CN115331775A - Time axis management system for intravenous infusion - Google Patents
Time axis management system for intravenous infusion 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
- G16H20/10—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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
- A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
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Abstract
The invention discloses a time axis management system for intravenous infusion, which comprises: the medical advice module is used for receiving medicine taking medical advice data; the time axis generation module is used for automatically generating at least one infusion time axis of a main infusion time axis, an auxiliary infusion time axis, a chemotherapy infusion time axis and a TPN infusion time axis according to the medicine medical advice data, the medicine type, the medicine using frequency and the medicine property, and the infusion starting time and the infusion sequence of each medicine are marked on each infusion time axis; and the auditing module is used for displaying the generated infusion time shaft so that a pharmacist can audit the infusion time shaft according to the medication advice data. The system dynamically adjusts the infusion time by simultaneously combining the shaft, the auxiliary shaft, the chemotherapy infusion time shaft and the TPN infusion time shaft so as to realize effective, safe and reliable management of infusion medicines.
Description
Technical Field
The invention belongs to the technical field of intelligent medical treatment, and particularly relates to a time axis management system for intravenous infusion.
Background
For the guarantee inpatient safety of using medicine, promote reasonable using medicine, take precautions against occupational exposure risk, medical institution more than the second grade all can establish vein and use medicine allotment center, it concentrates the allotment to the vein medicine, according to the difference of medicine nature, the infusion after the allotment has new "validity period", when giving the patient through carrying out the infusion treatment, often a patient has the multiunit infusion, to which a set of infusion uses earlier, it all has certain law to use after which a set of infusion, vein is used medicine allotment center according to patient's time of using medicine, the accurate allotment time of arranging, but because the doctor's advice quantity is very huge, and the doctor's advice is often in the change, only rely on the manual work to be difficult to accomplish.
The infusion retention time exceeds the medical advice time and even the ineffective infusion exists in the process of regularly checking the standby medication of each ward. For the situation, by carrying out statistics on the infusion order time and the actual use time of each ward, and using a 'ward vein medication time questionnaire' for registration, the results show that the reasons for the results are that the liquid amount of the patient is too much in one day and the medication time of the orders is the same time point, so that the patient is already delivered to the ward, besides the reason that the patient is temporarily scheduled for operation to cause retention, the patient order list of the patient on the day is only one infusion, but the medication waiting time is long, and the patient urge experience is poor. Based on the analysis, it was found that the patient had a partial infusion that was voided and stopped, with the order of time advanced, and the order of time scheduled for a subsequent infusion, could not be automatically advanced. Therefore, there is a need for improvements in the prior art.
Patent document CN109771742A discloses a ward infusion management method and system, which registers a patient before infusion, records the identity information of a user and infusion medicines issued by a doctor; the infusion starting time of the user is recorded, the system estimates the time for changing the infusion bottle each time and the total infusion time of the user according to the infusion amount, the specification of the infusion bottle and the number of the infusion bottles of the user, the infusion information of the user is recorded in the system, and the infusion finishing time of the user is estimated through big data comparison. The change of the total amount of the infusion bottle is monitored in real time and is transmitted to a system, and the infusion speed is calculated, so that the infusion time is estimated more accurately. After the calculated transfusion completion time is reached or the set transfusion bottle weight threshold value is reached, the system reminds a nurse to enable the user to replace the transfusion bottle or pull the needle of the user in time, and blood backflow of the user is prevented. In the technical scheme, the medical advice medicine taking device is only suitable for monitoring and timely replacing medicines or stopping medicine taking, and the technical scheme cannot solve the problems that the medicine taking time of the medical advice is the same time point, the medicine taking delay is caused by temporary arrangement of an operation, and the medicine taking time of the medical advice is earlier but the medicines are wasted.
Disclosure of Invention
In view of the above, the present invention discloses a time axis management system for intravenous infusion, which dynamically adjusts infusion time by simultaneously combining an axis, a countershaft, a chemotherapy infusion time axis and a TPN infusion time axis to realize effective, safe and reliable management of infusion drugs.
In order to achieve the above object, an embodiment of the present invention provides a timeline management system for intravenous infusion, including:
the medical advice module is used for receiving medication medical advice data;
the time axis generation module is used for automatically generating at least one infusion time axis of a main infusion time axis, an auxiliary infusion time axis, a chemotherapy infusion time axis and a TPN infusion time axis according to the medicine medical advice data, the medicine type, the medicine using frequency and the medicine property, and the infusion starting time and the infusion sequence of each medicine are marked on each infusion time axis;
and the auditing module is used for displaying the generated infusion time axis so that a pharmacist can audit the infusion time axis according to the medication advice data.
Preferably, when the drug type is a high-dose hydration drug, the infusion start time and the infusion sequence of the hydration drugs are generated on the secondary infusion timeline, and the infusion time of the multi-channel is adopted, so that the infusion of the drug on other infusion timelines is not influenced.
Preferably, when the type of the medicine is chemotherapy medicine, the pre-chemotherapy treatment medicine and the anti-tumor medicine are generated on a time axis of chemotherapy infusion according to the medicine-taking medical order data generated by the chemotherapy medicine-taking template, the infusion sequence of the anti-tumor medicine on the time axis of the chemotherapy infusion is determined according to the medicine property of the anti-tumor medicine, and the medicine on the time axis of the chemotherapy infusion is infused by a single infusion tube or a PICC tube without influencing the infusion of other medicines.
Preferably, when the drug type is total parenteral nutrition, the infusion start time and infusion sequence of these total parenteral nutrition are generated on the TPN infusion timeline, and a single central venous infusion is used without affecting the infusion of other drugs.
Preferably, when the drug type is other drugs than large-dose hydration drugs, chemotherapy drugs, and total parenteral nutrition solution, these other drugs are generated on the time axis of main infusion, and the infusion sequence on the time axis of main infusion is determined depending on the administration frequency and drug properties.
Preferably, when the infusion sequence is determined according to the medication frequency and the drug properties, the infusion sequence of the drugs is firstly sequenced by taking the medication frequency as a first priority, and then the multiple drugs in the same sequence are reordered according to the drug properties to determine the unique infusion sequence of each drug.
Preferably, the manner of determining the infusion start time of the drug comprises:
and determining the infusion starting time according to the infusion message sequence and the administration time by taking the ratio of the liquid amount divided by the dropping speed as the administration time of each medicine according to the liquid amount of each medicine obtained from the administration order data.
Preferably, when the infusion order of the medicines is determined according to the medicine properties, the infusion order of each type of medicine is determined according to the medicine priority recorded in the medicine dictionary.
Preferably, when the order module receives the changed medication order data, the medication order data is cancelled, or the patient initiates order data to be asked, the time axis generation module recalculates the infusion time axis within the influence range, and adjusts the infusion time of each drug in time.
Preferably, when the pharmacist checks the infusion time axis according to the medication order data and determines that the infusion time axis is correct, the pharmacist divides the medicines into batches according to the medication time starting point of the order, and issues the order and packages the order according to the batches to finally reach each ward.
Compared with the prior art, the invention has the beneficial effects that at least:
through according to medicine doctor's advice data, the medicine type, the frequency of using medicine, medicine nature automatic generation owner infuses time axis, vice infusion time axis, at least one infusion time axis in chemotherapy infusion time axis and the TPN infusion time axis, and the infusion initial time and the infusion order of each medicine of mark on every infusion time axis, realize accurate allotment and accurate medicine, infusion operating efficiency has been promoted, the stability of medicine infusion has been ensured, the exactness of order of using medicine has been ensured, make each infusion can both be used at the anticipated time point, the safety of using medicine has been ensured.
Meanwhile, the overtime retention condition of the medicine infusion in the ward is greatly reduced, all the infusions are used in the effective period of the medicine infusion, and the satisfaction of patients and clinic is obviously improved. The time of using medicine that the infusion time axis of intelligence appears has also solved simultaneously according to the inhomogeneous of the intravenous route allocation of medicines center work load that medical advice time allotment caused, has improved pharmacist's work efficiency, has laid the basis for providing more professional pharmacy service.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to these drawings without creative efforts.
FIG. 1 is a schematic diagram of a timeline management system for intravenous infusion according to an embodiment;
FIG. 2 is a schematic view of an infusion label provided by an embodiment;
FIG. 3 is a schematic diagram of the priority according to the property of the medicine provided by the embodiment;
FIG. 4 is a schematic diagram illustrating the setting of order frequency priority provided by the embodiment;
FIG. 5 is a chart illustrating an example of an order for intravenous infusion of a patient provided by the embodiment;
FIG. 6 is a diagram illustrating an exemplary infusion timeline provided in accordance with an embodiment.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention will be further described in detail with reference to the accompanying drawings and examples. It should be understood that the detailed description and specific examples, while indicating the scope of the invention, are intended for purposes of illustration only and are not intended to limit the scope of the invention.
Fig. 1 is a schematic configuration diagram of a timeline management system for intravenous infusion according to an embodiment. As shown in fig. 1, the timeline management system according to the embodiment includes: the system comprises a medical advice module, a time axis generation module and an auditing module, wherein the medical advice module is used for receiving medication medical advice data, and the medication medical advice data comprises medication categories, medication doses, medication requirement time and the like.
The time axis generation module is used for automatically generating at least one infusion time axis of a main infusion time axis, an auxiliary infusion time axis, a chemotherapy infusion time axis and a TPN infusion time axis according to the medicine medical advice data, the medicine type, the medicine using frequency and the medicine property, wherein the infusion starting time and the infusion sequence of each medicine are marked on each infusion time axis.
The sub-infusion timeline is mainly used for infusion time management of large-dose hydration medicaments. Specifically, when a large amount of hydration medicaments are used, the infusion starting time and the infusion sequence of the hydration medicaments are generated on the auxiliary infusion time axis, and the infusion time of multiple paths is adopted for not influencing the infusion of the medicaments on other infusion time axes. Wherein, the hydration drug is understood as: when some special medicines are used, a large amount of fluid replacement is given, namely, more fluid and water enter the body, so as to reduce the damage of the medicine to the body, for example, patients who use cyclophosphamide generally need to hydrate more than 1000ml of' normal saline + sodium bicarbonate in order to prevent hemorrhagic cystitis.
In medicine, the multichannel refers to infusion port, PICC pipeline, 2 select 1, with one or more indwelling needles, the infusion route of constitution. For example: the critical patients need multiple hydration medicaments for simultaneous use due to disease conditions, and can adopt multi-channel simultaneous infusion, chemotherapy medicament infusion in a chemotherapy patient infusion port or a PICC pipeline, and other medicaments infused by an indwelling needle.
The time line of chemotherapy infusion is mainly used for managing the infusion time of chemotherapy drugs. Specifically, when chemotherapy drugs are treated, the pretreatment drugs and the anti-tumor drugs are generated on a chemotherapy infusion time axis according to the medication advice data generated by the chemotherapy drug template, the infusion sequence of the anti-tumor drugs on the chemotherapy infusion time axis is determined according to the drug properties of the anti-tumor drugs, and in order to influence the infusion of other drugs, the drugs on the chemotherapy infusion time axis are infused by a single infusion tube or a PICC tube.
In the examples, the chemotherapy pretreatment drugs generally include hormones, antiemetic, antiallergic, stomach-protecting, cardiotoxicity-reducing, bladder-toxicity-reducing drugs, liver-protecting drugs, and the like.
The TPN infusion time axis is mainly used for managing infusion time of Total Parenteral Nutrition (TPN). Specifically for total parenteral nutrition, the infusion start time and the infusion sequence of the total parenteral nutrition are generated on the time axis of TPN infusion, and single central venous infusion is adopted in order not to influence the infusion of other medicines.
The time axis of the main transfusion is mainly used for time management of other medicines except large-dose hydration medicines, chemotherapy medicines and total parenteral nutrient solution. Specifically, when other drugs except large-dose hydration drugs, chemotherapy drugs and total parenteral nutrition liquid are taken, the other drugs are generated on the time axis of the main transfusion, and the transfusion sequence on the time axis of the main transfusion is determined according to the medicine taking frequency and the medicine properties.
In the embodiment, when the infusion sequence is determined according to the medication frequency and the drug property, the infusion sequence of the drugs is firstly sequenced by taking the medication frequency as a first priority, and then the multiple drugs in the same sequence are reordered according to the drug property to determine the unique infusion sequence of each drug.
In the embodiment, when the infusion sequence is determined according to the drug property, the drug administration time is determined by maintaining the infusion sequence management of the drug according to the drug dictionary and by using the priority of the drug, as shown in fig. 3. For example, the priority of antibiotics is set to 1 level, the priority of human serum albumin is set to 2 level, and vitamin B6 is set to 3 level, so when a patient has the three types of medical orders in the same time period, the antibiotics are preferentially allocated at the front end of the infusion time axis, then the human serum albumin with the priority of 2 level is delivered, the system determines the required infusion time through the conversion of the dropping speeds of the first two types of medicines, the accurate infusion time point of the vitamin B6 with the priority of 3 level is obtained, and the antibiotics are allocated in advance and delivered to a ward on time.
In an embodiment, when the patient has two drugs with the same priority at the same time point or has been ordered for intravenous medication temporarily, the order of the drugs in the infusion timeline needs to be determined by the frequency priority setting of the orders, according to the rule shown in fig. 4.
After the infusion sequence of the medicines is determined, the infusion starting time of the medicines needs to be determined, and the method comprises the following steps: and according to the liquid amount of each medicine obtained from the medication order data, taking the ratio of the liquid amount divided by the dropping speed as the medication time length of each medicine, and determining the infusion starting time according to the infusion information sequence and the medication time.
In the examples, the duration of the administration is specifically controlled by the drop rate: assuming that the specification of the used infusion apparatus is 20 drops per milliliter, then the dropping speed of the drug infusion is calculated according to the infusion time and the solvent volume required by the drug specification, for example, ceftazidime, the definite administration mode is intravenous infusion for 120 minutes, the infusion volume is 100ml, then 100ml multiplied by 20d/ml divided by (X) d/min =120 minutes, and X & lt 17 & gt is obtained as the dropping speed of the drug, and the dropping speed is maintained in a drug system of an intravenous drug dispensing center and is reflected on an infusion label at the same time together with the storage requirement. The example is shown in fig. 2, which facilitates the control of low speed for clinical use. By analogy, the dropping speed is used as the basis of the infusion time axis, and the system can automatically calculate the infusion time of each infusion so as to accurately schedule the allocation time of the next infusion.
In an embodiment, when a patient newly initiates an order to be asked, or generates order change and order cancellation, and the trigger information is received by the order module, the time axis generation module recalculates the infusion time axis within the influence range, and adjusts the infusion time of each drug in time. Therefore, the situation that after the patient has a part of the transfusion with the front medical advice time to be discarded and stopped, the rest transfusion can not be prepared and delivered in advance according to the theoretical time, and the patient can wait for a long time to take the medicine is avoided. Wherein, please get the medical order to understand as: the patient is asked to leave or go to examination, in which case the medication time needs to be modified.
Based on the time axis management system for intravenous infusion, the realized control process of the infusion sequence and time of the intravenous infusion comprises the following steps: doctor orders the prescription → executes the prescription → system automatically defines and sorts the time axes according to the frequency of medication and the nature of the medicine → pharmacist reviews the prescription → arranges the packing and allocation of the prescription according to the time starting point of medication of each prescription → delivery to each ward.
Examples of the experiments
The experimental example is to use the time axis management system for intravenous infusion to realize accurate time allocation of the time axis of intravenous medication infusion. Fig. 5 is an intravenous medication order for a patient who has 11 infusions a day, with 7 ordered times of 8: the medication time of 00,3 orders is 16:00, if uniformly dispensed according to the order time, then a large amount of pile up will result, so after applying the iv line time, the administration time is redefined intelligently, 7 parts 8:00 infusion according to the drug property and the frequency of administration, according to the frequency of administration Q6H > Q8H > Q12H > BID > QD, piperacillin tazobactam of Q12H is put in the first part, bromhexine with BID and priority 1 is put in human serum albumin, potassium chloride and polyene phosphatidyl choline, monoammonium glycyrrhizinate cysteine and vitamin K1 are put in the front part, and then the second infusion of BID is carried out, wherein the condition that one part of human serum albumin of the patient is wasted occurs, so that the time axis is rearranged, the infusion time required by the infusion is eliminated, and the subsequent infusion is correspondingly advanced.
After the intelligent transfusion medication time of all the medicines is determined, the intravenous medication allocation center performs printing, medicine discharging, allocation and delivery tasks in batches according to the determined intelligent transfusion medication time, the time axis of fig. 6 can be seen, and after the intravenous transfusion time axis is used, the transfusion sequence of the patient is very clear, the continuity is high, the medication frequency is BID, and the transfusion time interval of Q12H is very accurate. Meanwhile, for clinical nursing staff, the trouble that the patient hangs the patient at ordinary times and hangs the patient at other times is solved, and the working efficiency is improved.
Specifically, the regulation and control process applying the intravenous medication and infusion time axis comprises the following steps: the system automatically defines the starting time of each medicine and orders the medicine using time periods according to the medicine using frequency and the medicine property, the doctor reviews the medical advice after reviewing, the pharmacist divides batches according to the starting point of the medicine using time of the medical advice after reviewing, the pharmacist issues the allocation medical advice and packs the medical advice according to the batches, and finally the allocation medical advice and the packing medical advice are delivered to each ward. After the regulation and control, the efficiency and the quality of infusion sequence marking are further ensured. The intravenous medication allocation center utilizes the system to serve the configuration and the packing and distribution of long-term and temporary intravenous medication orders of departments in the universities, and all intravenous medications are defined by an intravenous medication infusion time shaft. The infusion device has the advantages that all infusion of each inpatient in one day is reasonably sequenced, PIVAS pharmaceutical service is extended to a finished product infusion using link from a doctor's advice preposition examining and verifying link, the clinical intravenous medication and administration process is standardized, and medication safety and regulation effectiveness are improved while the working efficiency of pharmacists and nursing staff is improved.
The above-mentioned embodiments are intended to illustrate the technical solutions and advantages of the present invention, and it should be understood that the above-mentioned embodiments are only the most preferred embodiments of the present invention, and are not intended to limit the present invention, and any modifications, additions, equivalents, etc. made within the scope of the principles of the present invention should be included in the scope of the present invention.
Claims (10)
1. A timeline management system for intravenous infusion, comprising:
the medical advice module is used for receiving medicine taking medical advice data;
the time axis generation module is used for automatically generating at least one infusion time axis of a main infusion time axis, an auxiliary infusion time axis, a chemotherapy infusion time axis and a TPN infusion time axis according to the medicine medical advice data, the medicine type, the medicine using frequency and the medicine property, and the infusion starting time and the infusion sequence of each medicine are marked on each infusion time axis;
and the auditing module is used for displaying the generated infusion time axis so that a pharmacist can audit the infusion time axis according to the medication advice data.
2. The timeline management system for intravenous infusion of claim 1, wherein when the medication type is bolus hydration medication, infusion start times and infusion sequences of the hydration medications are generated on the secondary infusion timeline, and infusion times of multiple paths are used without affecting infusion of medications on other infusion timelines.
3. The timeline management system for intravenous infusion according to claim 1, wherein when the type of drug is chemotherapy drug, pre-chemotherapy treatment drug and anti-tumor drug are generated on a chemotherapy infusion timeline according to the drug administration order data generated by the chemotherapy drug administration template, the infusion sequence of the anti-tumor drug on the chemotherapy infusion timeline is determined according to the drug property of the anti-tumor drug, and the drugs on the chemotherapy infusion timeline are infused by a single infusion tube or a PICC tube without affecting the infusion of other drugs.
4. The timeline management system for intravenous infusion of claim 1, where when the drug type is total parenteral nutrition solution, infusion start times and infusion sequences for the total parenteral nutrition solution are generated on the TPN infusion timeline, and a single central venous infusion is used without affecting the infusion of other drugs.
5. The timeline management system for intravenous infusion of claim 1, wherein when the drug type is other drugs than bolus hydration drug, chemotherapy drug, and total parenteral nutrition, the other drugs are generated on the main infusion timeline, and the infusion sequence on the main infusion timeline is determined according to the frequency of administration and the drug properties.
6. The timeline management system for intravenous infusion according to claim 5, wherein when determining the infusion order according to the medication frequency and the drug properties, the infusion order of drugs is first ordered with the medication frequency as a first priority and then reordered according to the drug properties for multiple drugs in the same order to determine a unique infusion order for each drug.
7. The timeline management system for intravenous infusion of claim 1-6, wherein the manner of determining an infusion start time for a medication comprises:
and determining the infusion starting time according to the infusion message sequence and the administration time by taking the ratio of the liquid amount divided by the dropping speed as the administration time of each medicine according to the liquid amount of each medicine obtained from the administration order data.
8. The timeline management system for intravenous infusion according to claim 3 or 5, wherein when determining the infusion order of drugs according to the drug properties, the infusion order of each type of drug is determined according to the drug priority recorded in the drug dictionary.
9. The timeline management system for intravenous infusion of claim 1, wherein the timeline generation module recalculates the infusion timeline for the range of influence and adjusts the infusion times for each medication when the order module receives the changed medication order data, the medication order data is cancelled, or patient initiated request order data.
10. The timeline management system for intravenous infusion of claim 1, wherein a pharmacist checks the infusion timeline according to medication order data, when the infusion timeline is determined to be correct, batches of medication are divided according to the medication time starting point of the order, and the pharmacist issues a preparation order and a packaging order in batches for final delivery to each ward.
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