIS system to facilitate data transmission, and a doctor inputs nutrition demand parameters into the system and then automatically converts the nutrition demand parameters into nutrition advice, and the nutrition advice is transmitted to the intravenous drug configuration center and the nutrition department for configuration and delivery, and prompts or limits nutrition parameter ranges, configuration safety parameters, nutrition optimal parameters and the like to form a whole set of management system.
At present, the related software for nutrient management of the newborn (premature infant) at home and abroad mainly has 3 expression forms:
1. a spreadsheet form with Microsoft excel as a development tool; the calculation table of the nutrition medical advice of the newborn is made by using excel office software, the defect that the nutrition calculation formula is tampered due to improper excel operation is overcome by using an encryption mode, effective prompt or limitation of a parameter input range is lacked, complexity of calculation of the nutrition medical advice of the newborn cannot be matched, and the application range is narrow.
2. The method is characterized in that a Microsoft Visual Basic or Microsoft C language is used as a development tool to generate a neonatal nutrition medical advice calculation software running mode and an Internet-based online calculation mode software mode, although the excel form calculation deficiency is made up, calculation results still need to be input into an HIS medical advice system, the operation is complex, the medical advice execution flow is not smooth enough, and a complete management automation system cannot be formed.
Disclosure of Invention
The present invention is directed to a neonatal parenteral nutrition order management system based on a hospital information system, which is designed to solve the above-described technical disadvantages.
The system for managing a newborn infant enteral and parenteral nutrition order based on a hospital information system according to the present invention is characterized by comprising:
an enteral nutrition order generation module: extracting or inputting gestational age and weight parameters of a newborn from a hospital information system to determine a required nutrition formula of the newborn on the current day, setting liquid amount, energy and nutrition parameters in the formula, further obtaining the water and milk type and dosage parameters of the newborn on the current day according to the required nutrition formula information of the newborn on the current day and the stored oral ability information of the previous day, and further generating an enteral nutrition medical advice column interface;
a parenteral nutrition order generation module: recognizing and removing water and milk dosage information and intravenous medicine solvent amount information in the intra-intestinal and external liquid amount information required by the newborn on the current day to obtain extra-intestinal nutrient liquid amount information and recognizing and removing intra-intestinal nutrient and energy parameter information in the intra-intestinal and external energy and nutrient parameter information required by the newborn on the current day to obtain extra-intestinal nutrient and energy parameter information, converting the obtained extra-intestinal nutrient liquid amount information and extra-intestinal nutrient and energy parameter information into an extra-intestinal nutrient preparation dosage and converting the extra-intestinal nutrient and energy parameter information into a volume unit, and further generating an extra-intestinal nutrient medical advice column interface;
the evaluation module: and judging the generated parenteral nutrition advice, wherein the judgment content comprises optimization of nutrition parameters and vein configuration safety, and at least one of warning information and limitation of prescribing advice is formed, so that an operator modifies the nutrition parameters or resets the nutrition formula according to the judgment conclusion.
Doctor advice transmission module: the enteral nutrition advice is transmitted to a nutrition department workstation through a hospital information system after being generated, and the parenteral nutrition advice is transmitted to a pharmacist workstation of the intravenous drug configuration center through the hospital information system after being generated.
Preferably, the daily required nutritional formula of the newborn in the enteral nutrition order generation module is determined by calling and combining the historical nutritional scheme and the water and milk intake capacity, and the energy and nutritional parameters of the daily required nutritional formula of the newborn determined in the way are set.
Preferably, the judging module is an enteral and parenteral nutrition index comparison module for comparing the generated enteral and parenteral nutrition orders with preset enteral and parenteral nutrition treatment indexes, wherein the compared nutrition treatment indexes comprise a caloric index limit value, a thermal nitrogen ratio index and a glycolipid ratio index limit value.
Preferably, the judgment module calculates the generated medical advice to obtain a limit value of an infusion safety index generated after the nutrient preparation is intravenously injected; the infusion safety index comprises a fluid osmotic pressure index limit value, a monovalent cation concentration limit value, a divalent cation concentration limit value, an electrolyte concentration index limit value and a sugar concentration index limit value.
Preferably, the method further comprises the step of generating a medical order template interface for infusion according to the neonatal intravenous nutrition infusion mode, wherein the medical order template interface comprises a peripheral intravenous infusion template interface, a central intravenous infusion template interface and a fat emulsion separate infusion template interface, so that a user can select at least one medical order template interface as a medical order template for intravenous nutrition infusion, and limit values are set in each medical order template interface.
Preferably, the medical apparatus further comprises a recording module for recording treatment parameters obtained by the enteral nutrition treatment and the parenteral nutrition treatment performed for each child patient, and a chart generating module for generating a chart interface according to a time axis.
Preferably, the chart generation module further comprises automatically reading and generating a growth curve chart interface according to the child age and weight parameters of the infant after daily treatment.
Preferably, when the dosage of the medicine is larger than zero, a check box in front of the medicine in the prescription column can automatically display a check state and correspondingly display the dosage; when the dosage is less than or equal to zero, a check box in front of the medicines in the prescription column can automatically display a non-check state without displaying the dosage, wherein the administration frequency and the administration route are uniformly displayed in the nutrition prescription column.
Preferably, the judgment module also prompts according to the nutrition treatment index limit value, the nutrition treatment index limit value comprises mandatory indexes and non-mandatory indexes, and when the mandatory indexes exceed the range value, warning information is prompted, and the prescription cannot be stored; and when the non-mandatory index exceeds the range value, warning information is prompted, and the prescription is stored.
Preferably, the judging module further comprises a step of automatically changing and marking the corresponding column color when the limit value is exceeded until the index limit value calculated according to the input water and milk quantity parameters is normal and the color is returned to the normal color.
The neonatal enteral and parenteral nutrition medical advice management system based on the hospital information system, which is designed by the invention, combines neonatal nutrition calculation and medical advice prescribing together, and reduces the complex workload of prescribing nutrition medical advice when doctors make a visit to the room; the executed medical advice is transmitted to a vein medicine configuration center for auditing and centralized configuration, the workload of nurse in liquid preparation is reduced, the configuration safety is ensured, and the prescription checking of pharmacists is assisted. The management method can save doctor advice time, medicine configuration time, prescription examining time of a pharmacist, centralized medicine delivery and guarantee safety and effectiveness of the medicines, and meanwhile, timeliness of medicine treatment of a patient is guaranteed.
In addition, nutrition calculation, medical advice preparation, report inquiry and growth curve drawing of the newborn are integrated, and the newborn is embedded into a Hospital Information System (HIS) without port connection, a middle table is simple, and data reading and transmission are smooth.
Drawings
FIG. 1 is a schematic view of the overall structure of the embodiment;
fig. 2 is a block flow diagram of an embodiment.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments that can be derived by one of ordinary skill in the art from the embodiments given herein are intended to be within the scope of the present invention.
Example (b):
as shown in fig. 1, the system for neonatal parenteral nutrition order management based on the hospital information system described in this embodiment includes:
an enteral nutrition order generation module: extracting or inputting gestational age and weight parameters of a newborn from a hospital information system to determine a required nutrition formula of the newborn on the current day, setting liquid amount, energy and nutrition parameters in the formula, further obtaining the water and milk type and dosage parameters of the newborn on the current day according to the required nutrition formula information of the newborn on the current day and the stored oral ability information of the previous day, and further generating an enteral nutrition medical advice column interface;
a parenteral nutrition order generation module: recognizing and removing water and milk dosage information and intravenous medicine solvent amount information in the intra-intestinal and external liquid amount information required by the newborn on the current day to obtain extra-intestinal nutrient liquid amount information and recognizing and removing intra-intestinal nutrient and energy parameter information in the intra-intestinal and external energy and nutrient parameter information required by the newborn on the current day to obtain extra-intestinal nutrient and energy parameter information, converting the obtained extra-intestinal nutrient liquid amount information and extra-intestinal nutrient and energy parameter information into an extra-intestinal nutrient preparation dosage and converting the extra-intestinal nutrient and energy parameter information into a volume unit, and further generating an extra-intestinal nutrient medical advice column interface; wherein the information on the amount of parenteral liquid required by the newborn on the day is extracted from a Hospital Information System (HIS), and the water-milk amount is an intestinal nutrient liquid amount information part.
The evaluation module: and judging the generated parenteral nutrition advice, wherein the judgment content comprises optimization of nutrition parameters and vein configuration safety, and at least one of warning information and limitation of prescribing advice is formed, so that an operator modifies the nutrition parameters or resets the nutrition formula according to the judgment conclusion.
Doctor advice transmission module: the enteral nutrition medical advice is generated and then transmitted to a nutrition department workstation through a hospital information system, nutrition in the intestines is reasonably configured through the nutrition department workstation, the parenteral nutrition medical advice is generated and then transmitted to a pharmacist workstation of a vein medicine configuration center through the hospital information system, and the pharmacist workstation of the vein medicine configuration center automatically checks the transmitted parenteral nutrition medical advice and centrally configures parenteral nutrition medicines.
In this example, the conversion method of the nutritional formula is as follows:
the weight of the infant is A, the daily fluid amount is B, the therapeutic fluid amount is C, the fat milk amount infused is D, the milk amount is E, the frequency is F, the amino acid is G, the fat milk is H, the sugar rate is I, the water milk energy is J, Na + is K, Ka + is L, Ca2+ is M, Mg2+ is N, heparin sodium is P, the fat-soluble Vita is Q, and the water-soluble Vita is R.
Because the newborn water and milk energy contains Na +, Ka +, Ca2+ and Mg2+, Na +, Ka +, Ca2+ and Mg2+ contained in the water and milk energy need to be removed when the prescription dosage is calculated, and parameters related to the amount of Na +, Ka +, Ca2+ and Mg2+ contained in the water and milk energy are calculated as shown in the following table:
TABLE 1
The specific calculation method is as follows when the Na + parameter is CS1, the Ka + parameter is CS2, the Ca2+ parameter is CS3, and the Mg2+ parameter is CS 4:
compound amino acid injection (19AA-I) for children at dosage S1
S1＝G*A/0.06
Medium-long chain fat emulsion injection (C6-24) dosage S2
If the fat-free milk is used for cardiac intravenous infusion, S2 is 0
Otherwise, S2 ═ H A/0.2
Concentrated sodium chloride injection (10%) dosage S3
S3＝(K*A-(CS1/100)*E*F)*58.44*10/1000
Dosage of potassium chloride injection S4
S4＝(L*A-(CS2/100)*E*F)*74.55*10/1000
Fat-soluble vitamin (I) dose S5 for injection
S5＝Q*A
Water-soluble vitamin dosage for injection S6
S6＝R*A
Dosage of calcium gluconate injection S7
S7＝(M*A-(CS3/100)*E*F)*448.4/(0.1*1000)
Magnesium sulfate injection dosage S8
S8＝(N*A-(CS4/100)*E*F)*246.48/(0.25*1000)
10% glucose injection (Soft bag) dosage S9
Total parenteral nutrition liquid amount T ═ A × B-C-D-E × F
The total amount of sugar liquid is T-S1-S2-S3-S4-S7-S8
Sugar ratio V ═ I X A60X 24/(1000X U)
S9＝(0.5-V)/0.4*U
50% glucose injection dosage S10
S10＝(V-0.1)/0.4*U
Heparin sodium injection dosage S11
S11＝P*A*24
When the dosage of the medicine is larger than zero, a check box in front of the medicine in the prescription column can be automatically displayed as a check state, and the dosage is correspondingly displayed; when the dosage is less than or equal to zero, a check box in front of the medicine in the prescription column can automatically display a non-check state and does not display the dosage, wherein the administration frequency and the administration route are uniformly displayed in the nutrition prescription column, the administration frequency gives an ST (immediate) mark, and the administration route is micro-pump injection.
In this embodiment, the method for calculating the nutritional parameters is as follows:
the system can automatically calculate each index value of the prescription according to the input parameter value and the calculated medicine dosage, specifically, calculate to obtain a nutrition treatment index limit value according to the input parameters of the gestational age and the weight of the newborn, wherein the nutrition treatment index comprises a caloric index limit value, a caloric nitrogen ratio index and a glycolipid ratio index limit value; the infusion safety index limit value generation module is used for calculating the generated medical advice to obtain an infusion safety index limit value generated after the nutrient preparation is intravenously injected; the transfusion safety index comprises a liquid osmotic pressure index limiting value, a monovalent cation concentration limiting value, a divalent cation concentration limiting value, an electrolyte concentration index limiting value and a sugar concentration index limiting value; meanwhile, a medical advice template interface for infusion is generated according to a neonatal intravenous nutrition infusion mode, the medical advice template interface comprises a peripheral intravenous infusion template interface, a central intravenous infusion template interface and a fat emulsion separate infusion template interface, so that a user can select at least one medical advice template interface as a medical advice template for intravenous nutrition infusion, and limit values are set in each medical advice template interface.
Meanwhile, the judging module in the system compares the generated enteral and parenteral nutrition advice with preset enteral and parenteral nutrition treatment indexes, wherein the compared nutrition treatment indexes comprise a caloric index limit value, a caloric nitrogen ratio index and a glycolipid ratio index limit value.
Total parenteral nutrient fluid (ml) T
T＝A*B-C-D-E*F
Total milk volume (ml) W1
W1＝E*F
Enteral nutrition energy (kcal/kg) W2
W2＝E*F*J/100/A
Sugar concentration% (g/100ml) W3
W3＝I*A*60*24/(T*1000)*100
Amino acid concentration% (g/100ml) W4
W4＝G*A/T*100
Fat milk concentration% (g/100ml) W5
If the template is not used for cardiac venous infusion in fat milk, W5 is 0
Otherwise, W5 ═ H A/T100
Parenteral nutrition energy (kcal/kg) W6
If the template is a cardiac venous infusion template without fat milk,
W6＝G*4+D*488/250/A+(I*24*60/1000)*4
otherwise, W6 ═ G4 + H488/0.2/250 + (I24 × 60/1000) × 4
Non-protein Heat (kcal/kg) W7
If the template is a cardiac venous infusion template without fat milk,
W7＝D*488/250/A+(I*24*60/1000)*4
otherwise, W7 ═ H488/0.2/250 + (I24 × 60/1000) × 4
Nitrogen (g/kg) W8
W8＝G/6.25
Heat to Nitrogen ratio (kcal/g) W9
W9＝W7/W8
Glycolipid ratio (kcal: kcal) W10
If the template is a cardiac venous infusion template without fat milk,
W10＝(I*24*60/1000)*4/(D*488/250/A)
otherwise, W10 ═ I24 ═ 60/1000 ═ 4/(H · 488/0.2/250)
NaCl concentration (% o) W11
W11＝S3*0.1*1000/T
Kcl concentration (‰) W12
W12＝S4*0.1*1000/T
Osmotic pressure (mmos/L) W13
If the template is a cardiac venous infusion template without fat milk,
W13＝(S9*550+S10*2750+S1*525+S4*2666+S3*3400+S7*697+S8*4166)/T
otherwise, W13 ═ S9 × 550+ S10 × 2750+ S1 × 525+ S2 × 273+ S4 × 2666+ S3 × 3400+ S7 × 697+ S8 × 4166)/T7 × 697+ S8 × 4166
Osmotic pressure (mmos/L) minus sugar W14
In the case of a peripheral intravenous infusion template,
W14＝(S1*525+S2*273+S4*2666+S3*3400+S7*697+S8*4166)/T
otherwise, W14 is 0
Monovalent cation concentration (mmos/L) W15
W15＝(0.1*S3/58.44+0.1*S4/74.55)*1000*1000/T
Divalent cation concentration (mmos/L) W16
W16＝(0.1*S7/448.4+0.25*S8/246.48)*1000*1000/T
Fat-soluble vita (bottle/kg) W17
W17＝Q*A
Water soluble Vita (bottle/kg) W18
W18＝R*A
The method for judging and warning various indexes of the neonatal parenteral nutrition medical advice prescription based on the method comprises the following steps:
wherein, the peripheral vein infusion template interface needs to set a limit value for the osmotic pressure of a vein configuration medical advice interface, and the limit value of the sugar concentration is 12.5%; if the central venous infusion template interface and the fat emulsion separate infusion template interface are not set with osmotic pressure limiting values, the sugar concentration is limited to be 25 percent, and 0.5IU/kg body weight/h heparin is added to set with limiting values; when the set limit value is exceeded, the system gives an alarm.
The judging module in the system also comprises a prompt aiming at the limit value of the nutrition therapeutic index, and all the nutrition therapeutic indexes are divided into mandatory indexes and non-mandatory indexes, wherein 4 of the Nacl concentration W11, the Kcl concentration W12, the monovalent cation concentration W15 and the divalent cation concentration W16 are mandatory indexes, and the others are non-mandatory indexes. Warning information is prompted when the mandatory index exceeds the range value, and the prescription cannot be stored; when the non-mandatory index exceeds the range value, warning information is prompted, and prescription storage is not affected (namely the prescription achieves the effect of immediate storage).
The mandatory index and the non-mandatory index are judged as follows:
TABLE 2-1
| Index name | Warning information |
| NaCl concentration W11 | The NaCl concentration exceeds 5.85%, please adjust |
| Kcl concentration W12 | The Kcl concentration exceeds 3%, please adjust |
| Monovalent cation concentration W15 | The concentration of univalent cations is more than 150mmoL/L, please adjust |
| Divalent cation concentration W16 | Adjusting the concentration of divalent cations to be more than 5mmoL/L |
| Concentrated sodium chloride injection dosage S3 | Please check that Na + is replenished in baby milk |
| Dosage of potassium chloride injection S4 | Please check that K + is replenished in baby milk |
| Dosage of calcium gluconate injection S7 | Please check that Ca2+ is replenished in baby milk |
| Magnesium sulfate injection dosage S8 | Please check that Mg2+ is replenished in baby milk |
Based on the above table, whether the indexes are mandatory indexes or non-mandatory indexes, when the judgment module finds that the indexes exceed the limit value, the corresponding cell color is automatically marked as warning color red; and the colors of the cells are not restored to normal colors until the index value calculated by the doctor by modifying the input parameters is restored to normal, and columns exceeding the index cannot be stored by orders, so that the need of re-proportioning is reminded.
In this example, the neonatal parenteral nutrition order query:
the pharmacist needs to check all parenteral nutrition medical advice queries of the neonate according to time periods, not only needs to check basic information of the sick child, but also needs to check prescription details and various index values.
The icon generation module records treatment parameters obtained by enteral nutrition treatment and parenteral nutrition treatment performed by each infant, generates a chart interface according to a time axis, automatically reads the parameters of gestational age and weight of the infant after daily treatment and generates a growth curve chart interface, so that doctors can conveniently and directly observe and obtain the treatment condition of the infant
The present invention is not limited to the above-mentioned preferred embodiments, and any other products in various forms can be obtained by anyone in the light of the present invention, but any changes in the shape or structure thereof, which have the same or similar technical solutions as those of the present application, fall within the protection scope of the present invention.
Claims (10)
1. A neonate intestines outer nutrition doctor advice management system based on hospital information system specifically includes:
an enteral nutrition order generation module: extracting or inputting gestational age and weight parameters of a newborn from a hospital information system to determine a required nutrition formula of the newborn on the current day, setting liquid amount, energy and nutrition parameters in the formula, further obtaining the water and milk type and dosage parameters of the newborn on the current day according to the required nutrition formula information of the newborn on the current day and the stored oral ability information of the previous day, and further generating an enteral nutrition medical advice column interface;
a parenteral nutrition order generation module: recognizing and removing water and milk dosage information and intravenous medicine solvent amount information in the intra-intestinal and external liquid amount information required by the newborn on the current day to obtain extra-intestinal nutrient liquid amount information and recognizing and removing intra-intestinal nutrient and energy parameter information in the intra-intestinal and external energy and nutrient parameter information required by the newborn on the current day to obtain extra-intestinal nutrient and energy parameter information, converting the obtained extra-intestinal nutrient liquid amount information and extra-intestinal nutrient and energy parameter information into an extra-intestinal nutrient preparation dosage and converting the extra-intestinal nutrient and energy parameter information into a volume unit, and further generating an extra-intestinal nutrient medical advice column interface;
the evaluation module: and judging the generated parenteral nutrition advice, wherein the judgment content comprises optimization of nutrition parameters and vein configuration safety, and at least one of warning information and limitation of prescribing advice is formed, so that an operator modifies the nutrition parameters or resets the nutrition formula according to the judgment conclusion.
Doctor advice transmission module: the enteral nutrition advice is transmitted to a nutrition department workstation through a hospital information system after being generated, and the parenteral nutrition advice is transmitted to a pharmacist workstation of the intravenous drug configuration center through the hospital information system after being generated.
2. The hospital information system-based neonatal parenteral nutrition order management system of claim 1 wherein the daily required nutritional formula of the neonate in the enteral nutrition order generation module is determined by retrieving and combining a historical nutritional regimen and water and milk intake capacity, and setting energy and nutritional parameters for the daily required nutritional formula of the neonate determined in this manner.
3. The hospital information system-based neonatal parenteral nutrition order management system of claim 2, wherein the evaluation module further comprises comparing the generated parenteral nutrition order with preset parenteral and parenteral nutrition therapy indicators, the compared nutrition therapy indicators comprising a caloric index limit value, a thermal nitrogen ratio indicator and a glycolipid ratio indicator limit value.
4. The hospital information system-based neonatal parenteral nutrition order management system of claim 1, wherein the evaluation module calculates for the generated order an infusion safety index limit value generated after intravenous administration of the nutritional formulation; the infusion safety index comprises a fluid osmotic pressure index limit value, a monovalent cation concentration limit value, a divalent cation concentration limit value, an electrolyte concentration index limit value and a sugar concentration index limit value.
5. The hospital information system-based neonatal parenteral nutrition order management system of claim 4, further comprising an order template interface for infusion generated according to the neonatal intravenous nutrition infusion mode, wherein the order template interface comprises a peripheral intravenous infusion template interface, a central intravenous infusion template interface and a fat emulsion separate infusion template interface, so that a user can select at least one order template interface as an order template for intravenous nutrition infusion, and each order template interface is set with a limit value.
6. The system for neonatal parenteral nutrition order management based on hospital information system of claim 1 further comprising a recording module for recording treatment parameters of enteral and parenteral nutrition treatments performed for each infant patient, and a chart generation module for generating a chart interface according to a time axis.
7. The hospital information system-based neonatal parenteral nutrition order management system of claim 6, wherein the chart generation module further comprises automatically reading and generating a growth curve chart interface according to the gestational age and weight parameters of the infant after daily treatment.
8. The hospital information system-based neonatal parenteral nutrition medical order management system of claim 1, wherein when the dose of medication is greater than zero, a checkbox in front of the medication in the prescription column is automatically displayed in a checkbox state and the dose is displayed correspondingly; when the dosage is less than or equal to zero, a check box in front of the medicines in the prescription column can automatically display a non-check state without displaying the dosage, wherein the administration frequency and the administration route are uniformly displayed in the nutrition prescription column.
9. The system for neonatal parenteral nutrition medical advice management based on hospital information system according to any one of claims 3 to 5, wherein the evaluation module further comprises a prompt for a nutrition therapy index limit value, wherein the nutrition therapy index limit value comprises mandatory and non-mandatory indexes, and the mandatory index indicates a warning message when exceeding the range value, and the prescription cannot be saved; and when the non-mandatory index exceeds the range value, warning information is prompted, and the prescription is stored.
10. The system according to claim 9, wherein the evaluation module further comprises a step of automatically changing and marking the color of the corresponding column when the limit value is exceeded, until the calculated index limit value is normal according to the inputted parameters of the amount of milk and water, and returning to the normal color.
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| CN113693945A (en) * | 2021-09-01 | 2021-11-26 | 代坤 | Hospital is with intelligent constant temperature alarm device that suckles |
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