JP2004208842A - Prescription filling support system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a prescription support system which automatically determines a preparation process for preparing one or more kinds of medicines in order to prepare an injection medicine, reduces load for determining the preparation process and enhances the efficiency of preparation work. <P>SOLUTION: A master data base DB2, an injection prescription data base DB4, a preparation pattern memory means M1 and a preparation process determining means M2 are provided. The preparation process determining means M2 determines the preparation process for preparing one or more kinds of medicines administered to a patient on the basis of injection prescription data being the prescription data of a prescription to each patient read from the injection prescription data base DB4, the data read from the master data base DB2 with respect to a medicine to be administered among injection prescription data and the data of the preparation pattern stored in the preparation pattern memory means M1. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

尚、払出量（２Ｖ、５Ｖ、１本、１本）等は、本願特徴部分である調剤手順解析決定処理において自動的に算出（確認）される。また、注射用エンドキサン５００ｍｇＶの必要量；５０ｍＬ、注射用エンドキサン１００ｍｇＶの必要量；２２．５ｍＬ、総液量；５７２．５ｍＬ は自動的に算出される。
【００５８】
処方例１の場合、次のように１０ステップからなる調剤手順が決定される。
（１）バーコードラベル２３を支給容器であるソリタＴ３号の容器に貼付ける。
（２）ソリタＴ３号の容器の初期重量を測定する。
（３）注射用エンドキサン；５００ｍｇが夫々入った２本のバイアルの初期の総重量を測定する。
（４）注射用エンドキサン；５００ｍｇが入った各バイアルの中に溶解剤；２５ｍＬ を入れて注射用エンドキサンを溶解する。
（５）注射用エンドキサン；５００ｍｇの溶液が入った各バイアルの重量を測定する。
【００５９】
（６）注射用エンドキサン；１００ｍｇが夫々入った５本のバイアルの総重量を測定する。
（７）注射用エンドキサン；１００ｍｇが入った各バイアルの中に溶解剤；５ｍＬを入れて注射用エンドキサンを溶解する。
（８）注射用エンドキサン；１００ｍｇの溶液が入った各バイアルの重量を測定する。
（９）溶解した注射用エンドキサン；５００ｍｇ／Ｖと溶解した注射用エンドキサン；１００ｍｇ／Ｖのエンドキサン溶液の溶解濃度を元に計算された必要量７２．５ｍＬをソリタＴ３号に混注する。
（１０）薬剤を収容した調剤後のソリタＴ３号の容器の最終重量を測定する。
【００６０】
ここで、前記必要量の計算について説明する。
この必要量の計算については、結局、オーダ値が規格量の倍数でない固形抗癌剤を使用して調剤する際に、その固形抗癌剤をオーダ値だけ支給容器に混注させるために行う為の計算である。
【００６１】
例えば、処方例１の場合、オーダされた注射用エンドキサン５００ｍｇＶ→１０００ｍｇは、１Ｖ（バイアル）につき５００ｍｇ 収容された規格品を２Ｖ（５００ｍｇ ×２＝１０００ｍｇ）使用してオーダ値（１０００ｍｇ）と一致するが、オーダされた注射用エンドキサン１００ｍｇＶ→４５０ｍｇ は、１Ｖ（バイアル）につき１００ｍｇ 収容された規格品を５Ｖ（１００ｍｇ ×５＝５００ｍｇ ）使用することになりオーダ値（４５０ｍｇ ）をオーバーする。
【００６２】
ところで、注射用エンドキサンを溶解させた際の濃度は、マスターデータにより ２０ｍｇ／ｍＬと決定されており、そのために、注射用エンドキサン５００ｍｇ 、注射用エンドキサン１００ｍｇ を夫々溶解させる為の溶解剤の量も決定されるのであるが、この濃度２０ｍｇ／ｍＬ を用いて、注射用エンドキサン１０００ｍｇと４５０ｍｇ ； 合計１４５０ｍｇ（オーダー値）の成分が入った注射用エンドキサン溶液（これが必要量である）は、１０００ｍｇ÷２０ｍｇ／ｍＬ ＋４５０ｍｇ ÷２０ｍｇ／ｍＬ の計算式から求めて７２．５ｍＬとなる。以上の計算は、調剤手順決定の際に自動的に行われるものである。
【００６３】
以上のように決定された処方例１の複数ステップ（上記１〜１０ステップ）からなる調剤手順は、支給容器の初期重量を測定するステップ、薬剤を収容した調剤後の支給容器の最終重量を測定するステップを含んでいる。このようなステップは、処方例２〜１３の複数ステップからなる調剤手順にも含まれている。こうして、支給容器に最終的に混注された薬剤、溶解液、希釈液の重量を確実に測定できるようになる。
【００６４】
処方例１の複数ステップからなる調剤手順は、固形抗ガン剤（固形薬剤）が有る（使用する）ので、固形抗ガン剤を溶解させる前に固形薬剤を収容した収容器の重量を測定するステップ、この収容器に溶解剤又は希釈液を入れて固形薬剤を溶解するステップ、固形薬剤の溶解後に収容器の重量を測定するステップ、更に、収容器に希釈液又は溶解剤を入れて溶解させた固形薬剤溶液の中の必要量を支給容器に混注するステップを含んでいる。このようなステップは、処方例２〜５，９，１１〜１３の複数ステップからなる調剤手順にも含まれている。こうして、固形薬剤を溶解させるために収容器に入れた希釈液又は溶解液の重量を確実に測定でき、固形薬剤溶液の必要量を支給容器に確実に混注できるようになる。
【００６５】
尚、処方例１の複数ステップからなる調剤手順は、収容器に収容した薬剤（固形薬剤溶液）を支給容器へ混注する前後に、その収容器の重量を測定するステップを含むようにしてもよい。但し、収容器に収容した薬剤を支給容器へ混注する前に、その収容器の重量を測定するステップについては、固形薬剤が有る（使用する）場合（処方例１の場合もそうである）、前記した固形薬剤の溶解後に収容器の重量を測定するステップと同じになる。このようなステップは、処方例２〜１３の複数ステップからなる調剤手順にも含まれようにしてもよい。こうして、収容器に収容した薬剤の中から、支給容器へ混注した薬剤を含む重量を確実に測定できるようになる。
【００６６】
また、処方例４，５，１１，１３のように、支給容器に収容されている希釈液が固形薬剤を溶解する溶解剤となり得る場合、この処方例４，５，１１，１３の複数ステップからなる調剤手順は、その溶解剤で固形薬剤を溶解した直後に支給容器の重量を測定するステップを含むものとなる。こうして、支給容器に収容されている希釈液の中から、溶解剤として固形薬剤を溶解させるため使用した重量を確実に測定できるようになる。
【００６７】
さて、決定された複数ステップからなる調剤手順は、図９に示すように、図表の形態にてプリンタ４ａにより印紙出力され、調剤手順書２１の調剤手順欄に絵と文字とで説明した形で印刷される。この調剤手順書２１には、調剤手順欄の他に、実施日、患者ＩＤ、患者名、病棟名（病室を含む）、医師名、発行日、調製日、生年月日、連絡番号、定時又は臨時、処方内容、臨床検査値等が記録され、また、バーコードも記録されている。
【００６８】
また、決定された複数ステップからなる調剤手順は、図１０、図１１に示すように、パソコン６（４、５）のディスプレイ６ｂにも表示される。図１０は調剤手順ステップ一部表示画面であり、図１１は調剤手順ステップ一覧表示画面である。ディスプレイ６ｂの表面にはタッチパネルが設けられ、このタッチパネルを介して画面操作等の各種操作を実行できる。尚、画面操作等の各種操作については、バーコードの読み取りにより実行可能にしてもよいし、一般的なキーボードやマウスを操作して実行可能にしてもよい。
【００６９】
さて、図１０の調剤手順ステップ一部表示画面と図１１の調剤手順ステップ一覧表示画面は切り換え可能であり、例えば、ディスプレイ６ｂに図１０の調剤手順ステップ一部表示画面が表示されている場合、「手順一覧」に対応するタッチパネル部分をタッチすることにより、図１１の調剤手順ステップ一覧表示画面に切換えることができ、ディスプレイに図１１の調剤手順一覧ステップ表示画面が表示されている場合、「戻る」に対応するタッチパネル部分をタッチすることにより、図１０の調剤手順ステップ一部表示画面に切換えることができる。
【００７０】
図１０、図１１の画面には、調剤手順の他には、作業者名と、基本患者情報としての、患者ＩＤ、診療科名、実施日、連絡番号、ＲＰ番号、患者氏名等が共通に表示される。そして、図１０の調剤手順ステップ一部表示画面では、複数ステップのうちの処理中のステップを含む５つのステップが表示される。所定のタッチ操作等によりステップ表示を上下にスクロールさせ、表示させる５つのステップを自由に変更することもできる。
【００７１】
このパソコン６においては、バーコードリーダ５ｂで調剤手順書２１のバーコードを読み取ることで、対応する調剤手順の表示データに基づいて、図１０、図１１の画面が表示されるが、この段階で、この調剤手順に含まれる重量測定ステップにおける重量値測定の入力が可能な状態となる。図１０の画面が表示されている状態で、「処理中」が表示された右側のステップが重量測定待ちとなるステップであり、その前（上）の重量測定ステップは既に完了したことになり、これら重量測定ステップ間のステップの左側に「直前」が表示される。
【００７２】
そして、重量値測定が行われた後、手動又は自動でその重力測定値が入力されて、その重量測定ステップが完了したこととなり、次の重量測定ステップの左側に「処理中」が表示され、そのステップが重量測定待ちとなる。尚、「処理中」のステップ、「処理中」の前のステップ、「処理中」の後のステップが３つに色分けした状態で表示されて区別できるようになっている。
【００７３】
図１１の調剤手順ステップ一覧表示画面では、複数ステップの全てが一覧表示される。この画面では、「処理中」の前のステップ、「処理中」を含むその後のステップが２つに色分けした状態で表示されて区別できるようになっている。但し、図１０の画面同様に、「処理中」、「直前」等を表示して、作業状況等をわかり易くした表示としてもよい。尚、前記複数ステップからなる調剤手順を、図表の形態にてディスプレイに表示出力可能に構成してもよい。このディスプレイに表示された調剤手順を見て調剤作業を行うことが可能になる。調剤手順を図形の形態にて表示出力するので、その調剤手順を把握し易くなる。
【００７４】
ところで、図１０、図１１の画面の調剤手順内容については、「ステップ」、「作業元」、「容量／状態」、「作業先」、「形状」、「作業」、「対称本数」、「重量」、「再測可能」の欄があり、各ステップには各欄に対応する文字や数値が表示され（表示されないところもある）、これを見て調剤手順を把握することが可能である。例えば、７ ／１０のステップでは、注射用蒸留水を５ｍＬ、注射用エンドキサン１００ｍｇ の容器に入れて、注射用エンドキサン１００ｍｇ を溶解させ、これを ５Ｖ分行うという手順を把握することができる。
【００７５】
次に、［薬品管理室］のパソコン４が行う処理について図１２〜図１４のフローチャート（但し、フローチャート中のＳｉ（ｉ＝１、２、３・・・））は各ステップを示す）に基づいて説明する。尚、この処理を実行する為のプログラムが、パソコン４のＲＯＭ又はハードディスク等の記憶媒体に格納されているものとする。
【００７６】
先ず、注射処方データが読み込まれると（Ｓ１）、その注射処方データが、臨時・外来処方データか或いは定時処方データかの何方かに振分けられ（Ｓ２）、その後、読み込まれた各注射処方データについて処方チェックが行われる（Ｓ３）。主にＳ３の処方チェックでＮＧとなった場合に、処方変更入力（処方中止）が行われる（Ｓ４）。
【００７７】
次に、処方チェックでＯＫとなった剤注射処方データが複数有る場合、これら剤注射処方データが所定の順番（例えば、施用時間が早い順）となるように並び替えられると共に、その順番に従って各注射処方データ毎に、その注射処方データの調剤手順の解析決定処理（Ｓ５）が実行される。
【００７８】
ここで、調剤手順の解析決定処理について、図１３、図１４のフローチャート（但し、フローチャート中のＳｉ（ｉ＝２０、２１、２２・・・）は各ステップを示す）に基づいて詳細に説明する。
図１３に示すように、この調剤手順の解析決定処理が開始されると、注射処方データと、その注射処方データに対する薬品のマスターデータとに基づいて、抗ガン剤が決定され（Ｓ２０）、このＳ２０では、抗ガン剤が固形か液状かの区別が行われ、抗ガン剤が複数の場合はこれら抗ガン剤の併用禁忌チェックが行われ、抗ガン剤が収容された収容器の払出し量（アンプルやバイアル等の数）が計算され、抗ガン剤が未検出時はエラーとなる。
【００７９】
次に、溶解剤が決定され（Ｓ２１）、このＳ２１では、溶解剤があれば、溶解対象の固形抗ガン剤の存在がチェックされ、その溶解剤の固形抗ガン剤に対する使用が許可されているかチェックされ、溶解液の量が十分かチェックされ、溶解剤が収容された収容器の払出し量（アンプルやバイアル等の数）が計算される。
【００８０】
次に、希釈液が決定され（Ｓ２２）、このＳ２２では、希釈液と抗ガン剤との配合可否がチェックされ、同時に溶解剤として使用する場合は量が十分かチェックされ、希釈液容器の混注可能量が十分かチェックされ、希釈液が収容された収容器の払出し量が計算され、希釈液がなければエラーとなる。
【００８１】
次に、支給容器が決定され（Ｓ２３）、このＳ２３では、基本的に、希釈液を収容した収容器が支給容器として決定されるが、支給容器として使用不可で登録されている場合は注射器（筒）や輸液バッグが使用され、希釈液を収容した収容器が複数ある場合は、支給容器として輸液バッグが決定される。注射器の場合は、混注液量により、自動的に適正注射器サイズ（１０ｍＬ，２０ｍＬ，５０ｍＬ）が判断されそのサイズの注射器が決定される。
【００８２】
この後、支給容器へバーコードラベル２３の貼り付けの指示情報が作成され（Ｓ２４）、次に、支給容器の重量測定の指示情報が作成され（Ｓ２５）、次に、固形抗ガン薬が有るか否か判定される（Ｓ２６）。そこで、固形抗ガン剤が有る場合（Ｓ２６；Ｙｅｓ ）、溶解前の固形抗ガン薬（固形抗ガン剤が入っている容器）の重量測定の指示情報が作成される（Ｓ２７）。
【００８３】
その後、溶解剤あるいは希釈液で固形抗ガン剤の溶解の指示情報が作成され（Ｓ２８）、次に、固形抗ガン剤の溶解後の（抗ガン剤が入っている容器）の重量測定の指示情報が作成される（Ｓ２９）。尚、溶解して作られた抗ガン剤の溶液の体積（つまり、溶解液の濃度）が、予め設定された容量決定テーブルを用いて演算される。
【００８４】
次に、固形抗ガン剤溶解のために支給容器の希釈液を溶解剤として使用するか否か判定され（Ｓ３０）。そこで、支給容器の希釈液を溶解剤として使用する場合には（Ｓ３０；Ｙｅｓ ）、支給容器の重量測定の指示情報が作成され（Ｓ３１）、Ｓ２６へリターンし、支給容器の希釈液を溶解剤として使用しない場合には（Ｓ３０；Ｎｏ）Ｓ２６へリターンする。ここで、Ｓ２６において、固形抗ガン剤が有る場合に、その後Ｓ２７以降が実行されて、Ｓ２６へリターンした場合、その固形抗ガン剤は無いものとみなされ再度Ｓ２７以降は実行されない。但し、他の固形抗ガン剤がある場合には、その他の固形抗ガン剤に対してＳ２７以降が再度実行される。
【００８５】
次に、固形抗ガン剤が無い場合（Ｓ２６；Ｎｏ）、図１４に示すように、液状抗ガン剤が有るか否か判定される（Ｓ３２）。そこで、液状抗ガン剤が有る場合（Ｓ３２；Ｙｅｓ ）、液状抗ガン剤を支給容器への混注の指示情報が作成され（Ｓ３３）、次に、液状抗ガン剤を支給容器へ混注した後の支給容器の重量測定の指示情報が作成され（Ｓ３４）、Ｓ３２へリターンする。ここで、Ｓ３２において、液状抗ガン剤が有る場合に、その後Ｓ３３以降が実行されて、Ｓ３２へリターンした場合、その液状抗ガン剤は無いものとみなされＳ３３以降は再度実行されない。
【００８６】
次に、液状抗ガン剤が無い場合（Ｓ３２；Ｙｅｓ ）、支給容器以外の収容器に溶解した固形抗ガン剤（溶液）があるか否か、即ち、Ｓ２８が実行されたか否か判定される（Ｓ３５）。Ｓ３５において、溶解した固形抗ガン剤があると判定された場合（Ｓ３５；Ｙｅｓ ）、溶解した固形抗ガン剤（溶液）を支給容器へ混注の指示情報が作成され（Ｓ３６）、次に、固形抗ガン剤（溶液）を混注した後の指示容器の重量測定の指示情報が作成され（Ｓ３７）、Ｓ３５へリーンする。
【００８７】
Ｓ３５において、固形抗ガン剤（溶液）が有る場合に、その後Ｓ３６以降が実行されて、Ｓ３５へリターンした場合、その固形抗ガン剤（溶液）は無いものとみなされる。但し、他の固形抗ガン剤（溶液）が有る場合には、その他の固形抗ガン剤（溶液）に対してＳ３６以降が再度実行される。そして、固形抗ガン剤が無い場合（Ｓ３５；Ｎｏ）、終了する。
【００８８】
こうして、患者に施用される複数種の薬剤を調剤する、調剤パターンが調剤パターン１〜８の何れかに決定され、その調剤パターンのデータと、注射処方データと、注射処方データのうちの施用対象の薬剤についてマスターデータベースＤＢ１から読み出すマスターデータとに基づいて、患者に施用される複数種の薬剤を調剤する具体的に調剤手順が決定され、その調剤手順データが作成される。その調剤手順データはパソコン６のハードディスク等に格納される。
【００８９】
ここで、調剤手順データについて、処方例１の場合を具体例として説明する。図１９に示すように、調剤手順データは、調製行番（１〜１０）データと、その調製行番データに対応する手順内容データとからなる。手順内容データは、作業元に含まれる作業元薬品行番と作業元区分（１；薬品名、２；溶解液）と作業元名称と、容量／状態に含まれる容量状態区分（１；溶解液量、２；混注溶液、３；混注前、４；混注後、５；溶解前、６；溶解後、７；溶解直後、８；吸引後、９；抜取り後）と容量と状態名称のデータを有する。
【００９０】
また、手順内容データは、作業先に含まれる作業先薬品行番と作業先名称と、形状に含まれる形状区分（１；容器、２；支給容器）と形状名称と、作業に含まれる作業区分（１；バーコード貼り付け、２；重量測定、３；溶解、４；混注、５；混注＋フィルタ、６；一部抜き取り、７；吸引）と作業名称と、対称本数とのデータを有し、重量測定値を対応付けて記録可能となっている。こうした形の調剤手順データが作成されることになる。
【００９１】
次に、Ｓ５の処理の後、図１２に示すように、薬品ピッキングデータが作成されて（Ｓ６）、その薬品ピッキングデータが薬品ピッキング装置１０に送信出力される（Ｓ７）。次に、注射処方箋２５，２６の印字が行われ（Ｓ８）、調剤手順書２１、薬袋ラベル２２の印字が行われる（Ｓ９）。更に、統計・履歴データが作成され（Ｓ１０）、注射処方データが作成され（Ｓ１１）、各種統計資料が印字され（Ｓ１２）、監査データが作成されて（Ｓ１３）、終了する。
【００９２】
［無菌調剤室］のパソコン６が行う処理について図１５のフローチャート（但し、フローチャート中のＳｉ（ｉ＝４０、４１、４２・・・））は各ステップを示す）に基づいて説明する。尚、この処理を実行する為のプログラムが、パソコン６のＲＯＭ又はハードディスク等の記憶媒体に格納されているものとする。
【００９３】
［無菌調剤室］に持ち込まれた調剤手順書２１のバーコードがバーコードリーダ６ａで読み取られると（Ｓ４０）、この調剤手順書２１に対応する調剤手順データが読み込まれる（Ｓ４１）。そして、この調剤手順データに基づいて、ディスプレイに図１０、図１１の調剤手順画面が切換え可能に表示され（Ｓ４２）、調剤処理が行われる（Ｓ４３）。薬剤師等は、調剤手順書２１やパソコン４の調剤手順画面を見て調剤作業を行うことになる。
【００９４】
Ｓ４３の調剤処理では、キーボードやマウスを操作することにより或いは自動で、調剤手順のステップ表示の切換えや、重量測定時には重量値入力が行われる。尚、この重量値入力については、無菌室の特性上タッチパネルの操作で可能に構成することが望ましい。入力された重量測定値は、前述のように、調剤手順データと共に記録され、パソコン５や６のハードディスク等に保持される。尚、このハードディスク等が重量値記録保持手段に相当する。
【００９５】
［製剤室］のパソコン５が行う処理について図１５のフローチャート（但し、フローチャート中のＳｉ（ｉ＝５０、５１、５２・・・））は各ステップを示す）に基づいて説明する。尚、この処理を実行する為のプログラムが、パソコン５のＲＯＭ又はハードディスク等の記憶媒体に格納されているものとする。
【００９６】
［製剤室］に持ち込まれた薬袋ラベル２２のバーコードがバーコードリーダ５ｂで読み取られると（Ｓ５０）、読み取ったバーコードの情報（患者情報）に対応する監査データテーブルが読み込まれる。この監査データテーブルは、前記調剤手順を決定する際に作成され、図２０に示すように、セッション番号である患者ＩＤと追番、オーダー日、連絡番号、ＲＰ番号、シーケンス番号、監査番号、監査データ部のデータを含んでいる。
【００９７】
監査内容のデータは、監査行番のデータに対応付けて、監査内容、計算用重量値調製行番１、計算用重量値調製行番２のデータからなり、監査測定値を重量測定値（予め定められた監査項目に対する監査結果に相当する）を対応付けて入力して記録保持可能となっている。この監査データテーブルに基づいて、調剤された注射薬を監査するのに必要な情報がディスプレイに表示される（Ｓ５２）。尚、パソコン５等が監査装置に相当し、そのディスプレイが表示手段に相当する。このパソコン５等により、ディスプレイにより記録された重量値を表示させて、監査作業を行うことができ、予め定められた監査項目に対する監査結果を入力して記録保持して管理することができる。
【００９８】
次に、抗ガン薬調製・監査録書３２が印字され（Ｓ５３）、電子天秤１１により支給容器の重量が測定されて、その支給容器の重量が入力され（Ｓ５４）、その後、薬剤師は印字された抗ガン剤調剤記録書３２のチェック欄に監査結果を記入すると共に、抗ガン剤無菌調剤連絡箋３１が印字され（Ｓ５６）、終了する。
【００９９】
以上説明した処方薬調剤支援システムＰＳの作用・効果について説明する。
この処方薬調剤支援システムＰＳによれば、マスターデータベースＤＢ２を設け、パソコン５のハードディスク等に、患者に１回に施用される複数種の薬剤を調剤して支給容器に収容する手順を示す調剤パターンであって、固形薬剤の有無、液状薬剤の有無、溶解剤の有無、希釈液の有無、支給容器の種類、のうちの一部又は全部をパラメータとする調剤パターン（調剤パターン１〜８）を、複数（８）とおり予め設定して記憶させた。
【０１００】
そして、パソコン５により、各患者に対する処方箋２０の処方情報としての注射処方データと、注射処方データのうちの施用対象の薬剤についてマスターデータベースＤＢ２から読み出すデータと、ハードディスク等に記憶した調剤パターンのデータに基づいて、患者に施用される複数種の薬剤を調剤する複数ステップからなる調剤手順を決定するようにした。こうして、注射薬を調剤するために複数種の薬剤を調剤する適切な調剤手順を自動的に決定できるため、調剤手順を決定する負荷を軽減でき、調剤の作業能率を高めることができる。結局、注射薬を調剤するのを大きく支援でき、多くの患者を診療する病院等、複数の患者に夫々施用する注射薬を順調に調剤していくことが可能になる。
【０１０１】
多数の薬剤のマスターデータの各々は、少なくとも、薬品コード、薬品名称、薬剤を収容する収容器の種類、収容器に収容する薬剤の規格量、の情報を含むので、調剤手順を決定する際に使用する、処方データのうちの施用対象の薬剤についてマスターデータベースＤＢ２から読み出すデータを、前記収容器の種類や規格量のデータとして、適切な調剤手順を確実に決定することができる。
【０１０２】
複数ステップからなる調剤手順は、支給容器の初期重量を測定するステップと、薬剤を収容した調剤後の支給容器の最終重量を測定するステップを含むので、調剤により支給容器に収容された、薬剤、溶解液、希釈液の重量を確実に測定することができる。
【０１０３】
決定された複数ステップからなる調剤手順を、図表の形態にて印字出力可能なプリンタ４ａを設けたので、このプリンタ４ａで印字出力された調剤手順２１を見て、調剤作業を行うことが可能になる。
【０１０４】
次に、前記実施の形態を部分的に変更した変更形態について説明する。
１］抗ガン剤を含む注射薬を調剤する場合において、複数種の薬剤を調剤する調剤手順を決定するようにしてあるが、抗ガン剤を含まない注射薬を調剤する場合においても、同等に調剤手順を決定することができる。
【０１０５】
２］調剤作業において、廃棄となる（空となった）アンプルやバイアル等の収容器の重量を測定するようにしてもよい。これにより、アンプルやバイアル等から収容器や支給容器に入れた希釈液や溶解剤を重量をより正確に測定できるようになる。そして、この場合、これらの廃棄となる収容器の重量を測定するステップを含む複数ステップからなる調剤手順を決定するようにしてもよい。
【０１０６】
３］各パソコンにおいて、上記の複数処理を分業せずに１つのパソコンにより実行可能に構成してもよい。
尚、本発明は以上説明した実施の形態に限定されるものではなく、当業者であれば、本発明の趣旨を逸脱しない範囲で、前記実施形態に種々の変更を付加して実施することができ、本発明はそれらの変更形態をも包含するものである。
【０１０７】
【発明の効果】請求項１の処方薬調剤支援システムによれば、マスターデータベース、調剤パターン記憶手段、調剤手順決定手段とを設けた。調剤パターン記憶手段には、患者に１回に施用される複数種の薬剤を調剤して支給容器に収容する手順を示す調剤パターンであって、固形薬剤の有無、液状薬剤の有無、溶解剤の有無、希釈液の有無、支給容器の種類、のうちの一部又は全部をパラメータとする調剤パターンを、複数とおり予め設定して記憶させている。調剤手順決定手段により、各患者に対する処方箋の処方情報と、処方情報のうちの施用対象の薬剤についてマスターデータベースから読み出す情報と、調剤パターン記憶手段に記憶した調剤パターンの情報に基づいて、患者に施用される複数種の薬剤を調剤する複数ステップからなる調剤手順を決定する。注射薬を調剤するために複数種の薬剤を調剤する適切な調剤手順を自動的に決定できるため、調剤手順を決定する負荷を軽減でき、調剤の作業能率を高めることができる。その結果、注射薬を調剤するのを支援するのに大きく寄与し、多くの患者を診療する病院等、複数の患者に夫々施用する注射薬を順調に調剤していくことが可能になる。
【０１０８】
請求項２の処方薬調剤支援システムによれば、多数の薬剤のマスターデータの各々は、少なくとも、薬品コード、薬品名称、薬剤を収容する収容器の種類、収容器に収容する薬剤の規格量、の情報を含むので、このマスターデータに基づいて、調剤手順決定手段により適切な調剤手順を確実に決定できる。
【０１０９】
請求項３の処方薬調剤支援システムによれば、多数の薬剤のマスターデータの各々は、剤形単位名称、容量単位名称、成分単位名称、容量換算値、成分換算値、抗ガン薬形状区分、保存区分、指定区分、薬品重量、溶解希釈液分類コード、有効溶解希釈液分類コード、必要溶解液量、溶液濃度、比重、希釈液下上限量、支給容器可否、フィルター可否、混注可能容量、キャップ重量、ｐＨ情報、混注時溶液名称、の中の何れかの情報を含むので、このマスターデータに基づいて、調剤手順決定手段により適切な調剤手順をより確実に決定できる。
【０１１０】
請求項４の処方薬調剤支援システムによれば、複数の調剤パターンは、抗ガン剤を含む複数種の薬剤を調剤する複数の調剤パターンを含むので、抗ガン剤を含む複数種の薬剤を調剤する調剤手順は複雑になる場合が多いが、その適切な調剤手順を自動的に簡単に決定することができる。
【０１１１】
請求項５の処方薬調剤支援システムによれば、前記複数ステップからなる調剤手順は、支給容器の初期重量を測定するステップと、薬剤を混注した調剤後の支給容器の最終重量を測定するステップを含むので、支給容器に最終的に混注された薬剤、溶解液、希釈液の重量を確実に測定できるようになる。
【０１１２】
請求項６の処方薬調剤支援システムによれば、前記調剤パターン記憶手段と前記調剤手順決定手段は、コンピュータでもって構成されているので、このコンピュータを用いて、調剤パターン記憶手段により調剤パターンを複数とおり予め設定して記憶させ、調剤手順決定手段により調剤手順を自動的に決定できる。
【０１１３】
請求項７の処方薬調剤支援システムによれば、前記複数ステップからなる調剤手順を、図表の形態にて表示出力可能な表示手段を設けたので、この表示手段で表示出力された調剤手順を見て調剤作業を行うことが可能になる。しかも、調剤手順を図形の形態にて表示出力するので、その調剤手順を把握し易くなる。
【０１１４】
請求項８の処方薬調剤支援システムによれば、前記複数ステップからなる調剤手順を、図表の形態にて印字出力可能な印字手段を設けたので、この印字手段で印字出力された調剤手順を見て調剤作業を行うことが可能になる。しかも、調剤手順を図形の形態にて印字出力するので、その調剤手順を把握し易くなる。
【０１１５】
請求項９の処方薬調剤支援システムによれば、前記複数ステップからなる調剤手順は、固形薬剤が有る場合には、その固形薬剤を溶解させる前に固形薬剤を収容した収容器の重量を測定するステップと、この収容器に希釈液又は溶解剤を入れて固形薬剤を溶解させるステップと、固形薬剤の溶解後に収容器の重量を測定するステップを含むので、固形薬剤を溶解させるために収容器に入れた希釈液又は溶解液の重量を確実に測定できるようになる。
【０１１６】
請求項１０の処方薬調剤支援システムによれば、前記複数ステップからなる調剤手順は、収容器に希釈液又は溶解剤を入れて溶解させた固形薬剤溶液の中の必要量を支給容器に混注するステップを含み、調剤手順決定手段は、処方情報及びマスターデータに基づいて、前記必要量を算出する。つまり、処方情報に含まれるオーダ量が、薬剤のマスターデータに基づく規格量の倍数でない固形薬剤を使用して調剤する場合、前記固形薬剤溶液の中の必要量を確実に算出し、その必要量、即ち、オーダ量の固形薬剤を支給容器に確実に混注できるようになる。
【０１１７】
請求項１１の処方薬調剤支援システムによれば、前記複数ステップからなる調剤手順は、収容器に収容した薬剤を支給容器へ混注する前後に、その収容器の重量を測定するステップを含むので、収容器に収容した薬剤の中から、支給容器へ混注した薬剤を含む重量を確実に測定できるようになる。
【０１１８】
請求項１２の処方薬調剤支援システムによれば、前記複数ステップからなる調剤手順は、支給容器に収容されている希釈液が固形薬剤を溶解する溶解剤となり得る場合、その溶解剤で固形薬剤を溶解した直後に支給容器の重量を測定するステップを含むので、支給容器に収容されている希釈液の中から、溶解剤として固形薬剤を溶解させるため使用した希釈液の重量を確実に測定できるようになる。
【０１１９】
請求項１３の処方薬調剤支援システムによれば、調剤手順決定手段で決定された重量測定を含むステップを実行する際、測定された重量値を記録保持する重量値記録保持手段を設け、この重量値記録保持手段に記録された重量値を表示する表示手段を備え、且つ、予め定められた監査項目に対する監査結果を入力して記録保持することが可能な監査装置を備えたので、監査装置において、表示手段により重量値記録保持手段に記録された重量値を表示させて、監査作業を行うことができ、予め定められた監査項目に対する監査結果を入力して記録保持して管理することができる。
【０１２０】
請求項１４の処方薬調剤支援システムによれば、調剤手順決定手段は、処方情報及びマスターデータに基づいて、固形薬剤を溶解させるために必要な希釈液又は溶解剤の種類及び量を決定するので、固形薬剤を適切に溶解させ得るようになる。
【図面の簡単な説明】
【図１】本発明の実施の形態に係る処方薬調剤支援システムを構成する機器やデータベース等のブロック図である。
【図２】病院に構築された処方薬調剤支援システムの説明図である。
【図３】病院に構築された処方薬調剤支援システムの説明図である。
【図４】処方薬調剤支援システムの主要な処理を含むブロック図である。
【図５】処方薬調剤支援システムの主要な構成のブロック図である。
【図６】８数種類の調剤パターンの内容を示す図表である。
【図７】処方例１〜８の内容を示す図表である。
【図８】処方例９〜１３の内容を示す図表である。
【図９】調剤手順書である。
【図１０】ディスプレイに表示された調剤手順指示画面である。
【図１１】ディスプレイに表示された調剤手順指示画面である。
【図１２】［薬品管理室］のパソコンが実行する処理のフローチャートである。
【図１３】［薬品管理室］のパソコンが実行する調剤手順解析決定処理のフローチャートの前半である。
【図１４】［薬品管理室］のパソコンが実行する調剤手順解析決定処理のフローチャートの後半である。
【図１５】［無菌調剤室］のパソコンが実行する処理のフローチャートである。
【図１６】［製剤室］のパソコンが実行する処理のフローチャートである。
【図１７】注射処方データの各情報を示す図表である。
【図１８】マスターデータの各情報を示す図表である。
【図１９】調剤手順データの各情報を示す図表である。
【図２０】監査テーブルの各情報を示す図表である。
【符号の説明】
ＰＳ 処方薬調剤支援システム
ＤＢ２ マスターデータベース
ＤＢ４ 注射処方データベース
Ｍ１ 調剤パターン記憶手段
Ｍ２ 調剤手順決定手段
１ ホストコンピュータ
２〜５ パソコン
４ａ プリンタ
２１ 調剤手順書[0001]
BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a prescription drug dispensing support system for assisting a hospital to prescribe an injection to be applied to a plurality of patients, and more particularly to dispensing a plurality of types of drugs to be applied to a patient. The present invention relates to a system for automatically determining a dispensing procedure comprising a plurality of steps.
[0002]
2. Description of the Related Art Conventionally, at a hospital or the like, prescription information such as a patient name, a medical department name, a name (type) of a drug, a (prescription) amount, a dosage method, and the like described in a prescription are input using a computer. Storage and management are generally performed. The stored and managed prescription information can be read out as appropriate using a computer and used for prescription confirmation and the like. In addition, a technique of printing a patient name, a name of a medicine, a method of taking the medicine, and the like on a medicine bag using the input prescription information, and a technique of creating a medicine information sheet on which information of the medicine is printed are well known.
[0003]
When dispensing (preparing) an injection at a pharmacy or the like in a hospital, a plurality of types of drugs are dispensed according to a prescription and stored in a supply container (supply bottle, infusion bag, syringe, etc.). The dispensing procedure (including the work of measuring the weight of the drug, dissolving the solid drug, diluting the drug, etc.) is determined empirically or according to a predetermined dispensing procedure manual or the like. The same applies when preparing an injection containing an anticancer drug.
[0004]
By the way, in the conventional dispensing support system, after inputting prescription information by using a computer, the output of the dispensing procedure is designated by specifying the ID of the patient. A technology for displaying pre-dispensed dispensing information previously dispensed for this time based on the input previous prescription information and information on a comparison result between the current prescription information and the previous prescription information is known. (For example, see Patent Document 1).
[0005]
In addition, a plurality of types of medicines to be dispensed are classified into those that are packaged by an automatic medicine packaging machine and those that are not processed by an automatic medicine packaging machine. 2. Description of the Related Art A dispensing support system that outputs an output and performs dispensing based on the output content is known (see Patent Document 2).
[0006]
[Patent Document 1] JP-A-2002-259564
[Patent Document 2] JP-A-9-140775
[0007]
Conventionally, when dispensing an injection, as described above, the procedure for dispensing a plurality of kinds of drugs and co-injecting them into a supply container is empirically or a predetermined dispensing procedure manual or the like. Is determined according to That is, the dispensing procedure is not automatically determined, and therefore, the load for determining the dispensing procedure becomes large.
[0008]
That is, it takes time to determine the dispensing procedure, and there is a risk that the dispensing may be performed by an incorrect dispensing procedure by mistake. In such a case, the dispensing time becomes longer, which reduces the efficiency of the dispensing work. Therefore, it is difficult for hospitals and the like that treat many patients to dispense injections to be applied to a plurality of patients smoothly. There is a risk of becoming. In particular, when preparing an injection containing an anticancer drug, the preparation procedure is often complicated, and therefore, the above-mentioned problem becomes more remarkable.
[0009]
In the dispensing support system of Patent Literature 1, the prescription dispensing information previously dispensed for the current time based on the current prescription information input and the previous input prescription information, It displays prescription information and information on the results of matching the previous prescription information, and does not disclose any technology for automatically determining a dispensing procedure including operations such as measuring the weight of a drug and dissolving a solid drug. Therefore, the same problem as described above occurs.
[0010]
In the dispensing support system of Patent Literature 2, the contents of the dispensing operation are output for the medicine that is not packaged by the automatic medicine dispensing machine. However, the specific contents of the dispensing operation are not specified. Even if the content of the work is a dispensing procedure, there is no disclosure of a technique for automatically determining the dispensing procedure. Therefore, the same problem as described above occurs in this system.
[0011]
An object of the present invention is to automatically determine a dispensing procedure for dispensing a plurality of types of drugs in order to dispense (prepare) an injection in a prescription drug dispensing support system, reduce the load of determining the dispensing procedure, And to improve the efficiency of the dispensing operation.
[0012]
A prescription medicine dispensing support system according to claim 1 is a prescription medicine dispensing support system for assisting a hospital to prescribe an injection to be applied to a plurality of patients, respectively. A master database storing data and a dispensing pattern showing a procedure for dispensing a plurality of types of drugs to be applied to a patient at one time and storing them in a supply container. Dispensing pattern storage means in which a plurality of dispensing patterns are set and stored as parameters, with or without presence, presence or absence of diluent, and types of supply containers, as well as prescription information on prescriptions for each patient And information read from the master database for the drug to be applied in the prescription information and the information on the dispensing pattern stored in the dispensing pattern storage means. Te, is characterized in that a dispensing procedure determining means for determining the dispensing procedure consisting of multiple steps of dispensing a plurality of kinds of drugs to be applied to the patient.
[0013]
The master database stores master data of a large number of medicines, and the dispensing pattern storage means stores a dispensing pattern indicating a procedure for dispensing a plurality of kinds of medicines to be applied to a patient at one time and storing them in a supply container. A plurality of dispensing patterns are set and stored in advance in which some or all of the presence or absence of a solid drug, the presence or absence of a liquid drug, the presence or absence of a dissolving agent, the presence or absence of a diluent, and the type of supply container are used as parameters. ing.
[0014]
The dispensing procedure determining unit applies the prescription to the patient based on the prescription information of the prescription for each patient, the information read out of the prescription information on the medicine to be applied from the master database, and the dispensing pattern information stored in the dispensing pattern storage unit. A dispensing procedure including a plurality of steps for dispensing a plurality of types of medicines to be performed is determined. In this way, since an appropriate dispensing procedure for dispensing an injection can be automatically determined, the load of determining the dispensing procedure can be reduced, and the work efficiency of dispensing can be increased.
[0015]
In addition to the configuration of the first aspect, the following configuration may be adopted.
Each of the master data of the plurality of medicines includes at least information of a medicine code, a medicine name, a type of a container for accommodating the medicine, and a standard amount of the medicine to be accommodated in the container (Claim 2). Based on the master data, the dispensing procedure determining means can reliably determine an appropriate dispensing procedure.
[0016]
Each of the master data of the large number of drugs includes a dosage form unit name, a volume unit name, a component unit name, a volume conversion value, a component conversion value, an anticancer drug shape classification, a storage classification, a designation classification, a drug weight, a dissolution diluent. Classification Code, Effective Dissolution Diluent Classification Code, Required Dissolution Solution Volume, Solution Concentration, Specific Gravity, Upper Limit Under Diluent, Availability of Supply Container, Filterability, Capable of Injectable Cap, Cap Weight, pH Information, Name of Mixed Solution (Claim 3). Based on the master data, the dispensing procedure determining means can more reliably determine an appropriate dispensing procedure.
[0017]
The plurality of dispensing patterns include a plurality of dispensing patterns for dispensing a plurality of types of drugs including an anticancer drug (Claim 4). Although the dispensing procedure for dispensing multiple drugs, including anticancer drugs, is often complex, the appropriate dispensing procedure can be automatically and easily determined.
[0018]
The dispensing procedure comprising a plurality of steps includes a step of measuring an initial weight of the dispensing container and a step of measuring a final weight of the dispensing container after dispensing the medicine. It is possible to reliably measure the weight of the drug, the dissolving solution, and the diluting solution finally injected into the supply container.
[0019]
The dispensing pattern storage means and the dispensing procedure determining means are configured by a computer (claim 6). Therefore, a plurality of dispensing patterns can be preset and stored by the dispensing pattern storage means using a computer, and the dispensing procedure determining means can automatically determine the dispensing procedure.
[0020]
A display means capable of displaying and outputting the dispensing procedure including the plurality of steps in the form of a chart is provided (claim 7). As this display means, a display means including a computer display according to claim 6 may be applied. In addition, display means including a display of a computer installed in a dispensing room or the like where the dispensing operation is performed may be applied, and the dispensing operation can be performed by looking at the dispensing procedure displayed on the display. Since the dispensing procedure is displayed and output in the form of a graphic, the dispensing procedure can be easily understood.
[0021]
A printing means capable of printing and outputting the dispensing procedure comprising a plurality of steps in the form of a chart is provided (claim 8). As the printing means, a printing means including a printer connected to the computer according to claim 6 may be applied. The dispensing operation can be performed by looking at the dispensing procedure printed out. Since the dispensing procedure is printed out in the form of a graphic, the dispensing procedure can be easily understood.
[0022]
The dispensing procedure comprising a plurality of steps, if there is a solid drug, the step of measuring the weight of the container containing the solid drug before dissolving the solid drug, and a diluent or dissolving agent in this container And dissolving the solid drug therein, and measuring the weight of the container after dissolving the solid drug (claim 9). This makes it possible to reliably measure the weight of the diluent or dissolution liquid contained in the container for dissolving the solid drug.
[0023]
The dispensing procedure comprising a plurality of steps includes a step of co-injecting a required amount of a solid drug solution in which a diluting solution or a dissolving agent is dissolved in a container into a supply container, wherein the dispensing procedure determining means includes the prescription. The required amount is calculated based on information and master data (claim 10). If the order amount contained in the prescription information is dispensed using a solid drug that is not a multiple of the standard amount based on the master data of the drug, the required amount in the solid drug solution is reliably calculated, and the required amount, that is, Thus, the order amount of the solid medicine can be surely co-injected into the supply container.
[0024]
The dispensing procedure including the plurality of steps includes a step of measuring the weight of the container before and after the medicine contained in the container is co-injected into the supply container (claim 11). It is possible to reliably measure the weight of the medicine contained in the container, including the medicine co-injected into the supply container.
[0025]
The dispensing procedure comprising a plurality of steps, when the diluent contained in the supply container can be a dissolving agent that dissolves the solid drug, the step of measuring the weight of the supply container immediately after dissolving the solid drug with the dissolving agent. (Claim 12). From among the diluents contained in the supply container, the weight of the diluent used for dissolving the solid drug as a solubilizer can be reliably measured.
[0026]
When performing the step including the weight measurement determined by the dispensing procedure determining means, a weight value recording and holding means for recording and holding the measured weight value is provided, and the weight value recorded on the weight value recording and holding means is displayed. And an auditing device capable of inputting and recording and retaining an audit result for a predetermined audit item (claim 13). The weight value recording and holding unit records and holds the measured weight value by executing the steps including the weight measurement, and causes the inspection device to display the weight value recorded on the weight value recording and holding unit by the display unit and perform the audit. Work can be performed, and an audit result for a predetermined audit item can be input, recorded, retained, and managed.
[0027]
The dispensing procedure determining means determines the type and amount of a diluent or a dissolving agent necessary for dissolving the solid drug based on the prescription information and the master data (claim 14). The solid drug can be appropriately dissolved.
[0028]
Embodiments of the present invention will be described below with reference to the drawings. In the present embodiment, the present invention is applied to a prescription drug dispensing support system that supports prescribing an injection to be applied to a plurality of patients at a hospital where both an inpatient and an outpatient are treated.
[0029]
As shown in FIGS. 1 to 3, the prescription drug dispensing support system PS includes, for example, a host computer 1 installed in a hospital H, a personal computer 2 (personal computer) installed in a [ward] of the hospital H, ], A personal computer 4 and a printer 4a installed in a [drug management room] and a drug picking device 10, a personal computer 5 and a printer 5a installed in a [formulation room] and a barcode reader 5b and an electronic balance 11 , A personal computer 6 and a barcode reader 6a installed in the [sterile dispensing room], an electronic balance 12, and the like. Although not shown, a clean bench is installed in the [aseptic dispensing room]. Particularly, when dispensing an injection containing an anticancer drug, the dispensing work is performed by handling the drug in the clean bench. .
[0030]
As shown in FIG. 1, the host computer 1 and the personal computers 2 to 6 are connected to each other via a local area network (LAN) so that they can communicate with each other by wire or wirelessly. Each of the personal computers 2 to 6 includes a personal computer, a display, a keyboard, a mouse, and the like. The personal computer is provided with a CPU, a ROM, a RAM, an input / output interface, a hard disk drive, a CD drive, and the like. One or more personal computers are provided as each of the personal computers 2 to 6.
[0031]
An OS such as "WINDOWS (registered trademark)" is installed in each of the personal computers 2 to 6, and stores a program that runs on the OS and executes various processes described below.
As shown in FIG. 1, in the host computer 1, for example, a hard disk (or a CD or other storage device) has a patient database DB1, a (drug) master database DB2, a prescription database DB3, an injection prescription database DB4, a prescription check database. A database such as DB5 is stored.
[0032]
Next, processing performed by the host computer 1 and the computers 2 to 5 and work performed by a pharmacist or the like will be described with reference to FIG.
(1) "Ordering process"
The prescription input of the prescription 20 prepared for the inpatient is performed using the personal computer 2, and the prescription of the prescription 20 prepared for the outpatient is performed and input using the personal computer 3. Prescription data is created from the received prescription input information and stored in the prescription database DB3 of the host computer 1.
[0033]
(2) “Injection prescription data extraction processing”
The PCs 2 and 3 or the host computer 1 extracts (creates) injection prescription data as prescription information for the directly injected into the body from the prescription data and stores it in the injection prescription database DB4 of the host computer 1. . Injection prescription text data that can identify the injection prescription data (for dispensing an injection containing an anticancer drug) requested by a sterile preparation of an anticancer drug from a plurality of injection prescription data is included in each injection prescription data. And is output to the personal computer 4.
[0034]
Here, as shown in FIG. 17, each injection prescription data of the injection prescription database DB4 includes a patient ID (01234456789) which is a session number, a serial number (0001), an order date (2002/6/1), and a contact number ( 00122), RP number (1), sequence number (1), usage (none), usage comment (none), drug row number (1, 2, 3, 4) for each ordered drug, drug for each ordered drug The drug code (ent50, ent10, show10, solita T3) and the name of the drug (injection endoxane 500 mg / V, injectable endoxane 100 mg / V, distilled water for injection 100 ml, solita T3 500m) and order amount (1000) , 450, 1, 1) and order unit (mg, mg, book, book), payout amount (2, 5, 1, 1), payout unit ( Contains V, books, book information).
[0035]
(3) "Data distribution processing"
Based on the injection prescription text data created in the “injection prescription data extraction process”, the personal computer 4 reads the injection prescription data for the anti-cancer drug aseptic dispensing request from the injection prescription data in the injection prescription database DB4, For each injection prescription data, the injection prescription data is sorted into either temporary / outpatient prescription data (injection prescription data for outpatients) or regular prescription data (injection prescription data for inpatients).
[0036]
(4) "Prescription check processing"
The personal computer 4 converts each injection prescription data for the anticancer drug aseptic preparation request into the master data of the drug read from the master database DB2 and the prescription check data read from the prescription check database BD5 corresponding to the injection prescription data. Based on the prescription, it is checked whether the content of the prescription is OK or NG (for example, whether or not a plurality of drugs contraindicated for combination is not included). This prescription check process is performed in real time for temporary / outpatient prescription data, and is performed via manual operation of the personal computer 4 for regular prescription data.
[0037]
(5) “Prescription change input processing”
Using the personal computer 4, the prescription is changed or the prescription is stopped mainly in response to the prescription change request / stop request for the injection prescription data which is NG in the "prescription check process". With the change of the injection prescription data, the data such as the drug name, the usage, and the usage comment included in the injection prescription data are also changed, and the injection prescription data before the change is stored as history data in, for example, the prescription database DB4.
[0038]
(6) “Dispensing procedure analysis decision processing”
The PC 4 automatically analyzes the injection prescription data for which the "prescription check processing" is OK, determines the dispensing procedure, and creates the dispensing procedure data. At the same time, examination data of the latest examination performed by the patient for the dispensing procedure data is read, and based on the dispensing procedure instruction data and the examination data, the dispensing procedure manual 21 is printed by the printer 4a, and the medicine bag label 22 (For supply container attachment / ward ward chart attachment) and supply container attachment barcode label 23 are printed. In addition, an injection tabulation table 24 for each TPN anticancer drug, an injection prescription 25 for a ward, an injection prescription 26 for outpatients, various statistical tables 29, and the like are printed.
[0039]
(7) "Picking data creation processing"
This is performed together with the preparation of the dispensing procedure data in the “dispensing procedure analysis determination processing” by the personal computer 4, and the drug codes (drug names) of a plurality of types of drugs to be dispensed and containers (ampules, vials, etc.) containing the respective drugs. ) Is generated and output to the drug picking device 10 including data on the quantity (one or two) of the picking data.
[0040]
(8) “Chemical procurement work”
The medicine picking device 10 automatically pays out necessary medicines from the medicines stored in the medicine picking device 10 based on the medicine picking data. The pharmacist or the like pastes the created medicine bag label 22 (recording the medicine name and order value of the necessary medicine and a barcode corresponding to these information) on the medicine bag 30 and puts the dispensed medicine on the medicine bag label 22. And put it in the medicine bag 30 while checking and checking the medicine name and the like described in. Then, the medicine is transported to the [formulation room], for example, where the medicines taken out of the medicine bag 30 are taken out and transported to the [sterile dispensing room]. In the medicine picking device 10, the stock amount of the medicine stored in the medicine picking device 10 is managed, and a list of the stock amount of the medicine is printed and issued by the printer.
[0041]
(9) "Dispensing work"
A pharmacist or the like reads the barcode of the dispensing procedure manual 21 with the barcode reader 6a of the personal computer 6, and then displays the dispensing procedure screen displayed on the display of the personal computer 6 based on the dispensing procedure manual 21 or the dispensing procedure data. , A plurality of types of medicines are handled, and a dispensing operation is performed according to the dispensing procedure described in the dispensing procedure manual 21 or displayed on the display.
[0042]
(10) “Auditing work”
Inspect the dispensed injections to determine if they are OK or NG. At this time, a pharmacist or the like reads the barcode of the medicine bag label 22 with the barcode reader 5b of the personal computer 5, displays an audit screen on the display, and inputs an audit result for a predetermined audit item. The anti-cancer drug aseptic dispensing note 31 and the anti-cancer drug preparation / inspection record 32 are printed by the printer 5a.
[0043]
(11) "Reanalysis instruction processing"
When the personal computer 4 or 5 or 6 becomes NG during the dispensing operation, the inspection operation, or the like, an instruction to determine the analysis of the dispensing procedure is issued in order to perform the dispensing operation again.
[0044]
As shown in FIG. 5, the prescription dispensing support system PS dispenses, in particular, a master database DB2 storing master data of a large number of medicines and a plurality of kinds of medicines applied to a patient at one time. A dispensing pattern indicating a procedure for accommodating in a container, wherein dispensing is performed using a part or the whole of the presence or absence of a solid drug, the presence or absence of a liquid drug, the presence or absence of a dissolving agent, the presence or absence of a diluent, and the type of supply container A dispensing pattern storage means M1 (such as a hard disk of the personal computer 4) in which a plurality of patterns (a total of eight dispensing patterns 1 to 8) are preset and stored, and an injection prescription database DB4 as prescription information of a prescription 20 for each patient. And the data read from the master database DB2 for the drug to be applied in the injection prescription data stored in the Based on the data of the stored dispensing pattern for the dispensing pattern storage means M1, and a dispensing procedure determining means M2 for determining the dispensing procedure consisting of multiple steps of dispensing a plurality of kinds of drugs to be applied to the patient.
[0045]
Here, as shown in FIG. 18, each of a large number of master data (for example, master data of endoxane for injection 500 mg / V 2) in the master database DB2 includes a medicine code (ent 50) and a medicine name (endoxane 500 mg / V for injection). V), dosage unit name (V), volume unit name (none), component unit name (mg), volume converted value (none), component converted value (500), and the type of container that stores the drug Drug container category (vial), anticancer drug shape category (solid), preservation category (cold place), designated category (drugs), standard amount of drug contained in container (500 mg), drug weight, dissolution diluent classification Code (none), Effective Dissolution Diluent Classification Code (1010, 1080), Required Dissolution Volume (25mL), Solution Concentration (20mg), Specific Gravity, Lower Limit of Diluent (None), Supply Information on the device availability (none), filter availability (no), co-injection capacity (none), cap weight (none), pH information (5.0 to 6.0), co-infusion solution name (endoxane injection solution) Contains.
[0046]
Now, as shown in FIG. 6, the dispensing patterns 1 to 8 are prepared using the presence or absence of a solid anticancer agent, the presence or absence of a liquid anticancer agent, the presence or absence of a dissolving agent, the presence or absence of a diluent, and the type of dispensing container as parameters. It has a pattern.
[0047]
Dispensing pattern 1 is when there is a solid anticancer agent (one type), there is no liquid anticancer agent, there is a dissolving agent, there is a diluent, and the supply container is a container with diluent (including information indicating the type of supply container). The dispensing agent is placed in a container containing the solid anticancer drug 1 to dissolve the solid anticancer drug 1, and the required amount calculated based on the solution concentration from the dissolved anticancer drug 1 (solution) Into a supply container and dilute with a diluent.
[0048]
The dispensing pattern 2 is a dispensing pattern in a case where there is a solid anticancer agent (two types), no liquid anticancer agent, no dissolving agent, there is a diluent (also used as a dissolving agent), and the supply container is a container containing a diluent. Yes, the diluent is put in the container containing the solid anticancer drug 1 to dissolve the solid anticancer drug 1, and the diluent is put in the container containing the solid anticancer drug 2 to dissolve the solid anticancer drug 2, A necessary amount calculated from the dissolved anticancer drugs 1 and 2 (solution) based on the solution concentration is placed in a supply container and diluted with a diluent.
[0049]
Dispensing pattern 3 includes solid anticancer agent (one type), other solid agents (one type), no liquid anticancer agent, no dissolving agent, diluent (used as a dissolving agent), supply container diluted This is a dispensing pattern in the case of a liquid-containing container, in which the diluent is put into the container containing the solid anticancer drug 1 to dissolve the solid anticancer drug 1, and the diluent is put in the container containing the solid anticancer drug 1, and the solid Drug 1 is dissolved, the required amount calculated based on the solution concentration from the dissolved anticancer drug 1 (solution) is put into a supply container, diluted with a diluent, and the solution concentration is calculated from the dissolved solid drug 1 (solution). Put the required amount calculated in the above into a supply container and dilute with the diluent.
[0050]
Dispensing pattern 4 is a dispensing pattern when there is no solid anticancer agent, there is a liquid anticancer agent (one type), there is no dissolving agent, there is a diluent, and the supply container is a diluent container. Put 1 in a supply container and dilute with a diluent.
[0051]
Dispensing pattern 5 is a dispensing pattern when there is no solid anticancer agent, there is a liquid anticancer agent (one type), there is no dissolving agent, there is a diluent, the supply container is a diluent container, and a part of the diluent is withdrawn. After extracting a part of the diluent from the supply container, the liquid anticancer agent 1 is put into the supply container and diluted with the diluent.
[0052]
The dispensing pattern 6 is a dispensing pattern in the case of a solid anticancer drug (one type), no liquid anticancer agent, no dissolving agent, no diluent, and the supply container is a syringe. The dissolving agent is put in the container to dissolve the solid anticancer drug 1, and the necessary amount calculated from the dissolved solid anticancer drug 1 (solution) based on the solution concentration is suctioned with a syringe.
[0053]
The dispensing pattern 7 is a dispensing putter when there is no solid anticancer agent, there is a liquid anticancer agent (one type), there is no dissolving agent, there is a diluent, and the supply container is an infusion bag. Then, put the liquid anticancer drug 1 in the infusion bag and dilute it.
[0054]
The dispensing pattern 8 is a case where a solid anticancer agent is present (two types), a liquid anticancer agent is present (one type), no dissolving agent is used, a diluent is used (also used as a dissolving agent), and the supply container is a container containing a diluent. The dispensing pattern is that the diluent of the supply container is put into the container containing the solid anticancer agent 1 to dissolve the solid anticancer agent 1, and the diluent of the supply container is put into the container containing the solid anticancer agent 2. To dissolve the solid anticancer agent 2 and dilute the liquid anticancer agent 1 into a supply container, dilute with a diluent, and supply the necessary amount calculated from the dissolved anticancer agent 1 (solution) based on the solution concentration. And diluted with a diluent, and the necessary amount calculated from the dissolved anticancer agent 2 (solution) based on the solution concentration is placed in a supply container and diluted with the diluent.
[0055]
Now, FIGS. 7 and 8 show specific prescription examples 1 to 13. In each of these formulation examples 1 to 13, the dispensing procedure is determined based on any of the dispensing patterns 1 to 8, and the dispensing procedure is shown on the right side of each dispensing pattern column shown in FIG. Formulation examples to which the pattern is applied (for example, Formulation Examples 1 to 3 for dispensing pattern 1 and Formulation Examples 4 and 5 for dispensing pattern 2) are shown.
[0056]
Here, Formulation Example 1 will be specifically described as an example. FIG. 9 is a dispensing procedure manual 21 in which prescription contents, determined dispensing procedures, and the like are recorded. The dispensing procedure manual 21 is issued after the dispensing procedure is determined. For convenience of explanation, refer to FIG. explain.
[0057]
The prescription content of this prescription example 1; the name of the prescribed drug, its order value (dosage), the dispensed amount, etc.

Note that the dispensed amount (2 V, 5 V, one bottle, one bottle) and the like are automatically calculated (confirmed) in the dispensing procedure analysis determination process which is a characteristic portion of the present invention. In addition, the required amount of endoxane for injection 500 mgV; 50 mL, the required amount of endoxane 100 mgV for injection; 22.5 mL, the total amount of liquid: 572.5 mL is automatically calculated.
[0058]
In the case of Formulation Example 1, a dispensing procedure consisting of 10 steps is determined as follows.
(1) The barcode label 23 is attached to a container of Solita T3 which is a supply container.
(2) Measure the initial weight of Solita T3 container.
(3) Endoxane for injection; measure the initial total weight of two vials each containing 500 mg.
(4) Endoxane for injection; 25 mL of dissolving agent is put into each vial containing 500 mg to dissolve endoxan for injection.
(5) Endoxane for injection; weigh each vial containing 500 mg of solution.
[0059]
(6) Endoxane for injection; Measure the total weight of five vials each containing 100 mg.
(7) Endoxane for injection; 5 mL of a solubilizer is placed in each vial containing 100 mg to dissolve endoxan for injection.
(8) Endoxane for injection; weigh each vial containing 100 mg of solution.
(9) Dissolved endoxane for injection; 500 mg / V and dissolved endoxane for injection; a required amount of 72.5 mL calculated based on the dissolved concentration of the endoxane solution of 100 mg / V is mixed and injected into Solita T3.
(10) The final weight of the container of Solita T3 after dispensing containing the drug is measured.
[0060]
Here, the calculation of the required amount will be described.
The calculation of the required amount is, after all, when dispensing using a solid anticancer agent whose order value is not a multiple of the standard amount, the solid anticancer agent is to be co-injected into the supply container by the order value.
[0061]
For example, in the case of Formulation Example 1, the ordered endoxane 500 mgV → 1000 mg matches the order value (1000 mg) using 2 V (500 mg × 2 = 1000 mg) of a standard product containing 500 mg per 1 V (vial). However, the ordered endoxane for injection 100 mgV → 450 mg will use 5 V (100 mg × 5 = 500 mg) of a standard product containing 100 mg per 1 V (vial), and will exceed the order value (450 mg).
[0062]
By the way, the concentration when dissolving the endoxane for injection is determined to be 20 mg / mL according to the master data. Therefore, the amount of the dissolving agent for dissolving 500 mg of the endoxane for injection and 100 mg of the endoxane for injection is also determined. However, using this concentration of 20 mg / mL, 1000 mg and 450 mg of endoxane for injection; an endoxane solution for injection containing a total of 1450 mg (order value) (this is the required amount) is 1000 mg ÷ 20 mg / mL + 450 mg 求 め 20 mg / mL is calculated to be 72.5 mL. The above calculation is automatically performed when determining the dispensing procedure.
[0063]
The dispensing procedure including a plurality of steps (the above-described 1 to 10 steps) of the prescription example 1 determined as described above includes a step of measuring an initial weight of the dispensing container and a step of measuring a final weight of the dispensing container after dispensing containing the medicine. Step. Such a step is also included in the dispensing procedure consisting of a plurality of steps in Formulation Examples 2 to 13. In this way, it is possible to reliably measure the weight of the drug, the dissolving solution, and the diluting solution finally injected into the supply container.
[0064]
In the dispensing procedure consisting of a plurality of steps of the prescription example 1, since the solid anticancer drug (solid drug) is (is used), the step of measuring the weight of the container containing the solid drug before dissolving the solid anticancer drug is performed. Placing the dissolving agent or diluent in the container to dissolve the solid drug, measuring the weight of the container after dissolving the solid drug, and further dissolving the container by placing the diluent or the dissolving agent in the container. Co-injecting the required amount of the solid drug solution into the dispensing container. Such steps are also included in the dispensing procedure consisting of a plurality of steps of Formulation Examples 2 to 5, 9, and 11 to 13. In this way, the weight of the diluting solution or the dissolving solution placed in the container for dissolving the solid drug can be reliably measured, and the required amount of the solid drug solution can be surely co-injected into the supply container.
[0065]
Note that the dispensing procedure including a plurality of steps in the prescription example 1 may include a step of measuring the weight of the container before and after co-injecting the drug (solid drug solution) stored in the container into the supply container. However, before the medicament contained in the container is co-injected into the supply container, the step of measuring the weight of the container is performed in the case where a solid drug exists (is used) (this is also the case in the prescription example 1). This is the same as the step of measuring the weight of the container after the dissolution of the solid medicine. Such a step may be included in a dispensing procedure including a plurality of steps of Formulation Examples 2 to 13. In this way, it is possible to reliably measure the weight of the medicine contained in the container, including the medicine mixedly injected into the supply container.
[0066]
Further, when the diluent contained in the supply container can be a dissolving agent for dissolving the solid drug as in the prescription examples 4, 5, 11, and 13, a plurality of steps of the prescription examples 4, 5, 11, and 13 are performed. One dispensing procedure would include the step of weighing the dispensing container immediately after dissolving the solid drug with the dissolving agent. In this way, the weight used to dissolve the solid drug as a solubilizer from the diluent stored in the supply container can be reliably measured.
[0067]
As shown in FIG. 9, the determined dispensing procedure consisting of a plurality of steps is printed out in the form of a chart by the printer 4 a and printed in the dispensing procedure column of the dispensing procedure manual 21 with pictures and characters. Printed. The dispensing procedure manual 21 includes, in addition to the dispensing procedure column, an implementation date, a patient ID, a patient name, a ward name (including a ward), a physician name, an issuance date, a preparation date, a date of birth, a contact number, a fixed time or Temporarily, prescription contents, clinical test values, and the like are recorded, and a barcode is also recorded.
[0068]
Further, the determined dispensing procedure including a plurality of steps is also displayed on the display 6b of the personal computer 6 (4, 5) as shown in FIGS. FIG. 10 is a partial dispensing procedure step display screen, and FIG. 11 is a dispensing procedure step list display screen. A touch panel is provided on the surface of the display 6b, and various operations such as screen operations can be executed through the touch panel. Various operations such as screen operations may be executed by reading a barcode, or may be executed by operating a general keyboard or mouse.
[0069]
Now, the dispensing procedure step partial display screen of FIG. 10 and the dispensing procedure step list display screen of FIG. 11 can be switched. For example, when the dispensing procedure step partial display screen of FIG. 10 is displayed on the display 6b, By touching the touch panel portion corresponding to the “procedure list”, the screen can be switched to the dispensing procedure step list display screen of FIG. 11, and when the dispensing procedure list step display screen of FIG. By touching the touch panel corresponding to "", it is possible to switch to the dispensing procedure step partial display screen of FIG.
[0070]
In the screens of FIGS. 10 and 11, in addition to the dispensing procedure, an operator name and a patient ID, a medical department name, an implementation date, a contact number, an RP number, a patient name, and the like as basic patient information are commonly used. Is displayed. Then, on the dispensing procedure step partial display screen of FIG. 10, five steps including the step being processed among the plurality of steps are displayed. The step display can be scrolled up and down by a predetermined touch operation or the like, and the five steps to be displayed can be freely changed.
[0071]
The personal computer 6 reads the barcode of the dispensing procedure manual 21 with the barcode reader 5b, and displays the screens of FIGS. 10 and 11 based on the display data of the corresponding dispensing procedure. At this stage, Then, it becomes possible to input a weight value measurement in the weight measurement step included in the dispensing procedure. In the state where the screen of FIG. 10 is displayed, the step on the right side where “processing” is displayed is a step of waiting for weight measurement, and the previous (upper) weight measurement step has already been completed. "Just before" is displayed on the left side of the steps between these weight measurement steps.
[0072]
Then, after the weight measurement is performed, the gravity measurement value is input manually or automatically, and the weight measurement step is completed, and `` Processing '' is displayed on the left side of the next weight measurement step, This step is waiting for weight measurement. It should be noted that the step of “processing”, the step before “processing”, and the step after “processing” are displayed in three colors and can be distinguished.
[0073]
In the dispensing procedure step list display screen of FIG. 11, all of the plurality of steps are displayed in a list. In this screen, the step before “under processing” and the subsequent steps including “under processing” are displayed in two colors and can be distinguished. However, similar to the screen of FIG. 10, "processing", "immediately before", and the like may be displayed to make it easier to understand the work status and the like. It should be noted that the dispensing procedure including the plurality of steps may be configured to be displayed on a display in the form of a chart. The dispensing operation can be performed by looking at the dispensing procedure displayed on the display. Since the dispensing procedure is displayed and output in the form of a graphic, the dispensing procedure can be easily understood.
[0074]
By the way, regarding the contents of the dispensing procedure on the screens of FIGS. 10 and 11, “step”, “work source”, “capacity / state”, “work destination”, “shape”, “work”, “number of symmetry”, “ There are columns for "weight" and "re-measureable", and each step displays characters and numerical values corresponding to each column (some are not displayed), and it is possible to grasp the dispensing procedure by looking at these. . For example, in the step of 7/10, it is possible to grasp the procedure of putting 5 mL of distilled water for injection and 100 mg of endoxane for injection, dissolving 100 mg of endoxane for injection, and performing this for 5 V.
[0075]
Next, the processing performed by the personal computer 4 in the [drug management room] is based on the flowcharts in FIGS. 12 to 14 (where Si (i = 1, 2, 3,...) In the flowcharts indicate each step). Will be explained. It is assumed that a program for executing this processing is stored in a storage medium such as a ROM or a hard disk of the personal computer 4.
[0076]
First, when the injection prescription data is read (S1), the injection prescription data is sorted into either temporary / outpatient prescription data or regular prescription data (S2). A prescription check is performed (S3). Mainly, when the prescription check in S3 results in NG, a prescription change input (prescription stop) is performed (S4).
[0077]
Next, when there are a plurality of drug injection prescription data that are OK in the prescription check, these drug injection prescription data are rearranged so as to be in a predetermined order (for example, application time is earlier), and each data is sorted according to the order. For each injection prescription data, analysis determination processing (S5) of the dispensing procedure of the injection prescription data is executed.
[0078]
Here, the analysis determination processing of the dispensing procedure will be described in detail based on the flowcharts of FIGS. 13 and 14 (where Si (i = 20, 21, 22,...) Indicate each step). .
As shown in FIG. 13, when the analysis determining process of the dispensing procedure is started, an anticancer drug is determined based on the injection prescription data and the master data of the medicine for the injection prescription data (S20). At S20, it is determined whether the anti-cancer drug is solid or liquid. If there are a plurality of anti-cancer drugs, a contraindicated combination of these anti-cancer drugs is checked, and the dispensed amount of the container containing the anti-cancer drugs ( The number of ampoules and vials) is calculated, and an error occurs when the anticancer drug is not detected.
[0079]
Next, a solubilizer is determined (S21). In S21, if there is a solubilizer, the presence of the solid anticancer agent to be dissolved is checked, and whether the use of the solubilizer for the solid anticancer agent is permitted or not is determined. It is checked whether the amount of the dissolving solution is sufficient, and the dispensed amount (the number of ampules, vials, etc.) of the container containing the dissolving agent is calculated.
[0080]
Next, a diluent is determined (S22). In S22, it is checked whether or not the diluent can be mixed with the anticancer agent. At the same time, if the diluent is used as a solubilizer, it is checked whether the amount is sufficient. It is checked whether the possible amount is sufficient, and the amount to be dispensed from the container containing the diluent is calculated. If there is no diluent, an error occurs.
[0081]
Next, the supply container is determined (S23). In S23, basically, the container containing the diluent is determined as the supply container. In the case where a tube or an infusion bag is used and there are a plurality of containers containing the diluent, the infusion bag is determined as the supply container. In the case of a syringe, the appropriate syringe size (10 mL, 20 mL, 50 mL) is automatically determined based on the mixed injection volume, and a syringe of that size is determined.
[0082]
Thereafter, instruction information for sticking the barcode label 23 to the supply container is created (S24), instruction information for measuring the weight of the supply container is created (S25), and then there is a solid anticancer drug. It is determined whether or not (S26). If there is a solid anticancer drug (S26; Yes), instruction information for weight measurement of the solid anticancer drug (container containing the solid anticancer drug) before dissolution is created (S27).
[0083]
Thereafter, instruction information for dissolving the solid anticancer agent is prepared with a dissolving agent or a diluent (S28), and then, an instruction for measuring the weight of the container (containing the anticancer agent) after dissolution of the solid anticancer agent is made. Information is created (S29). The volume of the dissolved anticancer drug solution (that is, the concentration of the solution) is calculated using a predetermined volume determination table.
[0084]
Next, it is determined whether or not the diluent in the supply container is used as a solubilizer for dissolving the solid anticancer drug (S30). Therefore, when the diluent in the supply container is used as the dissolving agent (S30; Yes), instruction information for measuring the weight of the supply container is created (S31), and the process returns to S26, where the diluent in the supply container is used as the dissolving agent. If not used (S30; No), the process returns to S26. Here, in step S26, if there is a solid anticancer drug, the process from step S27 is executed thereafter, and if the process returns to step S26, it is regarded that the solid anticancer agent does not exist, and the process from step S27 is not executed again. However, if there is another solid anticancer drug, S27 and subsequent steps are executed again for the other solid anticancer drug.
[0085]
Next, when there is no solid anticancer agent (S26; No), it is determined whether or not there is a liquid anticancer agent as shown in FIG. 14 (S32). Therefore, when there is a liquid anticancer agent (S32; Yes), instruction information for co-injecting the liquid anticancer agent into the supply container is created (S33), and then, after the liquid anticancer agent is co-injected into the supply container. Instruction information for measuring the weight of the supply container is created (S34), and the process returns to S32. Here, in S32, if there is a liquid anticancer agent, the process from S33 is executed thereafter, and if the process returns to S32, it is regarded that the liquid anticancer agent does not exist, and the processes from S33 and thereafter are not executed again.
[0086]
Next, when there is no liquid anticancer agent (S32; Yes), it is determined whether or not there is a dissolved solid anticancer agent (solution) in a container other than the supply container, that is, whether or not S28 has been executed. (S35). In S35, when it is determined that there is a dissolved solid anticancer agent (S35; Yes), instruction information for co-injecting the dissolved solid anticancer agent (solution) into the supply container is created (S36). Instruction information for weight measurement of the instruction container after co-injection of the anticancer agent (solution) is created (S37), and the routine proceeds to S35.
[0087]
In S35, if there is a solid anticancer agent (solution), then after S36 is executed, and if the process returns to S35, it is considered that the solid anticancer agent (solution) does not exist. However, if there is another solid anticancer agent (solution), S36 and subsequent steps are executed again for the other solid anticancer agent (solution). When there is no solid anticancer agent (S35; No), the process ends.
[0088]
In this way, the dispensing pattern for dispensing a plurality of types of drugs to be applied to the patient is determined to be one of dispensing patterns 1 to 8, and the dispensing pattern data, the injection prescription data, and the application target among the injection prescription data A specific dispensing procedure for dispensing a plurality of types of drugs to be applied to a patient is determined based on the master data read from the master database DB1 for the drug, and the dispensing procedure data is created. The dispensing procedure data is stored on a hard disk or the like of the personal computer 6.
[0089]
Here, the dispensing procedure data will be described using the case of prescription example 1 as a specific example. As shown in FIG. 19, the dispensing procedure data includes preparation line number (1 to 10) data and procedure content data corresponding to the preparation line number data. The procedure content data includes the source drug line number, source category (1; drug name, 2; solution) and source name included in the source, and the capacity status category (1; solvent) included in the volume / state. Volume, 2; co-infusion solution, 3; before co-infusion, 4; after co-infusion, 5; before dissolution, 6; after dissolution, 7; immediately after dissolution, 8; after suction, 9; after withdrawal) and the data of volume and state name. Have.
[0090]
In addition, the procedure content data includes the destination medicine line number and the destination name included in the destination, the shape classification (1; container, 2; supply container) and the shape name included in the shape, and the operation classification included in the operation. (1; barcode attachment, 2; weight measurement, 3; dissolution, 4; co-injection, 5; co-injection + filter, 6; partial extraction, 7; suction), work name, and data of the number of symmetry , And the weight measurement values can be recorded in association with each other. Such a form of dispensing procedure data will be created.
[0091]
Next, after the process of S5, as shown in FIG. 12, drug picking data is created (S6), and the drug picking data is transmitted and output to the drug picking device 10 (S7). Next, the injection prescriptions 25 and 26 are printed (S8), and the dispensing procedure manual 21 and the medicine bag label 22 are printed (S9). Further, statistics / history data is created (S10), injection prescription data is created (S11), various statistical materials are printed (S12), audit data is created (S13), and the process ends.
[0092]
The processing performed by the personal computer 6 in the [aseptic dispensing room] will be described based on the flowchart of FIG. 15 (where Si (i = 40, 41, 42,...) Indicates each step). It is assumed that a program for executing this process is stored in a storage medium such as a ROM or a hard disk of the personal computer 6.
[0093]
When the barcode of the dispensing procedure document 21 brought into the [aseptic dispensing room] is read by the barcode reader 6a (S40), dispensing procedure data corresponding to the dispensing procedure document 21 is read (S41). Then, based on the dispensing procedure data, the dispensing procedure screens of FIGS. 10 and 11 are switchably displayed on the display (S42), and the dispensing process is performed (S43). The pharmacist or the like performs dispensing work while viewing the dispensing procedure manual 21 or the dispensing procedure screen of the personal computer 4.
[0094]
In the dispensing process of S43, the step display of the dispensing procedure is switched by operating a keyboard or a mouse or automatically, and a weight value is input at the time of weight measurement. Incidentally, it is desirable that the weight value can be input by operating the touch panel due to the characteristics of the sterile room. The input weight measurement value is recorded together with the dispensing procedure data as described above, and is stored in the hard disk of the personal computer 5 or 6. The hard disk and the like correspond to a weight value recording and holding unit.
[0095]
The processing performed by the personal computer 5 in the [formulation room] will be described based on the flowchart of FIG. 15 (however, Si (i = 50, 51, 52...) In the flowchart indicates each step). It is assumed that a program for executing this processing is stored in a storage medium such as a ROM or a hard disk of the personal computer 5.
[0096]
When the barcode of the medicine bag label 22 brought into the [formulation room] is read by the barcode reader 5b (S50), an audit data table corresponding to the read barcode information (patient information) is read. This audit data table is created when determining the dispensing procedure, and as shown in FIG. 20, a patient ID and an additional number, which are session numbers, an order date, a contact number, an RP number, a sequence number, an audit number, an audit number. Contains the data of the data section.
[0097]
The data of the audit content is composed of the data of the audit content, the calculation weight value preparation line number 1 and the calculation weight value preparation line number 2 in association with the data of the audit line number. (Corresponding to an audit result with respect to a predetermined audit item) and can be recorded and retained. Based on the inspection data table, information necessary for inspecting the dispensed injection is displayed on the display (S52). The personal computer 5 and the like correspond to an inspection device, and its display corresponds to a display unit. With the personal computer 5 or the like, the weight value recorded on the display can be displayed to perform an audit operation, and an audit result for a predetermined audit item can be input, recorded, held, and managed.
[0098]
Next, the anticancer drug preparation / audit record 32 is printed (S53), the weight of the supply container is measured by the electronic balance 11, and the weight of the supply container is input (S54). The inspection result is entered in the check box of the anticancer drug dispensation record 32, and the anticancer drug aseptic dispensing contact note 31 is printed (S56), and the process ends.
[0099]
The operation and effect of the prescription medicine dispensing support system PS described above will be described.
According to the prescription drug dispensing support system PS, a master database DB2 is provided, and a dispensing pattern showing a procedure for dispensing a plurality of types of drugs to be applied to a patient at one time on a hard disk or the like of the personal computer 5 and storing the same in a supply container. A dispensing pattern (dispensing patterns 1 to 8) having some or all of the parameters of the presence / absence of a solid drug, the presence / absence of a liquid drug, the presence / absence of a dissolving agent, the presence / absence of a diluent, and the type of supply container as parameters. , A plurality of (8) settings were previously set and stored.
[0100]
Then, the personal computer 5 converts the injection prescription data as prescription information of the prescription 20 for each patient, data read out of the injection prescription data for the drug to be applied from the master database DB2, and data of the dispensing pattern stored in the hard disk or the like. Based on this, a multi-step dispensing procedure for dispensing a plurality of types of drugs to be applied to a patient is determined. In this way, since an appropriate dispensing procedure for dispensing a plurality of drugs for dispensing an injection can be automatically determined, the load of determining the dispensing procedure can be reduced, and the working efficiency of dispensing can be increased. As a result, it is possible to greatly support the dispensing of injections, and it is possible to smoothly dispense injections to be applied to a plurality of patients, such as a hospital where many patients are treated.
[0101]
Each of the master data of a large number of medicines contains at least information of a medicine code, a medicine name, a type of a container for accommodating a medicine, and a standard amount of the medicine to be accommodated in the container, so that when determining a dispensing procedure, It is possible to reliably determine an appropriate dispensing procedure using data read from the master database DB2 for the medicine to be applied among the prescription data to be used as data of the type and the standard amount of the container.
[0102]
Since the dispensing procedure including a plurality of steps includes a step of measuring the initial weight of the dispensing container and a step of measuring the final weight of the dispensing container after dispensing the medicine, the medicine contained in the dispensing container by the dispensing, The weight of the dissolving solution and diluting solution can be reliably measured.
[0103]
Since the printer 4a capable of printing and outputting the determined dispensing procedure including a plurality of steps in the form of a chart is provided, it is possible to perform the dispensing operation by looking at the dispensing procedure 21 printed out by the printer 4a. Become.
[0104]
Next, a modified embodiment in which the above-described embodiment is partially modified will be described.
1] When dispensing an injection containing an anticancer drug, the dispensing procedure for dispensing a plurality of drugs is determined. However, even when dispensing an injection that does not contain an anticancer drug, the procedure is the same. The dispensing procedure can be determined.
[0105]
2] In the dispensing operation, the weight of a container such as an ampoule or a vial that is discarded (empty) may be measured. This makes it possible to more accurately measure the weight of the diluent or the dissolving agent placed in a container or a supply container from an ampoule, a vial, or the like. In this case, a dispensing procedure including a plurality of steps including a step of measuring the weight of the container to be discarded may be determined.
[0106]
3) Each of the personal computers may be configured to be able to execute the plurality of processes by one personal computer without division of labor.
It should be noted that the present invention is not limited to the above-described embodiments, and those skilled in the art can add various changes to the above-described embodiments without departing from the spirit of the present invention. Yes, and the present invention covers those modifications.
[0107]
According to the prescription medicine dispensing support system of claim 1, a master database, a dispensing pattern storage means, and a dispensing procedure determining means are provided. The dispensing pattern storage means is a dispensing pattern indicating a procedure for dispensing a plurality of types of medicines to be applied to a patient at one time and storing the same in a supply container. A plurality of dispensing patterns, in which some or all of the presence / absence, presence / absence of diluent, and type of supply container are used as parameters, are set and stored in advance. The dispensing procedure determining means applies to the patient based on the prescription information of the prescription for each patient, the information read from the master database for the drug to be applied in the prescription information, and the information on the dispensing pattern stored in the dispensing pattern storage means. A dispensing procedure including a plurality of steps for dispensing a plurality of types of drugs to be performed is determined. Since an appropriate dispensing procedure for dispensing a plurality of drugs for dispensing an injection can be automatically determined, the load of determining the dispensing procedure can be reduced, and the working efficiency of dispensing can be increased. As a result, it greatly contributes to assisting in dispensing an injection, and it is possible to smoothly dispense an injection to be applied to each of a plurality of patients such as a hospital where many patients are treated.
[0108]
According to the prescription medicine dispensing support system of claim 2, each of the master data of a large number of medicines includes at least a medicine code, a medicine name, a type of a container for accommodating the medicine, a standard amount of the medicine to be accommodated in the container, Therefore, an appropriate dispensing procedure can be reliably determined by the dispensing procedure determining means based on the master data.
[0109]
According to the prescription medicine dispensing support system of claim 3, each of the master data of a large number of medicines includes a dosage form unit name, a volume unit name, a component unit name, a volume conversion value, a component conversion value, an anticancer drug shape classification, Storage category, designated category, chemical weight, dissolution diluent classification code, effective dissolution diluent classification code, required dissolution volume, solution concentration, specific gravity, diluent lower limit, supply container availability, filter availability, co-injection capacity, cap Since any information among the weight, the pH information, and the name of the co-infusion solution is included, an appropriate dispensing procedure can be more reliably determined by the dispensing procedure determining means based on the master data.
[0110]
According to the prescription medicine dispensing support system of claim 4, since the plurality of dispensing patterns include a plurality of dispensing patterns for dispensing a plurality of drugs including an anticancer drug, the plurality of drugs including an anticancer drug are dispensed. The dispensing procedure to be performed is often complicated, but the appropriate dispensing procedure can be automatically and easily determined.
[0111]
According to the prescription medicine dispensing support system of claim 5, the dispensing procedure including the plurality of steps includes a step of measuring an initial weight of the dispensing container and a step of measuring a final weight of the dispensing container after dispensing the medicine. As a result, the weight of the drug, the solution, and the diluent finally co-injected into the supply container can be measured.
[0112]
According to the prescription drug dispensing support system of claim 6, since the dispensing pattern storage means and the dispensing procedure determining means are constituted by a computer, a plurality of dispensing patterns are stored by the dispensing pattern storage means using the computer. As described above, the dispensing procedure can be automatically determined by the dispensing procedure determining means.
[0113]
According to the prescription medicine dispensing support system of claim 7, since the dispensing procedure comprising the plurality of steps is provided with a display means capable of displaying and outputting in the form of a chart, the dispensing procedure displayed and output by this display means is viewed. Dispensing work can be performed. In addition, since the dispensing procedure is displayed and output in the form of a graphic, the dispensing procedure can be easily understood.
[0114]
According to the prescription medicine dispensing support system of the eighth aspect, the dispensing procedure consisting of the plurality of steps is provided with a printing means capable of printing out in the form of a chart, so that the dispensing procedure printed out by this printing means can be viewed. Dispensing work can be performed. In addition, since the dispensing procedure is printed out in the form of a graphic, the dispensing procedure can be easily understood.
[0115]
According to the prescription medicine dispensing support system of the ninth aspect, in the dispensing procedure including the plurality of steps, when there is a solid medicine, the weight of the container containing the solid medicine is measured before dissolving the solid medicine. And dissolving the solid drug by adding a diluting solution or a dissolving agent to the container, and measuring the weight of the container after dissolving the solid drug. This makes it possible to reliably measure the weight of the diluting solution or the dissolving solution that has been placed.
[0116]
According to the prescription medicine dispensing support system of the tenth aspect, in the dispensing procedure including the plurality of steps, a required amount in a solid medicine solution in which a diluting solution or a dissolving agent is put into a container and dissolved is co-injected into a supply container. A dispensing procedure determining means for calculating the required amount based on prescription information and master data. That is, when dispensing using a solid drug whose order amount contained in the prescription information is not a multiple of the standard amount based on the master data of the drug, the required amount in the solid drug solution is reliably calculated, and the required amount is calculated. That is, the order amount of the solid medicine can be reliably co-injected into the supply container.
[0117]
According to the prescription medicine dispensing support system of claim 11, since the dispensing procedure including the plurality of steps includes a step of measuring the weight of the container before and after co-injecting the medicine stored in the container into the supply container, It is possible to reliably measure the weight of the medicine contained in the container, including the medicine co-injected into the supply container.
[0118]
According to the prescription medicine dispensing support system of claim 12, in the dispensing procedure including the plurality of steps, when the diluent stored in the supply container can be a dissolving agent for dissolving the solid drug, the solid drug is dissolved by the dissolving agent. Since the step of measuring the weight of the supply container immediately after dissolution is included, the weight of the diluent used for dissolving the solid drug as a dissolving agent can be reliably measured from the diluent contained in the supply container. become.
[0119]
According to the prescription medicine dispensing support system of claim 13, when executing the step including the weight measurement determined by the dispensing procedure determining means, the weight value recording and holding means for recording and holding the measured weight value is provided. Since the display device for displaying the weight value recorded in the value record holding device is provided, and the audit device capable of inputting and recording and holding the audit result for a predetermined audit item is provided, The weight value recorded in the weight value recording and holding means can be displayed on the display means to perform an auditing operation, and the audit result for a predetermined audit item can be inputted, recorded and retained for management. .
[0120]
According to the prescription drug dispensing support system of claim 14, the dispensing procedure determining means determines the type and amount of the diluent or dissolving agent necessary for dissolving the solid drug based on the prescription information and the master data. Thus, the solid drug can be appropriately dissolved.
[Brief description of the drawings]
FIG. 1 is a block diagram of devices, databases, and the like that constitute a prescription drug dispensing support system according to an embodiment of the present invention.
FIG. 2 is an explanatory diagram of a prescription medicine dispensing support system constructed in a hospital.
FIG. 3 is an explanatory diagram of a prescription drug dispensing support system constructed in a hospital.
FIG. 4 is a block diagram including main processing of a prescription drug dispensing support system.
FIG. 5 is a block diagram of a main configuration of a prescription drug dispensing support system.
FIG. 6 is a table showing the contents of eight dispensing patterns.
FIG. 7 is a table showing the contents of prescription examples 1 to 8.
FIG. 8 is a table showing the contents of prescription examples 9 to 13.
FIG. 9 is a dispensing procedure manual.
FIG. 10 is a dispensing procedure instruction screen displayed on a display.
FIG. 11 is a dispensing procedure instruction screen displayed on a display.
FIG. 12 is a flowchart of a process executed by a personal computer in a [drug management room].
FIG. 13 is the first half of a flowchart of a dispensing procedure analysis determination process executed by the personal computer in the [drug management room].
FIG. 14 is the second half of the flowchart of the dispensing procedure analysis determination process executed by the personal computer in the [drug management room].
FIG. 15 is a flowchart of a process executed by a personal computer in a [sterile dispensing room].
FIG. 16 is a flowchart of a process executed by a personal computer in a [formulation room].
FIG. 17 is a table showing each information of injection prescription data.
FIG. 18 is a table showing information of master data.
FIG. 19 is a table showing information of dispensing procedure data.
FIG. 20 is a table showing each information of an audit table.
[Explanation of symbols]
PS Prescription drug dispensing support system
DB2 Master Database
DB4 Injection prescription database
M1 dispensing pattern storage means
M2 dispensing procedure determination means
1 Host computer
2-5 PC
4a Printer
21 Preparation Procedure

Claims (14)

In a prescription drug dispensing support system that supports prescribing an injection to be applied to a plurality of patients respectively in a hospital,
A master database storing master data of many drugs,
It is a dispensing pattern showing a procedure of dispensing a plurality of types of drugs to be applied to a patient at one time and storing them in a supply container, the presence or absence of a solid drug, the presence or absence of a liquid drug, the presence or absence of a dissolving agent, the presence or absence of a diluent, Dispensing pattern storage means in which a plurality of types of dispensing patterns are set and stored in advance as a plurality of dispensing patterns with some or all of the parameters as parameters.
Based on the prescription information of the prescription for each patient, information read from the master database for the drug to be applied in the prescription information, and a plurality of types of drugs applied to the patient based on the dispensing pattern information stored in the dispensing pattern storage means. Dispensing procedure determining means for determining a dispensing procedure consisting of a plurality of steps of dispensing,
A prescription drug dispensing support system, comprising: 2. The master data of the plurality of medicines includes at least information of a medicine code, a medicine name, a type of a container storing the medicine, and a standard amount of the medicine stored in the container. Or the prescription medicine dispensing support system according to 2. Each of the master data of the large number of drugs includes a dosage form unit name, a volume unit name, a component unit name, a volume conversion value, a component conversion value, an anticancer drug shape classification, a storage classification, a designation classification, a drug weight, a dissolution diluent. Classification Code, Effective Dissolution Diluent Classification Code, Required Dissolution Solution Volume, Solution Concentration, Specific Gravity, Upper Limit Under Diluent, Availability of Supply Container, Filterability, Capable of Injectable Cap, Cap Weight, pH Information, Name of Mixed Solution 4. The prescription drug dispensing support system according to claim 3, wherein the system includes any one of the following information. The prescription drug dispensing support system according to any one of claims 1 to 3, wherein the plurality of dispensing patterns include a plurality of dispensing patterns for dispensing a plurality of types of drugs including an anticancer drug. The dispensing procedure comprising a plurality of steps includes a step of measuring an initial weight of the dispensing container and a step of measuring a final weight of the dispensing container after dispensing the medicine. A prescription drug dispensing support system according to Crab. The prescription drug dispensing support system according to any one of claims 1 to 5, wherein the dispensing pattern storage means and the dispensing procedure determining means are configured by a computer. 7. The prescription drug dispensing support system according to claim 6, wherein a display means capable of displaying and outputting the dispensing procedure including the plurality of steps in the form of a chart is provided. 7. The prescription drug dispensing support system according to claim 6, further comprising a printing unit capable of printing and outputting the dispensing procedure including the plurality of steps in the form of a chart. The dispensing procedure comprising a plurality of steps, if there is a solid drug, the step of measuring the weight of the container containing the solid drug before dissolving the solid drug, and a diluent or dissolving agent in this container The prescription medicine dispensing support system according to any one of claims 1 to 4, further comprising a step of dissolving the solid medicine by putting the solid medicine therein and a step of measuring the weight of the container after the solid medicine is dissolved. The multi-step dispensing procedure includes the step of co-injecting a required amount of the solid drug solution dissolved by putting a diluting solution or a dissolving agent in a container into a supply container,
10. The prescription drug dispensing support system according to claim 9, wherein the dispensing procedure determination means calculates the required amount based on the prescription information and master data. The dispensing procedure comprising a plurality of steps includes a step of measuring the weight of the container before and after co-injecting the medicine contained in the container into the supply container. Drug dispensing support system. The dispensing procedure comprising a plurality of steps, when the diluent contained in the supply container can be a dissolving agent that dissolves the solid drug, the step of measuring the weight of the supply container immediately after dissolving the solid drug with the dissolving agent. The prescription medicine dispensing support system according to claim 9, wherein the system comprises: When performing the step including the weight measurement determined by the dispensing procedure determination means, provided a weight value record holding means to record and hold the measured weight value,
A display unit for displaying the weight value recorded in the weight value recording and holding unit, and an audit device capable of inputting and recording and holding an audit result for a predetermined audit item; The pharmaceutical preparation support system according to claim 5, 9, 11, or 12. The prescription according to claim 9, wherein the dispensing procedure determining means determines the type and amount of a diluent or a dissolving agent necessary for dissolving the solid drug based on the prescription information and the master data. Drug dispensing support system.

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