CN115331775A - Timeline management system for intravenous fluids - Google Patents

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

Timeline Management System for IV Infusion

technical field

The invention belongs to the technical field of intelligent medical treatment, and in particular relates to a timeline management system for intravenous infusion.

Background technique

In order to ensure the drug safety of inpatients, promote rational drug use, and prevent occupational exposure risks, medical institutions above the second level will establish intravenous drug dispensing centers to centrally allocate intravenous drugs. When infusion therapy is given to patients, there are often multiple sets of infusions for one patient. There are certain rules for which set of infusions to use first and which set to use after the infusion. Time, precise arrangement and allocation of time, but because the number of doctor's orders is very large, and the doctor's orders are often changing, it is difficult to complete only by manual labor.

During the regular inspection of the standby medicines in each ward, it was found that the infusion was retained for longer than the time prescribed by the doctor, and there were even invalid infusions. In response to this situation, the statistics of the infusion doctor's order time and actual use time in each ward were carried out, and the "Ward Area Intravenous Medication Time Survey Form" was used to register. The results showed that most of the reasons for this result were that the patient had too much fluid in a day and The time of the doctor’s prescription is at the same time, so all of them have been delivered to the ward. In addition, some patients temporarily arranged surgery and caused the reason for staying. In addition, it was found that there was only one infusion on the doctor’s order of the day, but the waiting time for medication was long. The urging experience is poor. According to the analysis, it is found that part of the infusion of the patient has been canceled and stopped, and the time of the doctor's order is earlier, and the time of the doctor's order is arranged later, and the infusion cannot be automatically advanced. Therefore, it is necessary to improve the prior art.

Patent document CN109771742A discloses a ward infusion management method and system. The patient is registered before the infusion, and the user's identity information and the infusion medicine prescribed by the doctor are recorded; the user's infusion start time is recorded, and according to the user's infusion volume, According to the bottle specifications and the number of infusion bottles, the system estimates the user's time for each infusion bottle replacement and the total infusion time. By recording the user's infusion information in the system and comparing with big data, the user's infusion completion time is estimated. By monitoring the change of the total volume of the infusion bottle in real time and sending it to the system, the infusion speed is calculated to make the estimation of the infusion time more accurate. When the calculated infusion completion time is reached or the set weight threshold of the infusion bottle is reached, the system will remind the nurse to allow the user to replace the infusion bottle or pull out the needle in time to prevent blood backflow. In this technical solution, it is only applicable to monitor and change the medicine in time or to stop the medicine. In view of the above-mentioned doctor’s prescribed medicine time is at the same time point, the temporary arrangement of the operation leads to the delay of the medicine, and the doctor’s prescribed medicine time is earlier but the medicine has been invalidated. This technical scheme all can not solve.

Contents of the invention

In view of the above, the present invention discloses a time axis management system for intravenous infusion, which dynamically adjusts the infusion time by combining the axis, auxiliary axis, chemotherapy infusion time axis and TPN infusion time axis at the same time, so as to realize the effective and timely administration of infusion drugs. Safe and reliable management.

In order to achieve the purpose of the above invention, the embodiment provides a timeline management system for intravenous infusion, including:

Doctor's order module, used to receive medication order data;

The time axis generation module is used to automatically generate at least one infusion time axis in the main infusion time axis, the auxiliary infusion time axis, the chemotherapy infusion time axis and the TPN infusion time axis according to the drug doctor's order data, drug type, medication frequency, and drug properties. The infusion start time and infusion sequence of each drug are marked on each infusion time axis;

The review module is used to display the generated infusion time axis for the pharmacist to review the infusion time axis according to the medication order data.

Preferably, when the drug type is a high-dose hydration drug, the infusion start time and infusion sequence of these hydration drugs are generated on the secondary infusion time axis, and the infusion time of multiple channels is adopted, which does not affect other infusions Infusion of drugs on timeline.

Preferably, when the drug type is a chemotherapy drug, according to the drug order data generated by the chemotherapy drug template, the chemotherapy pretreatment drug and anti-tumor drug are generated on the chemotherapy infusion time axis, and the anti-tumor drug infusion on the chemotherapy infusion time axis The sequence is determined according to the nature of the antineoplastic drugs, and the drugs on the chemotherapy infusion timeline are infused with separate infusion tubes or PICC tubes, which do not affect the infusion of other drugs.

Preferably, when the drug type is total parenteral nutrition solution, the infusion start time and infusion sequence of these total parenteral nutrition solutions are generated on the TPN infusion time axis, and the central venous infusion is adopted alone, which does not affect Infusion of other medicines.

Preferably, when the drug type is other drugs except high-dose hydration drugs, chemotherapy drugs and total parenteral nutrition solution, these other drugs are generated on the main infusion time axis, and the infusion on the main infusion time axis The order is determined according to the frequency of medication and the nature of the drug.

Preferably, when the infusion sequence is determined according to the frequency of medication and the properties of the drugs, the infusion sequence of the drugs is first sorted with the frequency of medication as the first priority, and then for multiple drugs in the same order, they are re-sorted according to the properties of the drugs to Identify a unique infusion sequence for each drug.

Preferably, the method of determining the infusion start time of the drug includes:

According to the liquid amount of each drug obtained from the medication order data, the ratio of the liquid amount divided by the drip rate is used as the medication duration of each drug, and the infusion start time is determined according to the order of the infusion letter and the medication time.

Preferably, when determining the infusion sequence of the drugs according to the properties of the drugs, the infusion sequence of each type of drugs is determined according to the priority of the drugs recorded in the drug dictionary.

Preferably, when the doctor's order module receives the changed medication order data, the medication order data is revoked, or the patient initiates to receive the doctor's order data, the time axis generation module will recalculate the infusion time axis within the scope of influence, To timely adjust the infusion time of each drug.

Preferably, when the pharmacist reviews the infusion time axis according to the medication order data, when the infusion time axis is determined to be correct, the drug is divided into batches according to the starting point of the medication time of the doctor's order. Each ward.

Compared with the prior art, the beneficial effects of the present invention at least include:

By automatically generating at least one of the main infusion time axis, secondary infusion time axis, chemotherapy infusion time axis, and TPN infusion time axis based on drug order data, drug type, medication frequency, and drug properties, and in each infusion time axis The infusion start time and infusion order of each drug are marked on it to achieve precise deployment and precise medication, improve the efficiency of infusion operation, ensure the stability of drug infusion, and ensure the correctness of the order of medication, so that each infusion It can be applied at the expected time point, ensuring the safety of medication.

At the same time, the overtime retention of drug infusion in the ward has been greatly reduced, and all infusions have been used within the validity period of the drug infusion, and the satisfaction of patients and clinics has been significantly improved. The medication time presented by the intelligent infusion time axis also solves the uneven workload of the intravenous drug dispensing center caused by the time deployment according to the doctor's order, improves the work efficiency of the pharmacist, and lays the foundation for providing more professional pharmaceutical services.

Description of drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the following will briefly introduce the drawings that need to be used in the description of the embodiments or the prior art. Obviously, the accompanying drawings in the following description are only These are some embodiments of the present invention. Those skilled in the art can also obtain other drawings based on these drawings without creative work.

FIG. 1 is a schematic structural diagram of a timeline management system for intravenous infusion provided in an embodiment;

Fig. 2 is the schematic diagram of the infusion label provided by the embodiment;

Figure 3 is a schematic diagram of priorities according to drug properties provided by the embodiment;

Fig. 4 is a schematic diagram of setting the frequency priority of the doctor's order provided by the embodiment;

Fig. 5 is an example diagram of the patient's intravenous infusion doctor's order form provided by the embodiment;

Fig. 6 is an example diagram of an infusion time axis provided by the embodiment.

Detailed ways

In order to make the object, technical solution and advantages of the present invention clearer, the present invention will be further described in detail below in conjunction with the accompanying drawings and embodiments. It should be understood that the specific embodiments described here are only used to explain the present invention, and do not limit the protection scope of the present invention.

Fig. 1 is a schematic structural diagram of a timeline management system for intravenous infusion provided by an embodiment. As shown in Figure 1, the timeline management system provided by the embodiment includes: a doctor's order module, a timeline generation module, and an audit module, wherein the doctor's order module is used to receive medication order data, and the medication order data includes medication category, medication dosage and Medication requires time, etc.

The time axis generation module is used to automatically generate at least one infusion time axis in the main infusion time axis, auxiliary infusion time axis, chemotherapy infusion time axis and TPN infusion time axis according to the drug doctor's order data, drug type, medication frequency, and drug properties, wherein, Each infusion time axis is marked with the infusion start time and infusion sequence of each drug.

For the secondary infusion time axis, it is mainly used for infusion time management of large doses of hydration drugs. Specifically for large doses of hydration drugs, the infusion start time and infusion sequence of these hydration drugs are generated on the auxiliary infusion time axis. In order not to affect the infusion of other drugs on the infusion time axis, multi-channel infusion is adopted time. Among them, hydration drugs are understood as: when using certain special drugs, a large amount of rehydration is given, that is, more liquid and water enter the body to reduce the damage of the drug to the body. For example, in patients receiving cyclophosphamide, in order to prevent bleeding Cystitis usually requires more than 1000ml of "normal saline + sodium bicarbonate for hydration.

In medicine, multi-channel refers to an infusion channel composed of an infusion port, a PICC line, 1 out of 2, and one or more indwelling needles. For example, critically ill patients need to use multiple hydration drugs at the same time due to their condition, and they will be infused through multiple channels at the same time. Chemotherapy patients will be infused with chemotherapy drugs through the infusion port or PICC line, and other drugs will be infused with indwelling needles.

For the chemotherapy infusion time axis, it is mainly used to manage the infusion time of chemotherapy drugs. Specifically for chemotherapy drugs, according to the medication order data generated by the chemotherapy drug template, the generation of chemotherapy pretreatment drugs and anti-tumor drugs is on the chemotherapy infusion time axis, and the anti-tumor drug infusion time is determined according to the drug properties of the anti-tumor drugs The infusion sequence on the axis, in order to affect the infusion of other drugs, the drugs on the chemotherapy infusion time axis are infused with separate infusion tubes or PICC tubes.

In the embodiment, pre-treatment drugs for chemotherapy generally include hormones, antiemetic, anti-allergic, stomach-protecting, cardiotoxicity-reducing, bladder-toxic drugs, and liver-protecting drugs.

For the TPN infusion time axis, it is mainly used for infusion time management of total parenteral nutrition (TPN). Specifically for total parenteral nutrition solutions, the infusion start time and infusion sequence of these total parenteral nutrition solutions are generated on the TPN infusion time axis. In order not to affect the infusion of other drugs, a separate central venous infusion is used.

For the main infusion time axis, it is mainly used for time management of other drugs except high-dose hydration drugs, chemotherapy drugs and total parenteral nutrition solution. Specifically for drugs other than high-dose hydration drugs, chemotherapy drugs, and total parenteral nutrition solutions, these other drugs are generated on the main infusion time axis, and determined on the main infusion time axis according to the frequency of medication and the nature of the drug infusion sequence.

In the embodiment, when the infusion sequence is determined according to the frequency of medication and the properties of the drugs, the infusion sequence of the drugs is first sorted with the frequency of medication as the first priority, and then for multiple drugs in the same order, they are re-sorted according to the properties of the drugs. to determine a unique infusion sequence for each drug.

In the embodiment, when the infusion sequence is determined according to the properties of the drugs, according to the drug dictionary, the priority of the drugs is used to maintain the management of the infusion sequence of the drugs, as shown in Figure 3, so as to determine the drug administration time. For example, if the priority of antibiotics is set to level 1, that of human serum albumin is set to level 2, and that of vitamin B6 is set to level 3, then when a patient has these three drugs at the same time, the antibiotics will be delivered at the infusion time. The front end of the shaft is given priority for deployment, and then the human serum albumin with priority 2 is delivered. The system determines the required infusion time by converting the drop rate of the first two drugs, and obtains the precise infusion time of vitamin B6 with priority 3. points, deployed in advance and delivered to the ward on time.

In the embodiment, when the patient has two medicines with the same priority at the same time point, or a doctor's order for intravenous medicine is issued temporarily, at this time, it is necessary to determine the frequency of these medicines at the infusion time by setting the priority of the doctor's order. The ordering in the axes follows the rules shown in Figure 4.

After determining the order of drug infusion, it is also necessary to determine the start time of drug infusion, including: according to the liquid volume of each drug obtained from the medication order data, the ratio of the liquid volume divided by the drip rate is used as the medication duration of each drug , determine the start time of infusion according to the order of infusion letters and the time of medication.

In the embodiment, the duration of medication is specifically controlled by the drip rate: assuming that the specification of the infusion set used is 20 drops per milliliter, and then the drip rate of the drug infusion is calculated according to the infusion time and volume of the solvent medium required by the drug instructions, such as ceftazidime avibactam , it is clear that the administration method is intravenous infusion for 120 minutes, and the infusion volume is 100ml, then 100ml×20d/ml÷(X)d/min=120 minutes, X≈17 is the instillation speed of the drug, and the infusion Quick maintenance is in the drug system of the intravenous drug compounding center, and it is also reflected in the infusion label, together with the storage requirements. See Figure 2 for an example, which is convenient for referring to the low-speed control in clinical use. By analogy for all intravenous medications, the drip rate is used as the basis of the infusion time axis, which will be used by the system to automatically calculate the infusion time of each infusion, so as to accurately arrange the deployment time of the next infusion.

In the embodiment, when a patient initiates a new request for a doctor's order, or produces a doctor's order change or a doctor's order revocation, after these trigger information is received by the doctor's order module, the timeline generation module will change the infusion timeline within the scope of influence Recalculate to adjust the infusion time of each drug in time. This avoids the situation that when some infusions ordered earlier by the patient are invalidated and stopped, the remaining infusions cannot be allocated and distributed according to the theoretical time in advance, resulting in the patient having to wait for a long time before taking the medicine. Among them, requesting a doctor's order is understood as: the patient asks for leave or goes for an examination, in which case the medication time needs to be modified.

Based on the above time axis management system for intravenous infusion, the control process of the infusion sequence and time of intravenous infusion includes: the doctor issues the medication order→executes the medication order→the system automatically defines the time axis according to the frequency of medication and the nature of the drug Sorting of the time axis → pharmacists review the doctor's order → arrange the packaging and deployment of the doctor's order according to the starting point of the medication time of each doctor's order → deliver to each ward.

Experimental example

In this experimental example, the above-mentioned time axis management system for intravenous infusion is used to realize the precise deployment time of the time axis of intravenous drug infusion. Figure 5 is a doctor's order for intravenous medication of a patient. The patient has 11 infusions a day, 7 of which are ordered at 8:00, and 3 are ordered at 16:00. It will cause a large amount of accumulation, so after applying the intravenous infusion time axis, intelligently redefine the medication time, 7 infusions at 8:00 according to the nature of the drug and the frequency of medication, according to the frequency of medication Q6H>Q8H>Q12H>BID>QD, Q12H Put the piperacillin and tazobactam in the first part, put the bromhexine with BID and priority 1 in the human serum albumin, potassium chloride, polyene phosphatidylcholine in the front, put the glycyrrhizic acid mono Ammonium cysteine and vitamin K1 came next, followed by the second infusion of BID, where the patient's human albumin was invalidated, so the timeline was rearranged to remove the need for this infusion. The infusion time, the subsequent infusion should be advanced accordingly.

After the intelligent infusion administration time of all medicines is determined, the intravenous drug dispensing center will designate batches to print and dispatch the medicine and prepare and deliver the tasks. You can see the timeline in Figure 6. After using the intravenous infusion timeline, the patient's The order of infusion is very clear, the continuity is high, the frequency of medication is BID, and the infusion time interval of Q12H is very precise. At the same time, for clinical nurses, it also solves the problem of which job to get first and which job to get in the usual work, improving work efficiency.

Specifically, the control process of applying the intravenous drug infusion time axis includes: firstly, the doctor issues a medication order, the ward executes the medication order, and the system automatically defines the starting time and medication time of each drug according to the frequency of medication and the nature of the drug. Sorting of the segments, and then the pharmacist reviews the doctor's order, and after passing the review, divides the batches according to the starting point of the medication time of the doctor's order, and the pharmacist issues the deployment doctor's order and packaged doctor's order according to the batch, and finally delivers it to each ward. After regulation, the efficiency and quality of infusion sequence labeling are further guaranteed. The intravenous drug dispensing center uses the above-mentioned system to serve the configuration, packaging and distribution of long-term and temporary intravenous drug orders in all departments of the hospital. All intravenous drugs use the sequence defined by the intravenous drug infusion time axis. Realize the reasonable sorting of all infusions for each inpatient within a day, extend the PIVAS pharmaceutical service from the pre-approval of doctor's orders to the use of finished infusions, standardize the clinical intravenous drug delivery process, and improve the work efficiency of pharmacists and nurses At the same time, the safety and regulatory effectiveness of medication are improved.

The above-mentioned specific embodiments have described the technical solutions and beneficial effects of the present invention in detail. It should be understood that the above-mentioned are only the most preferred embodiments of the present invention, and are not intended to limit the present invention. Any modifications, supplements and equivalent replacements made within the scope shall be included in the protection 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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