JP2006133910A - Nursing care information management method and nursing care information management apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To manage nursing care activity so that it can be carried out appropriately. <P>SOLUTION: A problem item preparation support section 30 supports the preparation of items of nursing care problems for a patient in conjunction with a first database 32. A plan preparation support section 34 supports the preparation of a nursing care plan by searching a second database 36 based on the prepared items of nursing care problems. An instruction section 38 gives instructions for the implementation of nursing care items included in the prepared nursing care plan in conjunction with a third database 40. A communication section 52, on receiving the implementation result of the nursing care items, outputs it to a recording section 60. A nurse inputs evaluation for the implementation result of the nursing care items in an operation apparatus 62. The inputted evaluation is recorded in the recording section 60. A management section 56 associates mutually corresponding items among the items of nursing care problems, the nursing care items included in the nursing care plan, the implementation result and the evaluation which are stored in the recording section 60. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a nursing information management technique, and more particularly, to a nursing information management method and a nursing information management apparatus for managing a nursing action.

A system for managing medical practice, particularly nursing practice includes a server, a personal computer (hereinafter referred to as “PC”), a PDA (Personal Digital Assistants), and the like, and further includes a wired or wireless LAN (Local Area Network). ). In such a configuration, the server records data used in the entire system, and the PC accepts order registration or the like from a nurse or the like. The nurse carries the PDA with reference to a work schedule list such as a drip scheduled to be carried with the PDA. Furthermore, after completion of the infusion, the nurse inputs the execution result to the PDA. Since the PDA transmits the input execution result to the PC or server, the PC or server can manage the execution result (see, for example, Patent Document 1).
JP 2004-110818 A

  In the background art, since the nurse confirms the contents of nursing while operating the PDA at the place where nursing is performed, errors in nursing work can be reduced. Furthermore, since the nurse inputs the nursing result while operating the PDA, the possibility of forgetting to input the nursing result can be reduced. It is desirable to consider the operation on the PC in order to perform management of the nursing action that has been performed or is scheduled to be performed. Considering the operability of PDAs, in general, PDA is not supposed to input a lot of data, but it is possible to browse data in actual nursing sites such as hospital rooms and operating rooms, and simple data. Input is assumed. Therefore, the nurse manages the nursing action while inputting a lot of data while using the PC at the nurse station. In other words, the PC is required to operate so that the nursing care is accurately managed. In general, appropriate nursing is required for hospitals, but accurate management of nursing actions is also required for appropriate nursing.

  The present invention has been made in view of such circumstances, and an object thereof is to provide a nursing information management technique for providing an appropriate nursing action.

  In order to solve the above-described problems, a nursing information management device according to an aspect of the present invention is a nursing information management device that manages nursing information for a patient, and includes an implementation result input unit that inputs a nursing implementation result for the patient , A divergence information input unit for inputting information on the cause of divergence between the nursing plan including the nursing goals for the patient and the implementation result, and divergence information for recording information on the implementation result and the cause of the divergence in association with the nursing plan A recording unit.

  According to this aspect, since the cause of the divergence is recorded, the cause when the difference between the result of the nursing item and the goal of the nursing item is large can be acquired, and by reflecting the cause in the nursing action, Can provide nursing action.

  The divergence information input unit may input information regarding the factor of divergence by presenting a plurality of candidates for information regarding the factor of divergence to the operator and causing the operator to select one of the plurality of candidates. In this case, since the operator selects a plurality of candidates, the processing amount of the operator can be reduced.

  The divergence information input unit presents a free description field to the operator, and the divergence information recording unit records the contents of the free description field described by the operator in association with any of a plurality of selected candidates. May be. In this case, the evaluation corresponding to each patient can be recorded by adding the contents of the free description column.

  You may further provide the total part which totals the number of the information regarding the factor of deviation recorded on the deviation information recording part for every some candidate regarding the factor of deviation. The totaling unit may perform totaling by paying attention to the relationship between the execution result and the target. In this case, since the factor of deviation is totaled, the factor of deviation can be analyzed.

  Another aspect of the present invention is also a nursing information management apparatus. This device is a nursing information management device that prescribes a nursing policy for a patient as a nursing plan, and is based on a nursing plan created for the patient, and an instruction unit that instructs the implementation of nursing items included in the nursing plan. And an input unit for inputting an evaluation on the result of the nursing item and a recording unit for recording the input evaluation. When the result of the nursing item and the goal of the nursing item instructed to diverge, the input unit inputs information on the cause of the divergence and also receives instructions on the completion or continuation of the nursing plan. The input information is recorded while being associated with the input evaluation, and the received instruction is reflected in the nursing plan referred to by the instruction unit.

  According to this aspect, since the received instruction is reflected in the nursing plan, the nursing plan can be maintained in the latest state.

  Yet another aspect of the present invention is a nursing information management method. This method is a nursing information management method for managing nursing information for a patient, and includes a step of inputting a nursing implementation result for the patient, a nursing plan including a nursing goal for the patient, and a factor of a difference between the implementation result. And a step of recording information on the result of the implementation and the cause of the divergence in association with the nursing plan.

  It should be noted that any combination of the above-described constituent elements and a conversion of the expression of the present invention between a method, an apparatus, a system, a recording medium, a computer program, etc. are also effective as an aspect of the present invention.

  According to the present invention, an appropriate nursing action can be provided.

  Before describing the present invention in detail, an outline will be described. An embodiment of the present invention relates to a nursing information management system that manages nursing actions performed on a patient and nursing actions to be performed on the patient. The nursing information management system includes a PC installed in a nurse station or the like, a PDA carried by the nurse, and a server for recording data used in the nursing information management system, which are connected by a LAN. The nursing information management system according to the present embodiment mainly has the following characteristics.

  The first is to define multiple stages for nursing and manage nursing while relating each stage. Further, since the plurality of stages are configured to be cyclic, it is possible to determine future nursing implementation contents in consideration of past nursing implementation contents. Second, the PC screen is configured so that the contents of nursing at a plurality of stages can be listed. A nurse uses a PDA when performing nursing, but basically uses a PC in other situations. By configuring the screen as described above, the contents of nursing can be confirmed while associating each of a plurality of stages. Further, in relation to this, what is important for nursing is selected as the content displayed on the screen.

  Thirdly, since two adjacent stages of a plurality of stages should be related, if one of the related parts is determined, the contents are automatically reflected in the other. Perform the following process. As a result, the other input is supported, so that input load and input mistakes can be reduced. Fourth, if the patient's recovery schedule and the actual recovery are different, the factor is also entered. The content of nursing can be improved by analyzing the factors of the difference.

  Further, the nursing information management system according to the present embodiment aims to provide an appropriate nursing action based on the above features. This has the following background. Due to the reform of the medical system, it is necessary to manage income and expenditure in hospitals. Considering hospital management, hospitals tend to control spending. In the medical system, the hospital spending increases as the patient's hospitalization period increases. Therefore, it is desired to improve the hospital nursing action to an appropriate one so as to shorten the hospitalization period and shorten the patient's hospitalization period. This is the same not only from the hospital standpoint but also from the patient standpoint.

  Hereinafter, the nursing information management system will be described. However, in order to clarify the explanation, the whole is divided into six parts. That is, the outline of the entire nursing information management system is described in (1), and each part included in the nursing information management system is described in (2) to (6).

(1. Overall configuration)
Before describing the configuration of the management information management system, terms defined in the nursing information management system will be described. The “nursing problem” indicates symptoms that should be the subject of nursing, and corresponds to a problem to be solved by the nurse's independent activities. Examples of nursing problems are "I have anxiety about rebleeding and treatment", "I can't maintain a comfortable environment due to vomiting and melena", and "I am mentally upset by a lot of blood and melena" A challenge that may affect the extent of patient recovery. When a nursing problem includes a plurality of items, each item is indicated as “nursing problem item”.

  The “nursing plan” indicates a nursing policy for a patient and corresponds to a nursing schedule. The nursing plan consists of four items: a plan for solving the nursing problem that obstructs the goal, the expected effect when the solution is made, the condition of the target patient, and the evaluation. The goal represents the expected state for one nursing problem and corresponds to the desired patient state. Examples of goals include: “Can accept and coexist with disease”, “Can understand the need for long-term treatment and actively participate in treatment”, “Awareness of self-care “I am motivated and can take daily life behaviors according to my symptoms”.

  The plan includes an observation plan (OP), a care plan (CP), and an education / teaching plan (EP). The OP indicates an observation item for determining the course of progress, and the CP indicates nursing care, EP indicates treatment, treatment, etc. EP shows education and guidance on knowledge, methods, techniques, etc. necessary to face problem prevention, mitigation, and resolution. Examples of OP are “upper airway obstruction, nighttime respiratory distress (sinking of tongue base / snoring-like breathing)”, “breathing status (number, depth, rhythm, chest movement, presence of effort-like breathing)” An example of CP is “a posture that does not impose a burden on the rib cage exercise”, “promotes coughing, and fixes the abdomen with both hands during sputum”. Explain the condition and get cooperation. "

The “nursing item” indicates the content of nursing for the patient. Nursing items are included in the nursing plan and correspond to the aforementioned plan. Here, the nursing items include OP, CP, and EP included in the above-described plan. Any other content may be used as long as the content is to be actually executed by the nurse.

  The problem here may be indicated as follows. In order to make nursing content appropriate, I would like to clarify the correspondence between nursing content and the results. I want to reduce mistakes in managing nursing content. I also want to prevent falsification of recorded nursing content. In addition, I would like to clarify the responsibility of nurses regarding correction work on recorded nursing contents. I also want to shorten the length of hospitalization for patients.

  FIG. 1 shows a nursing information management system 10 according to an embodiment of the present invention. The nursing information management system 10 includes a server 12, a first PC subsystem 14a collectively referred to as a PC subsystem 14, a KPC subsystem 14k, a first PDA subsystem 16a generally referred to as a PDA subsystem 16, a first LPDA subsystem 16l, LAN18 is included. The first PC subsystem 14a includes a first PC 20a and an NPC 20n collectively referred to as PC 20, and the first PDA subsystem 16a includes an AP (Access Point) 24, a first PDA 22a collectively referred to as PDA 22, and an MPDA 22m. For the sake of clarity, the description of the configuration of the PC subsystem 14 and the PDA subsystem 16 is omitted except for the first PC subsystem 14a and the first PDA subsystem 16a. However, it is assumed that their configurations are the same as those of the first PC subsystem 14a and the first PDA subsystem 16a.

  The PC subsystem 14 is provided in a nurse station, for example, and includes a plurality of PCs 20. Each of the PC subsystems 14 is connected to each other via the LAN 18, and each of the PCs 20 is also connected to each other. A medical staff such as a nurse performs data input, data reference, and confirmation at a nurse station where the PC 20 is installed. The PC 20 assists the nurse in creating a nursing problem item, supports the creation of a nursing plan based on the created nursing problem item, and includes the nursing items included in the created nursing plan. Instruct the implementation of.

  Here, “nursing problem item” corresponds to each nursing problem item when the nursing problem includes a plurality of items. “Nursing problem item creation support” and “nursing plan creation support” are executed by the PC 20 when the nurse creates a nursing problem and a nursing plan. It corresponds to that. Although details will be described later, the creation of a nursing plan is supported by searching the database based on the nursing problem items created for the patient. Here, the database includes items of a nursing plan associated with each of a plurality of types of items to be included in the nursing problem.

  The PDA subsystem 16 is provided at a place where nursing is performed such as a hospital room, an examination room, and an operating room, and includes an AP 24 and a PDA 22. In the PDA subsystem 16, the PDA 22 and the AP 24 are connected by a wireless LAN. The PDA subsystem 16 is connected to the PC subsystem 14 via the LAN 18. The PDA 22 has normal PDA functions such as data input means using a touch panel, processing means such as a CPU for the input data, data storage means, and display means for displaying processed data. Further, the PDA 22 has a wireless LAN communication function and an identification code reader that can read an identification code, for example, as a means for reading identification information. The identification information reading means may be an OCR (Optical Character Reader) that optically reads characters, an image scanner that reads characters and figures as images, a transponder that can read identification information by wireless communication, and the like. Further, the identification information may be input by the user.

  Since the PDA 22 has a wireless LAN communication function, it can access the LAN 18 within the service area provided by the AP 24. As a result, the PDA 22 accesses the PC 20 and the server 12, acquires the items of the nursing plan, and displays the acquired items of the nursing plan on the display device of the PDA 22. The nurse confirms the items of the nursing plan displayed on the display device of the PDA 22, and performs nursing according to the items of the nursing plan. In addition, the implementation result of the nursing item is input to the PDA 22 by the nurse. The PDA 22 transmits the input execution result to the PC 20.

  The PC 20 receives the execution result from the PDA 22. Furthermore, an evaluation for the result of the nursing item is input to the PC 20 by the nurse. “Evaluation” includes subjective and objective evaluation of the patient. Details thereof will be described later. The PC 20 records the input evaluation and the execution result input via the PDA 22 in a memory. Further, the PC 20 selects an execution result satisfying a predetermined condition from among the execution results recorded in the memory, and then displays it in a partial area of the screen. Implementation results are displayed in a part of the screen, and other information such as nursing problems and nursing plans are displayed in other areas.

  Further, the PC 20 inputs information on the cause of the deviation (hereinafter referred to as “variance factor”) when the result of the nursing item diverges from the target of the nursing item instructed to be implemented while inputting the evaluation. , Record this in association with the input evaluation. Here, the variance factor is a case where the implementation result shows a better result than the target (hereinafter referred to as “positive variance”) and a case where the implementation result shows a result worse than the target (hereinafter referred to as “negative”). "Variance of"). Moreover, the case where the implementation result shows a result better than the target corresponds to the case where the actual scheduled discharge date is earlier than the predetermined scheduled discharge date. That is, it shows a case where recovery is earlier than planned.

  The server 12 stores data used in the nursing information management system 10. Although one server 12 is assumed here, a plurality of servers 12 may be provided in the nursing information management system 10. At that time, the server 12 may be included in the PC subsystem 14, and a hierarchical structure may be formed by the plurality of servers 12. In the following description, for the sake of brevity, it is assumed that data is communicated between the PC 20 and the PDA 22. However, such data may be communicated between the PC 20 and the PDA 22 via the server 12. Further, the content of data recorded in the server 12 and the content of data recorded in the PC 20 may be subjected to the same processing by a known technique. Here, the description is omitted.

  The PC subsystem 14 and the PDA subsystem 16 are more specifically an outpatient system in which orders such as injections are registered, a ward system, a drug department system that dispenses drugs by registering orders such as injections, It corresponds to medical systems that perform accounting for medical practices, nurse (station) systems that perform mixed injections by nurses, etc. This embodiment is directed to a nurse system. In particular, in the nurse system and ward system where nurses perform nursing actions, each nurse carries a PDA 22, and the nurse goes to the place where the nursing action is performed, specifically to the bedside of a patient who is hospitalized. , Input and output data on the nursing action at that location. As a result, the nursing information status is recorded or grasped by the nursing information management system 10 in real time.

  FIG. 2 shows the configuration of the PC 20. The PC 20 includes a problem creation support unit 30, a first database 32, a plan creation support unit 34, a second database 36, an instruction unit 38, a third database 40, a control unit 42, a screen creation unit 44, a selection unit 46, and a holding unit 48. , An input control unit 50, a communication unit 52, a correction unit 54, a management unit 56, and a totaling unit 58. The management unit 56 includes a recording unit 60. Further, the PC 20 connects the operation device 62 and the display device 64.

  The display device 64 displays predetermined information. The display device 64 may be configured integrally with the PC 20. The screen creation unit 44 generates a screen to be displayed on the display device 64. The screen creation unit 44 receives information for generating a screen to be displayed from the control unit 42. In the present embodiment, the screen generated by the screen creation unit 44 is configured to be able to list each content at a plurality of stages of nursing. The configuration of the screen will be described later.

  The operation device 62 is operated by a nurse and inputs predetermined information to the PC 20. The operation device 62 is configured by a keyboard, a mouse, and the like. Further, the operation device 62 may also be configured integrally with the PC 20. The input control unit 50 receives information input by the operation device 62. Further, the input control unit 50 outputs the received information to the control unit 42. In general, the nurse uses the operation device 62 to input predetermined information while checking the screen displayed on the display device 64. Therefore, in order to recognize which part of the screen the information input by the operation device 62 corresponds to, the input control unit 50 receives information related to the screen configuration from the screen creation unit 44.

  The communication unit 52 is connected to the LAN 18 in FIG. 1 and communicates with the server 12, another PC 20, and the PDA 22 via the LAN 18. The communication unit 52 receives information to be transmitted from the control unit 42 and outputs the received information to the control unit 42. In addition, the communication unit 52 communicates with the PDA 22 at a predetermined timing in order to realize data synchronization between the PC 20 and the server 12. The control unit 42 controls input / output of predetermined information between components included in the PC 20. That is, the control unit 42 receives information from one component and outputs information to another component. In addition, one component and another component are appropriately switched according to the function to be realized. Therefore, the control unit 42 has a switch function. Hereinafter, for the sake of clarity, the operation of one component and another component will be described, and the description of the operation of the control unit 42 will be omitted.

  The problem creation support unit 30 assists the patient in creating items of nursing problems. The problem creation support unit 30 outputs options for creating a nursing problem on the display device 64 in cooperation with the first database 32. Following this, the problem creation support unit 30 receives the selected option from the operation device 62. Furthermore, by repeatedly performing the above operations, it finally supports the creation of nursing problem items. In addition, the problem creation support unit 30 receives comments on the created nursing problem items. The problem creation support unit 30 outputs the created nursing problem items to the plan creation support unit 34 and the recording unit 60. The output is made via the control unit 42 and the management unit 56.

  The plan creation support unit 34 supports the creation of a nursing plan based on the created nursing problem items. The plan creation support unit 34 extracts a nursing plan corresponding to the created nursing problem item by searching the second database 36 based on the created nursing problem item. Here, the contents of the data included in the second database 36 will be described later. The plan creation support unit 34 displays the extracted nursing plan on the display device 64. Furthermore, the plan creation support unit 34 receives comments on the created nursing plan. The plan creation support unit 34 outputs the created nursing plan to the recording unit 60.

  The instruction unit 38 instructs the implementation of the nursing items included in the created nursing plan in cooperation with the third database 40. The instruction unit 38 transmits an instruction to perform nursing items to the PDA 22 via the communication unit 52. The instruction unit 38 may display an instruction to perform nursing items on the display device 64. When the instructed nursing item is executed by the nurse, the nurse inputs the result into the PDA 22, and the PDA 22 transmits the implementation result of the nursing item to the communication unit 52. Upon receiving the nursing item implementation result, the communication unit 52 outputs the result to the recording unit 60. Further, the nursing result stored in the recording unit 60 is displayed on the display device 64. At that time, a nursing result to be displayed on the display device 64 is selected by the selection unit 46 and the holding unit 48.

  The nurse inputs an evaluation of the result of the nursing item into the operation device 62. The input evaluation is recorded in the recording unit 60. The management unit 56 associates items corresponding to each other among items of nursing problems stored in the recording unit 60, nursing items included in the nursing plan, implementation results, and evaluations by a series of identifiers. That is, for example, if “# 1” is given to one nursing problem item as an identifier, “# 1” is also included in nursing items, implementation results, and evaluations included in the nursing plan corresponding to the nursing problem item. Is given. As a result, the screen creation unit 44 creates a screen so that nursing problem items, nursing items included in the nursing plan, implementation results, and evaluation are integrally included in one screen. Furthermore, a new nursing plan is input to the recording unit 60 in cooperation with the input evaluation. Since the process following the input nursing plan is the same as the process described so far, the description is omitted. The recording unit 60 only needs to have a function of storing predetermined information, and includes a hard disk and a RAM (Random Access Memory). Further, it may be physically constituted by a plurality of media, for example, one hard disk and one RAM. They are not distinguished here for the sake of brevity.

  The correction unit 54 receives corrections for at least one of nursing problem items, nursing items included in the nursing plan, implementation results, and evaluations stored in the recording unit 60. At that time, in order to prevent falsification by a third party, the correction unit 54 manages the correction history so that it cannot be deleted. For example, the correction history is managed. At this time, the correction date and time and the corrector are also managed.

  When the evaluation is input to the operation device 62, a variance factor may be input. Although the variance factors will be described later, the recording unit 60 records the variance factors in association with the items of nursing problems, the nursing items included in the nursing plan, the implementation results, and the evaluation. Further, the totaling unit 58 performs a predetermined totaling process on the variance factors recorded in the recording unit 60.

  This configuration can be realized in terms of hardware by a CPU, memory, or other LSI of an arbitrary computer, and in terms of software, it is realized by a program having a reservation management function loaded in memory. The functional block realized by those cooperation is drawn. Accordingly, those skilled in the art will understand that these functional blocks can be realized in various forms by hardware only, software only, or a combination thereof.

  FIG. 3 shows the data structure of nursing information recorded in the recording unit 60. The figure corresponds to nursing information for one patient, but nursing information for a plurality of patients is stored in the recording unit 60. The nursing information includes an identification number column 100, a nursing problem column 102, a nursing plan column 104, an implementation result column 106, a nursing record column 108, and a variance factor column 110. In the identification number column 100, an identification number assigned by the management unit 56 is recorded. In the nursing problem column 102, the nursing plan column 104, the implementation result column 106, the nursing record column 108, and the variance factor column 110, a nursing problem item corresponding to a predetermined identification number, a nursing item included in the nursing plan, an implementation result, Each evaluation and variance factor is recorded. The contents of information included in the nursing plan column 104, the implementation result column 106, the nursing record column 108, and the variance factor column 110 will be described later.

  FIG. 4 is a flowchart showing a nursing information management procedure in the nursing information management system 10. Each step in the flowchart corresponds to each of a plurality of stages defined for nursing. The management unit 56 executes a patient selection stage (S10). The patient selection step corresponds to a step of selecting one piece of information to be processed from a plurality of pieces of patient information stored in the recording unit 60. At that time, the nurse uses the operation device 62 to select one patient. The problem creation support unit 30 executes a problem creation stage (S12). The problem creation stage corresponds to the stage of creating items for nursing problems. The plan creation support unit 34 executes a plan creation stage (S14). The plan creation stage corresponds to the stage of creating a nursing plan. The instruction unit 38 executes the order stage (S16). The order stage corresponds to a stage instructing the implementation of nursing items. At that time, an order is issued and the contents of the nursing item are output to the PDA 22.

  The nurse executes the nursing action stage (S18). The nursing action stage mainly corresponds to the stage of artificial work. The PDA 22 and the recording unit 60 execute an implementation result recording stage (S20). The implementation result recording stage corresponds to a stage in which the nurse inputs the implementation result to the PDA 22 and the recording unit 60 records the implementation result after the communication unit 52 receives it. The recording unit 60 executes the evaluation recording stage (S22). The evaluation recording stage corresponds to a stage where the recording unit 60 records the evaluation and the variance factor via the operation device 62. At that time, the management unit 56 receives an input as to whether or not to end the nursing plan. If the plan is finished (Y in S24), the process is finished. If the plan is not completed (N in S24), the management unit 56 and the like execute a feedback stage (S26). The feedback stage corresponds to a stage in which the processing from step 14 is repeatedly executed. At that time, the nursing plan may be corrected or a new nursing plan may be added.

  The operation of the nursing information management system 10 having the above configuration will be described. The nurse operates the PC 20 installed in the nurse station and selects a patient to be a nursing target. The nurse creates a nursing problem item in the PC 20, and the PC 20 creates a nursing plan based on the created nursing problem item. The nurse issues an order from the PC 20 to the server 12 while referring to the nursing items included in the nursing plan. The order is also transmitted to the PDA 22. The nurse performs the nursing action while confirming the nursing items displayed on the PDA 22 in the hospital room. Further, the nurse inputs the implementation result of the nursing action to the PDA 22, and the PDA 22 transmits the implementation result to the PC 20. The nurse returns to the nurse station again and uses the PC 20 to enter the evaluation. The PC 20 records the execution result received from the PDA 22 in association with the evaluation. A nursing plan is added based on the evaluation.

  According to the above configuration, a plurality of stages are defined for nursing, and management is performed while associating each of the plurality of stages. Therefore, the relationship between the contents of nursing and the nursing results can be clarified. In addition, since the relationship between the content of nursing and the nursing result is clarified, the content of nursing for providing a predetermined nursing result can be grasped. In addition, the content of nursing can be improved more appropriately. Moreover, since the content of nursing can be improved, the hospitalization period of the patient can be shortened. It is also desirable for the patient because the patient's hospital stay can be shortened. In addition, among the nursing problem items, the nursing items included in the nursing plan, and the evaluation, the items corresponding to each other are related by a series of identifiers, so that errors in the management of these items can be reduced. In addition, management of these items can be facilitated. Further, since the correction history is managed so that it cannot be erased, tampering can be prevented. In addition, when the inconvenience occurs in the nursing due to the correction, the correction can be specified. Also, nurses' attention to correction can be urged. In addition, nurses' responsibilities can be clarified regarding corrections.

  In addition, since the difference between the recorded nursing action execution time and the actual nursing action execution time is reduced, it is possible to accurately record and grasp the nursing action. In addition, since the nurse confirms the contents of the work schedule of the nursing action by the PDA at the place where the nursing action is performed, the accuracy of the nursing action can be improved. Further, since the nurse inputs the execution result immediately at the place where the nursing action is performed, the input becomes accurate. In addition, since the nurse confirms the content of the nursing action at an arbitrary place and time by the PDA, the nursing action can be smoothly performed. In addition, even if the contents of the nursing action are changed, the nurse can cope with the change of the contents of the nursing action by using the PDA at the place of implementation and confirming the changed contents before performing nursing. it can. In addition, since the nursing information management system accurately records the result of the nursing action, the manager or the like can improve the system so as to be in a more appropriate state by analyzing the recorded data thereafter.

(2. Patient selection)
Patient selection corresponds to step 10 in FIG. The problem here may be indicated as follows. I want to select patients easily. I want to select patients accurately. Here, the screen creation unit 44, the display device 64, the operation device 62, the input control unit 50, the control unit 42, the management unit 56, and the recording unit 60 of FIG. 2 are mainly used for nursing selection.

  The recording unit 60 records patient information. FIG. 5 shows a data structure of patient information recorded in the recording unit 60. The patient information includes a patient ID column 112, a patient name column 114, a gender column 116, an age column 118, a hospitalization date column 120, a scheduled discharge date column 122, a hospital stay date column 124, and a comment column 126. The patient ID column 112 records the identification number assigned to the patient, and the patient name column 114 records the patient's name. The sex column 116 records the patient's gender, and the age column 118 records the patient's age. The hospitalization date column 120 records the patient's hospitalization date, the hospital discharge date column 122 records the patient's scheduled hospital discharge date, and the hospitalization date column 124 records the patient's hospitalization date. The comment column 126 records a comment for the patient. The patient information recorded in the recording unit 60 may include information other than these, for example, the basic profile of the patient such as family structure, occupation, ward, etc., the patient's medical history, lifestyle before hospitalization, It may be the history up to the hospital visit, daily activities, or psychological aspects.

  The screen creation unit 44 causes the display device 64 to display a list of patient information recorded in the recording unit 60. The input control unit 50 receives an instruction to select one patient from the patient information from the operation device 62. The management unit 56 selects patient information and nursing information for one patient from the recording unit 60 based on the instruction received by the input control unit 50.

  FIG. 6 is a flowchart showing a procedure for selecting patient information in the PC 20. The management unit 56 outputs a list of patient information recorded in the recording unit 60 (S30). The screen creation unit 44 displays a list of patient information on the display device 64 (S32). FIG. 7 shows a screen at the patient selection stage displayed on the display device 64. A patient selection button 200, a planning button 202, an order issue button 204, and a recording / evaluation button 206 are arranged at the top of the screen, and the patient selection button 200 is selected at the stage of patient selection. The screen includes a hospital room column 208, a patient ID column 210, a patient name column 212, a gender column 214, an age column 216, a hospitalization date column 218, a scheduled discharge date column 220, a hospital stay date column 222, and a comment column 224. These contents correspond to the patient information recorded in the recording unit 60.

  Returning to FIG. If no patient is selected by the operating device 62 (N in S34), the process waits until it is selected. On the other hand, if a patient is selected by the operating device 62 (Y in S34), the input control unit 50 receives selection information. In FIG. 7, the nurse selects “Taro Tokyo” as one patient while using the operation device 62. Returning to FIG. If the nursing information for the selected patient exists in the recording unit 60 (Y in S36), the management unit 56 reads the corresponding nursing information (S38). On the other hand, if there is no nursing information for the selected patient in the recording unit 60 (N in S36), the management unit 56 creates new nursing information (S40).

  The operation of the PC 20 having the above configuration will be described. The nurse determines a patient to be a subject of nursing from the list of patient information displayed on the display device 64. The nurse operates the operation device 62 to select the determined patient. Thereafter, the nursing information for the selected patient is displayed on the display device 64.

  According to the above configuration, since the patient who should be the subject of nursing is selected from the list displayed on the display device, the selection process can be facilitated. Moreover, since the patient who should become the nursing object is selected from the list displayed on the display device, the selection process can be performed accurately. Moreover, since the screen used for nursing management and the screen for selecting a patient can be switched by pressing a button, switching between the two can be facilitated.

(3. Preparation of nursing problems / nursing plans)
The creation of a nursing problem / nursing plan corresponds to Step 12 and Step 14 in FIG. The problem here may be indicated as follows. I want to create nursing problems easily. I want to create nursing problems accurately. I also want to create nursing problems for each patient. In addition, I want to create a nursing plan easily. In addition, I want to make a nursing plan accurately. I want to create a nursing plan for each patient. Here, in order to create a nursing problem / nursing plan, the screen creation unit 44, display device 64, operation device 62, input control unit 50, control unit 42, management unit 56, recording unit 60, problem creation support in FIG. The unit 30, the first database 32, the plan creation support unit 34, and the second database 36 are mainly used.

  The problem creation support unit 30 assists the patient in creating items of nursing problems. The problem creation support unit 30 uses the nursing problem database included in the first database 32 to support the creation of nursing problem items. FIG. 8 shows the data structure of the nursing problem database included in the first database 32. The nursing problem database includes a medical department column 130, a disease column 132, a nursing problem column 134, and a nursing problem code column 136. The medical department column 130 records a plurality of medical departments targeted for medical care in the hospital. The plurality of departments include, for example, “Gastroenterology” and “Pediatrics”. The disease column 132 records, for each of a plurality of departments, a plurality of diseases to be treated by each department.

  For example, diseases such as esophagitis and colorectal cancer are recorded corresponding to the clinical department of the gastroenterology department. The nursing problem column 134 records a plurality of types of items to be included in the nursing problem for each of a plurality of diseases. For example, “There is a risk of falling into hemorrhagic shock due to bleeding or melena” is recorded corresponding to colorectal cancer. Each of a plurality of types of items to be included in a nursing problem is assigned a nursing problem code as an identifier. The nursing problem code column 136 records nursing problem codes corresponding to a plurality of types of items to be included in the nursing problem. As described above, items of clinical departments, diseases, and nursing problems are associated with each other. In other words, the nursing problem database defines a plurality of types of items that should be included in nursing problems across a plurality of clinical departments.

  Returning to FIG. The problem creation support unit 30 presents a plurality of types of items to the nurse in an integrated manner via the screen creation unit 44 and the display device 64, and further provides nursing to the nurse through the operation device 62 and the input control unit 50. Have the problem item selected. Here, the term “overall” corresponds to the grouping of a plurality of types of items by medical departments and diseases, and the grouping of a plurality of types of items into a predetermined category. More specifically, it will be as follows. The problem creation support unit 30 presents a plurality of clinical departments to the nurse via the screen creation unit 44 and the display device 64, and then, from the nurse through the operation device 62 and the input control unit 50, Accept instructions for selection.

  The problem creation support unit 30 extracts a plurality of disease names corresponding to the medical department selected by the nurse from the first database 32, and the extracted plurality of disease names via the screen creation unit 44 and the display device 64. Present to the nurse. Further, the problem creation support unit 30 receives an instruction regarding selection of a disease name from the nurse via the operation device 62 and the input control unit 50. The problem creation support unit 30 extracts a plurality of types of items corresponding to the disease name selected by the nurse from the first database 32, and extracts the extracted types of items via the screen creation unit 44 and the display device 64. Present to the nurse. Finally, the problem creation support unit 30 receives an instruction regarding selection of an item from the nurse via the operation device 62 and the input control unit 50, and first sets a nursing problem code corresponding to the item selected by the nurse. Extract from database 32. As a result of the above processing, the problem creation support unit 30 outputs the created nursing problem code to the plan creation support unit 34.

  As described above, the first database 32 stores a plurality of types of items to be included in the nursing problem as fixed phrases, and the problem creation support unit 30 causes the nurse to select one of the fixed phrases. Furthermore, the problem creation support unit 30 presents a free description field to the nurse. This free description column corresponds to a column for describing a comment for a fixed phrase. The item of the nursing problem for the patient may not be uniquely determined, and in that case, a comment is described. The management unit 56 associates the comment in the free description column input by the nurse with the selected fixed phrase. The comment in the associated free description field is stored in the recording unit 60 together with the fixed sentence. That is, it is stored in the nursing problem column 102 of FIG.

  Returning to FIG. The plan creation support unit 34 assists in creating a nursing plan by searching the nursing plan database included in the second database 36 based on the nursing problem code created for the patient. Here, the nursing plan database includes nursing plan items associated with each of a plurality of types of items to be included in the nursing problem. FIG. 9 shows the data structure of a nursing care plan database included in the second database 36. The nursing plan database includes a nursing problem code column 140, a goal column 142, and a plan column 144. The nursing problem code column 140 records a nursing problem code corresponding to each of a plurality of items to be included in the nursing problem. The goal column 142 records a goal corresponding to the nursing problem code. As the target, for example, “Bleeding is detected early and a serious shock state is not caused” is recorded. In the plan column 144, a plan corresponding to the target is recorded. It can be said that goals and plans correspond to nursing problem codes. As described above, the plans are classified into OP, CP, and EP.

  As described above, the second database 36 stores nursing plan items as standard sentences, and the plan creation support unit 34 stores the standard sentence according to the nursing problem code selected by the problem creation support unit 30. Let them choose one. Furthermore, the plan creation support unit 34 presents a free description field to the nurse. This free description column corresponds to a column for describing a comment for a fixed phrase. The item of the nursing plan for the patient may not be uniquely determined, and in that case, a comment is described. The management unit 56 associates the comment in the free description column input by the nurse with the selected fixed phrase. The comment in the associated free description field is stored in the recording unit 60 together with the fixed sentence. That is, it is stored in the nursing plan column 104 of FIG.

  Returning to FIG. The screen creation unit 44 causes the problem creation support unit 30, the plan creation support unit 34, and each GUI to be provided for display of an implementation result and evaluation described later to be displayed on the screen of the display device 64. Hereinafter, the GUI to be provided for the problem creation support unit 30 is referred to as “problem list”, and the GUI to be provided for the plan creation support unit 34 is referred to as “nursing plan” for displaying the execution result and evaluation. The GUI that should be provided to is called “nursing record”. Here, the management unit 56 operates for “nursing record”. Note that the communication unit 52, the input control unit 50, and the operation device 62 are used to input nursing records. The screen creation unit 44 configures a problem list, a nursing plan, and a nursing record in a single screen. That is, a screen is provided for the nurse so that a list of nursing problems, nursing plans, implementation results, and evaluations can be displayed.

  In addition, the screen creation unit 44 displays the GUI to be provided for the evaluation display in a part of the area where the GUI to be provided for the display of the implementation result is displayed in the nursing record. In other words, a screen is provided that makes the correspondence between the implementation result and evaluation clear. Further, the evaluation includes information on the current state of the patient. In the screen creation unit 44, an area for displaying the GUI to be provided for display of the evaluation includes an area corresponding to the information on the patient status, The area is divided into areas corresponding to evaluations other than information on the state.

  Here, the evaluation corresponds to “SOAP format” which is one of the recording formats of the progress record. “S (Subjective)” corresponds to the patient's subjective complaint and corresponds to the patient's remarks related to the nursing problem as it is or according to it. That is, S can be said to be subjective information about the patient. For example, “Would you like me to wipe my body?” Or “Change my pajamas.” “O (Objective)” corresponds to numerical values such as test results and vitals, and contents based on objective observations and facts of nurses. That is, O can be said to be objective information about the patient. For example, “At the time of the round, the lower limbs, upper limbs, and front chest could not be wiped, so the skin was a little sticky.” I cannot change my clothes. "

  “A (Assessment)” corresponds to a nurse's judgment and thought process for S and O. That is, A can be said to be an evaluation by a nurse. For example, “the risk of developing pressure sores increases if the skin is contaminated or moistened”. “P (Plan)” corresponds to a future schedule or plan based on A. That is, P can be said to be a future nursing plan. For example, “(1) wipe the upper limbs / lower limbs / front chest” (2) observe the state of the skin, (3) change the underwear and nightclothes after wiping ”. The information regarding the patient state corresponds to S and O in the SOAP format, and the evaluation other than the information regarding the patient state corresponds to A and P in the SOAP format.

  The screen creation unit 44 is linked to the operation of the problem creation support unit 30 and is included in a first area where a plurality of medical departments are to be displayed, a second area where a plurality of diseases are to be displayed, and a nursing problem. A third region in which a plurality of types of items to be displayed is to be displayed is defined. These contents correspond to the above description. The first region to the third region are regions that do not overlap each other on the screen, and their sizes, positions, etc. may be arbitrary. In order to clarify the correspondence between the departments, diseases, and items, the first region to the third region may be arranged adjacent to each other. Furthermore, the screen creation unit 44 displays a plurality of departments in the first area. When the nurse selects one of a plurality of departments displayed in the first area via the operation device 62, the screen creation unit 44 displays a plurality of diseases corresponding to the selected department. Display in two areas. When one of the plurality of diseases displayed in the second area is selected by the nurse via the operation device 62, the screen creation unit 44 selects a plurality of types of items corresponding to the selected disease as the third item. Display in the area.

  The screen creation unit 44 displays information on the nursing plan on the screen in conjunction with the operation of the plan creation support unit 34. That is, when the plan creation support unit 34 searches the second database 36 based on the nursing problem items created for the patient, the screen creation unit 44 finds the search result in the area assigned to the nursing plan. Is displayed.

  FIG. 10 is a flowchart showing a procedure for creating a nursing problem and a nursing plan in the PC 20. The screen creation unit 44 causes the display device 64 to display an initial screen. FIG. 11 shows an initial screen at the planning stage displayed on the display device 64. As in FIG. 7, a record / evaluation button 206 is displayed from the patient selection button 200, but here the planning button 202 is selected. In addition, a problem list field 230, a nursing plan field 232, and a nursing record field 234 are displayed on the screen, and these correspond to the above-described problem list, nursing plan, and nursing record. As shown in the figure, the problem list, nursing plan, and nursing record are arranged so that they can be listed. Returning to FIG. The problem creation support unit 30 presents a plurality of departments on the display device 64 (S50). The clinical department is selected by the nurse via the operation device 62 (S52).

  Subsequently, the problem creation support unit 30 presents a plurality of diseases on the display device 64 (S54). A disease is selected by the nurse via the operation device 62 (S56). Furthermore, the problem creation support unit 30 presents a plurality of types of items of nursing problems on the display device 64 (S58). The nursing problem item is selected by the nurse via the operation device 62 (S60). FIG. 12 shows a nursing problem selection screen displayed on the display device 64. A nursing problem selection window 240 is displayed at the center of the screen. The nursing problem selection window 240 includes a medical department field 242, a disease field 244, and a nursing problem field 246, which correspond to the first to third areas described above.

  The figure corresponds to the state of step 60, in which “digestive organ department” in the medical department column 242 has already been selected and “colon cancer” in the disease column 244 has been selected. In addition, one of the nursing problem selection windows 240 is selected. In the step 50, nothing is displayed in the disease column 244 and the nursing problem column 246, and nothing is displayed in the nursing problem column 246 in the step 54. That is, when one option is selected, the subsequent options are displayed.

  Returning to FIG. If a nursing problem item is selected, the plan creation support unit 34 selects a nursing plan while searching the second database 36 (S62). FIG. 13 shows a screen after input of the nursing plan displayed on the display device 64. Nursing problem items are displayed in the problem list column 230, and nursing plan items are displayed in the nursing plan column 232. Here, “# 1” or the like corresponds to an identifier that associates items corresponding to each other among items of nursing problems, nursing items included in a nursing plan, implementation results, and evaluations. Returning to FIG. The management unit 56 prompts the user to input a nursing problem comment. If there is a nursing problem comment (Y in S64), the nurse uses the operation device 62 to input the comment (S66).

  The management unit 56 associates the nursing problem item with the comment (S68) and records them in the recording unit 60. If there is no nursing problem comment (N in S64), these processes are not executed. FIG. 14 shows a nursing question comment addition screen displayed on the display device 64. A nursing problem free description window 250 is displayed at the center of the screen. The nurse inputs a comment in the comment field included in the free description window 250 for nursing problems. FIG. 15 shows a screen after inputting a comment on a nursing problem displayed on the display device 64. A comment is entered in the problem column “# 1” in the problem list field 230.

  Returning to FIG. If there is a comment on the nursing plan (Y in S70), the nurse inputs the comment using the operation device 62 (S72). The management unit 56 associates the nursing plan item with the comment (S74) and records them in the recording unit 60. If there is no comment on the nursing plan (N in S70), these processes are not executed. FIG. 16 shows a nursing plan editing screen displayed on the display device 64. A nursing plan editing window 260 is displayed at the center of the screen. The nursing plan edit window 260 includes a fixed description column 262 and a free description column 264. The nurse edits the already entered nursing plan item by inputting a predetermined instruction in the fixed form description field 262. In addition, the nurse inputs a comment in the free description field 264. FIG. 17 shows a screen after editing the nursing plan displayed on the display device 64. A comment is entered as “(Other)” in the plan in “# 1” of the nursing plan column 232.

  The operation of the PC 20 having the above configuration will be described. The nurse selects a corresponding nursing problem item via the operation device 62 from a plurality of types of items to be included in the nursing problem displayed on the display device 64. The PC 20 selects a nursing plan item corresponding to the selected nursing problem item, and displays the selected nursing problem item on the display device 64. Furthermore, the nurse inputs a comment on the nursing problem and a comment on the nursing plan while using the operation device 62. The PC 20 associates the created nursing problem item, nursing plan item, and comments with the item, and records them in the recording unit 60.

  According to the above configuration, since a nursing problem is created, selection is made from items specified in advance, so that the nursing problem can be easily created. In addition, errors in creating nursing problems can be reduced. Nursing problems are defined by multiple stages. When one of the multiple stages is selected, selection candidates for the next stage are displayed, so the selection process becomes clear. Selection mistakes can be reduced. In addition, since the plurality of stages are arranged so as to be adjacent to each other on one screen, the relationship between them can be clarified. In addition, when creating a nursing problem, not only pre-defined items but also comments can be added, so that a nursing problem suitable for each patient can be created.

  In addition, since the nursing plan item is selected from the nursing problem items while referring to the database in which the nursing problem item and the nursing plan item are associated with each other, the creation of the nursing plan can be facilitated. In addition, since the items of the nursing plan are defined in advance, errors in creating the nursing plan can be reduced. In addition, when creating a nursing plan, not only pre-defined items but also comments can be added, so that a nursing plan suitable for each patient can be created. In addition, nursing problems, nursing plans, implementation results, and evaluations are arranged on a single screen, so their relevance can be clarified. In addition, since the response becomes clear, the accuracy of nursing action can be improved. Moreover, since evaluation is displayed in a part of area | region which should display an implementation result, the relevance of an implementation result and evaluation can be clarified. Moreover, in the area where the evaluation is to be displayed, information relating to the current state of the patient and the other evaluations are displayed in association with each other, so that the relationship between them can be clarified.

(4. Order issuance)
The order issuance corresponds to step 16 in FIG. The problem here may be indicated as follows. I want to reduce mistakes in order creation. In addition, I want to reduce the amount of processing in order issue. I want to reduce mistakes in nursing.

  Before describing a specific configuration, order issue will be described. FIG. 18 is a schematic diagram for illustrating order issue processing in the nursing information management system 10. The figure shows injection order issue as order issue. The nurse creates an order (S80) and registers the order (S82). In the case of injection, when an order is registered, the process branches as follows. First, the ward system (not shown) is instructed to receive instructions in the ward (S84). The instruction reception is executed by the nurse. Second, the medicine department system (not shown) is instructed to dispense medicines in the medicine department (S86). The payout is performed by a pharmacist.

  Third, the ward system (not shown) is instructed to mix the drugs in the ward (S88). Mixed injection is also called mixing. The mixed injection is performed by a nurse. Fourth, the nursing information management system 10 is instructed to start injection to the patient in the ward (S90). Fifth, the nursing information management system 10 is instructed to end the injection to the patient in the ward (S92). The injection is performed by a nurse. Here, the injection includes both drip injection and one-shot injection. In the case of drip injection, since administration is performed over time, generally, in the case of one-shot injection in which the work of starting and ending administration is performed separately, the administration is completed in one action. Administration starts and ends almost simultaneously.

  2, the screen creation unit 44, display device 64, operation device 62, input control unit 50, control unit 42, management unit 56, recording unit 60, instruction unit 38, third database 40, communication unit in FIG. 52 is mainly used.

  The instruction unit 38 supports generation of an order for an instruction based on nursing items in an area in the screen displayed by the screen creation unit 44. The instruction unit 38 uses the order database included in the third database 40 in order to support the generation of orders. FIG. 19 shows the data structure of the order database included in the third database 40. The order database includes an item type field 150, a classification field 152, and an order item field 154. The order database associates each of the item type fields 150 with a plurality of classifications defined in the classification field 152, and each of the classification fields 152 has a plurality of order items defined in the order item field 154. It is prescribed to correspond.

  The item type column 150 defines the type of order. Here, the types of orders include “observation”, “care”, “guidance”, “observation measures”, “other”, and “reservation”. The classification column 152 defines the classification of the disease. Here, “digestive organ disease”, “circulatory disease” and the like are included as classification of diseases. The order item column 154 defines the contents of the order. Here, the contents of the order include “nausea”, “vomiting” and the like. Such an order database is displayed on the display device 64 by the screen creation unit 44, and the nurse selects a predetermined item from the order database while referring to the nursing item. For example, if the nursing item relates to a digestive organ disease, the nurse selects the digestive organ disease from the classification field 152.

  Returning to FIG. The selection by the nurse as described above is accepted by the operation device 62 and the input control unit 50. The generated order is recorded in the recording unit 60. Further, the instruction unit 38 displays on the display device 64 that the generated order is to be transmitted. Thereafter, if the instruction unit 38 receives a confirmation operation from the nurse via the operation device 62, the instruction unit 38 outputs the order to the communication unit 52. The communication unit 52 transmits the order to the server 12. The order is transmitted to the PDA 22 via the server 12.

  FIG. 20 is a sequence diagram showing a processing procedure for order issuance in the nursing information management system 10. In the first PC 20a, the nurse creates an order (S100). Based on the order issuance instruction by the nurse, the first PC 20a transmits the created order to the server 12 (S102). The server 12 registers the order (S104). Furthermore, the server 12 confirms the destination to which the registered order is to be transmitted (S106). As a result, it is assumed that the destination is the first PDA 22a. The server 12 transmits the registered order to the first PDA 22a (S108). The first PDA 22a displays the received order on a display unit (not shown) (S110).

  FIG. 21 is a flowchart showing the order issue processing procedure in the PC 20. The instruction unit 38 refers to the third database 40 to present the item type on the display device 64 (S120). The item type is selected by the nurse via the operation device 62 (S122). The instruction unit 38 receives the selection instruction. The instruction unit 38 refers to the third database 40 and presents the classification on the display device 64 (S124). A classification is selected by the nurse via the operation device 62 (S126). The instruction unit 38 receives the selection instruction. The instruction unit 38 refers to the third database 40 and causes the display device 64 to present the order item (S128). The order item is selected by the nurse via the operation device 62 (S130).

  The instruction unit 38 receives the selection instruction. If the selection of the order item has not been completed (N in S132), the process of step 130 is repeated. On the other hand, if the selection of the order item is completed (Y in S132), the nurse inputs an implementation schedule using the operation device 62 (S134). The instruction unit 38 receives the inputted execution schedule. FIG. 22 shows a screen at the order issue stage displayed on the display device 64. The figure corresponds to step 134 in FIG. The record / evaluation button 206 is displayed from the patient selection button 200, but here, the order issue button 204 is selected. An order issue window 270 is displayed at the center of the screen. The order issue window 270 includes an item type column 272, a classification column 274, an order item column 276, and a schedule column 278. The item type column 272, the classification column 274, and the order item column 276 respectively correspond to the item type column 150, the classification column 152, and the order item column 154 in FIG.

  The schedule column 278 corresponds to an implementation schedule. Here, at the stage of selecting one of the item type fields 272, the contents of the classification field 274 and the order item field 276 are not displayed, and when any of the item type fields 272 is selected, The contents are displayed. That is, when selection is performed in a predetermined option in the order of the item type column 272, the classification column 274, and the order item column 276, the subsequent options are displayed. Returning to FIG. The instructing unit 38 combines the selected item type, classification, order item, and execution schedule into an order. When the instruction unit 38 receives an order instruction from the nurse via the operation device 62, the communication unit 52 transmits the order to the server 12 (S136).

  The operation of the nursing information management system 10 having the above configuration will be described. The nurse creates an order using the operation device 62 while referring to the nursing items displayed on the display device 64. If the created order is acceptable, the nurse uses the operation device 62 to input the confirmation. The PC 20 transmits an order to the server 12. Further, the order is also transmitted to the PDA 22.

  According to the above configuration, the nurse creates an order while referring to the nursing plan displayed on the screen, so that mistakes in order creation can be reduced. When the created order is transmitted, it is registered in the server, so that the creation and registration of the order can be unified. In addition, since order creation and registration can be unified, processing in order issuance can be reduced. Further, the order issuance can be integrated with another system by transmitting the order to a server corresponding to the other system. In addition, when an order is transmitted, a confirmation operation by the nurse is performed, so that an order created in error can be corrected. Further, since the transmitted order is transmitted to the PDA owned by the nurse, the nurse can confirm the contents of the order on the PDA. In addition, mistakes in nursing actions can be reduced.

(5. Record and display of implementation results)
The recording and display of the execution result corresponds to step 20 in FIG. The problem here may be indicated as follows. When displaying the implementation results, I would like to display a list of the implementation results even in a limited display area. We also want to make it easier for nurses to confirm the necessary information. Here, in order to record and display the implementation results, the screen creation unit 44, the display device 64, the control unit 42, the management unit 56, the recording unit 60, the communication unit 52, the holding unit 48, and the selection unit 46 in FIG. Mainly used. As a premise, in step 18 of FIG. 4, the nurse performs a nursing action. Further, the nurse inputs the result of the nursing action into the PDA 22. The PDA 22 transmits the accepted execution result to the PC 20.

  The communication unit 52 receives the implementation result of the nursing item for the patient from the PDA 22. The accepted implementation result may be for one nursing item or may be for a plurality of types of nursing items. In the latter case, for example, body temperature and urine volume are included. Accompanying the result of the operation, information regarding the person who performed the nursing action and the time of the operation (hereinafter referred to as “additional information”) is also accepted. The communication unit 52 outputs the received execution result and additional information to the recording unit 60. The recording unit 60 records the input execution result and additional information.

  The holding unit 48 holds a predetermined condition used in the selection unit 46 in advance. Although details will be described later, the selection unit 46 selects at least a part of the implementation results recorded in the recording unit 60 and causes the display device 64 to display the selected implementation results. The holding unit 48 holds a condition that is a selection criterion in the selection unit 46. Here, when there are a plurality of types of implementation results recorded in the recording unit 60, the holding unit 48 holds the conditions for each of the plurality of types of nursing items. For example, there are a condition for body temperature and a condition for urine volume, and these are conditions for nursing items that are targets of the display device 64. In the recording unit 60, the holding unit 48 defines a condition for a difference between an implementation result recorded in the past and a newly recorded implementation result. The implementation result recorded in the past is, for example, the implementation result recorded last time. That is, the holding unit 48 defines a condition for the variation in the implementation result. For example, the body temperature is defined as a condition that there is a change of ± 1 ° C. from the body temperature recorded last time. The condition may define an absolute value as a threshold value. For example, the body temperature is defined as being higher than 37 ° C.

  FIG. 23 shows the conditions held by the holding unit 48. The condition includes an item column 160 and a change amount column 162. Here, with respect to “body temperature”, it is defined as a condition that the amount of change from the previous time is “greater than 1 ° C.”, and for “urine volume”, the amount of change from the previous time is defined as “greater than 50 cc”. , “Pulse” is defined as a condition that the amount of change from the previous time is “greater than 10”. Returning to FIG. The holding unit 48 receives an instruction to change the held condition from the nurse via the operation device 62. Furthermore, the holding unit 48 updates the condition according to the received instruction.

  The selection unit 46 selects an execution result that satisfies the conditions held in the holding unit 48 among the execution results recorded in the recording unit 60. As described above, since the condition held in the holding unit 48 is defined for the difference between the execution result recorded in the past and the newly recorded execution result, the selection unit 46 is newly recorded. If the implementation result satisfies the condition, the newly recorded implementation result is selected. According to the above example, if the difference between the newly recorded execution result and the previously recorded execution result becomes large, the selection unit 46 selects the newly recorded execution result. That is, the selection unit 46 selects an implementation result with a certain degree of variation. This is because, in general, a nurse pays attention to a case where the variation of the implementation result is large. The screen creation unit 44 displays the list of implementation results selected by the selection unit 46 in a partial area of the screen of the display device 64 assigned to display the list. Since the implementation results to be displayed are selected, the implementation results to be confirmed by the nurse can be displayed as much as possible even in a limited area.

  FIG. 24 is a sequence diagram showing a procedure for recording and displaying an implementation result in the nursing information management system 10. The nurse inputs the result of the nursing action to the first PDA 22a (S140). FIG. 25 shows an implementation result input screen displayed by the PDA 22. The figure shows the display when the measured body temperature is input. A button for entering numbers appears in the center of the screen. The nurse taps the button corresponding to the value to be input, and inputs the value of the implementation result. When the input of the value of the execution result is completed, the nurse taps the “Confirm” button. If there is another implementation result to be input, the first PDA 22a changes to a screen for inputting it. The first PDA 22a requests input of an implementation result corresponding to the nursing item. The nursing item is notified to the first PDA 22a by an already issued order.

  Returning to FIG. When the first PDA 22a receives the input of the execution result, the first PDA 22a confirms transmission to the nurse (S142). FIG. 26 shows a transmission screen of the execution result displayed by the PDA 22. As contents to be transmitted to the screen, nursing items “body temperature”, “urine volume”, “pulse”, their measured values, and measurement time are displayed. If these contents are correct, the nurse taps the “Send” button. Returning to FIG. The first PDA 22a transmits the implementation result to the first PC 20. The first PC 20a records the implementation result (S146). Following this, the first PC 20a selects an implementation result (S148). Further, the first PC 20a displays the implementation result (S150).

  FIG. 27 is a flowchart showing a procedure for displaying an implementation result in the PC 20. The recording unit 60 records the input implementation result (S160). The selection unit 46 acquires the implementation result from the recording unit 60 (S162), and acquires the condition from the holding unit 48 (S164). When there are a plurality of types of implementation results, the selection unit 46 compares one of the implementation results with the condition (S166). If one of the implementation results satisfies the condition (Y in S168), the selection unit 46 selects one of the implementation results (S170). On the other hand, if one of the implementation results does not satisfy the condition (N in S168), the selection process is not executed. If the comparison between all the implementation results and the conditions has not been completed (N in S172), the selection unit 46 repeatedly executes the process of step 166.

  When the comparison between all the implementation results and the conditions is completed (Y in S172), the selection unit 46 outputs the selected implementation result to the screen creation unit 44, and the screen creation unit 44 displays the selected implementation result on the display device. 64 (S174). FIG. 28 shows an initial screen at the recording / evaluation stage displayed on the display device 64. A record / evaluation button 206 is displayed from the patient selection button 200, and here, the record / evaluation button 206 is selected. At this stage, the implementation result is not displayed in the nursing record column 234. Although an implementation result window 280 is shown in the figure, this may not be displayed. The contents displayed in the execution result window 280 correspond to the transmission contents of the execution result shown in FIG. FIG. 29 shows a screen after the execution result displayed on the display device 64 is input. Here, since the body temperature has been selected by the selection unit 46, the body temperature is displayed in the nursing record field 234 as the execution result.

  The operation of the nursing information management system 10 having the above configuration will be described. The nurse confirms the nursing items displayed on the PDA 22 and executes the nursing action for the patient. The nurse inputs the result of the nursing action into the PDA 22. The PDA 22 transmits the execution result to the PC 20. The PC 20 stores the received execution result in the recording unit 60. If the variation in the stored execution result is larger than a predetermined condition, the selection unit 46 selects the execution result. The display device 64 displays the selected execution result.

  According to the above configuration, when displaying the execution result on the screen, since the display is executed after selecting the execution result based on a predetermined condition, the necessary execution result is displayed even if the display area of the execution result is small. Many can be displayed. In addition, since the conditions for selecting the execution result are stored in advance, the conditions for selecting the execution result to be noted can be set. In addition, since a condition is set for the difference between the past execution result and the current execution result, it is possible to select a case where the fluctuation of the execution result is large. Further, even when a plurality of types of implementation results are defined, conditions corresponding to each are set, so that necessary implementation results can be selected. In addition, since the implementation results that are not important are not displayed on the screen, the nurse can easily confirm necessary information. In addition, even if the result is not desirable, it is less likely to be overlooked, so the nurse can be alerted. You can also consider changing your nursing plan.

(6. Feedback and variance input)
The feedback and variance input correspond to Step 22, Step 24, and Step 26 in FIG. The problem here may be indicated as follows. I want to reflect the contents of the evaluation in the nursing plan. In addition, I want to make the nursing plan suitable for patients. I also want to speed up patient recovery. Also, I want to display them on the screen so that the actual information and the judgment by the nurse can be clearly understood. In addition, we would like to analyze the factors in the case where there is a discrepancy between the result of the nursing item and the goal of the nursing item instructed to be performed.

  Here, for feedback and variance input, the screen creation unit 44, the display device 64, the input control unit 50, the operation device 62, the control unit 42, the management unit 56, the recording unit 60, the plan creation support unit 34, FIG. The counting unit 58 is mainly used.

(6.1. Input of evaluation)
The input control unit 50 receives an evaluation on the result of the nursing item from the nurse via the operation device 62. Here, as described above, the evaluation is defined by the SOAP format. The recording unit 60 records the received evaluation. At that time, the management unit 56 gives the identification number of the item of the nursing problem corresponding to the evaluation to the evaluation. As a result, the nursing problem item stored in the recording unit 60, the nursing item included in the nursing plan, the implementation result, and the evaluation are associated with each other by a predetermined identification number as shown in FIG.

  The screen creation unit 44 displays the received evaluation on the display device 64. The screen creation unit 44 divides the screen into at least two areas, displays S and O in the first area of the areas divided into at least two areas, and displays the displayed S and O in the second area. A and P are displayed in correspondence. That is, among the constituent elements included in the SOAP format, S and O corresponding to information related to the patient's condition and A and P corresponding to evaluation other than information related to the patient's condition are displayed separately. Make the distinction clear. In addition, by displaying the combination of S and O and the combination of A and P in correspondence with each other, their relationship is clarified.

(6.2. Feedback)
When receiving an evaluation from the nurse via the operation device 62, the input control unit 50 receives an input of a new nursing plan in cooperation with the evaluation. Specifically, when inputting P, the input of a new nursing plan reflecting the contents of A is received. That is, a nursing plan having contents that have not been input so far is input. The entered nursing plan is recorded in the recording unit 60 while being managed by the management unit 56. Further, when receiving an evaluation from the nurse, the input control unit 50 receives an instruction regarding completion or continuation of the nursing plan. When accepting the completion of the nursing plan, the management unit 56 executes processing such as closing corresponding information among the nursing information recorded in the recording unit 60, and executes end processing of the corresponding information.

  On the other hand, when the continuation of the nursing plan is accepted, the corresponding information among the nursing information recorded in the recording unit 60 is continuously valid. In addition, when receiving an instruction regarding continuation of the nursing plan, the input control unit 50 also receives an instruction regarding whether or not to change the nursing plan. When the nursing plan is not changed, the nursing information recorded in the recording unit 60 is valid as it is. On the other hand, when the nursing plan is changed, the input control unit 50 also accepts the change contents of the nursing plan. The management unit 56 reflects the changed contents in the nursing information recorded in the recording unit 60. The plan creation support unit 34 may reflect the received instruction on the already created nursing plan. As described above, the contents of the evaluation are reflected in the nursing plan.

(6.3. Variance input)
When the result of the nursing item deviates from the target of the nursing item instructed to be performed, the input control unit 50 also inputs a variance factor when receiving an evaluation from the nurse via the operation device 62. It should be noted that the variance factor can be said to be information relating to a factor of the difference between the nursing plan including the nursing goal for the patient and the implementation result. The case where the target in the nursing item that has been instructed deviates corresponds to the case where the recovery state of the patient being executed is different from the recovery state of the patient scheduled in advance. That is, the case where the recovery is performed earlier than the schedule and the case where the recovery is performed later than the schedule are included. At that time, the management unit 56 presents a plurality of candidates for variance factors to the nurse via the display device 64. When the nurse selects any of the plurality of candidates via the operation device 62, the management unit 56 receives a variance factor.

  FIG. 30 is a data structure showing candidates for variance factors stored in the management unit 56. Here, “patient / family”, “medical staff”, “system”, and “other” are defined as the variance factors. It is assumed that the “patient / family” factor is caused by the patient / family. Specifically, this includes cases such as delayed healing due to diabetes and lack of family understanding. For this, it is effective to review the indication and treatment. The “medical staff” factor is attributed to the medical staff. Specifically, this includes the case of erroneous drugs, patient misconceptions, instruction mistakes, and the like. For this, medical staff education and OJT are effective. It is assumed that the “system” factor is caused by the system. Specifically, this is the case when the equipment is broken or the reservation is full. For this, efficient use of equipment and facilities is effective. It is assumed that the “other” factor has a cause other than the above. For example, this may be the case for social factors, such as inability to secure a transfer destination and lack of family care. For this, cooperation between medical examinations, review of bed regulations, and home-visit nursing are effective.

  Furthermore, the management unit 56 presents a free description field for inputting an evaluation to the nurse. This free description column corresponds to a column for describing a comment for the evaluation. The management unit 56 associates the comment in the free description column input by the nurse with the selected variance factor. The associated free description field comments are stored in the recording unit 60. Further, the recording unit 60 records the implementation result and the variance factor in association with the nursing plan as shown in FIG.

  The tabulation unit 58 tabulates the number of variance factors recorded in the recording unit 60 for each of a plurality of candidates regarding variance factors. That is, since “patient / family”, “medical staff”, “system”, and “other” are defined as a plurality of candidates, the counting unit 58 classifies the accepted variance factors into each of the plurality of candidates. , Count the number of variance factors in one candidate unit. At that time, the totaling unit 58 performs totaling by paying attention to the relationship between the execution result and the target. That is, when the number of accepted variance factors is counted for one candidate, for example, “patient / family”, the counting is performed by separating the variance into positive variance and negative variance. The positive variance factor is a variance factor when the recovery is faster than the target, and this corresponds to the variance factor that should be the improvement target. On the other hand, the negative variance factor is a variance factor in the case where the recovery is slower than the target, and this corresponds to a variance factor that needs to be improved.

  FIG. 31 shows the counting results recorded in the counting unit 58. The tabulation result includes a variance column 170, a factor column 172, and a frequency column 174. In the variance column 170, positive variance factors and negative variance factors are separated. Here, “+” corresponds to a positive variance factor, and “−” corresponds to a negative variance factor. In the factor column 172, each of the plurality of candidates is defined. The number column 174 is the number of variance factors for each of a plurality of candidates. In the case of FIG. 31, the number of “medical staff” is large as a positive variance factor, and the number of “systems” is large as a negative variance factor. It can be concluded that the “medical staff” needs to be improved to recover faster than the target, and that the “system” needs to be improved to improve when it is recovered later than the target.

(6.4. Operation)
FIG. 32 is a flowchart showing the procedure of feedback processing in the PC 20. The input control unit 50 receives input of subjective information (S) via the operation device 62 (S180). The received subjective information is recorded in the recording unit 60. FIG. 33 shows an initial screen at the time of evaluation input displayed on the display device 64. The figure shows a screen in a stage before subjective information is input. The record / evaluation button 206 is selected, and areas for displaying “S”, “O”, “A”, and “P” are secured in the nursing record column 234. FIG. 34 shows a subjective information input screen displayed on the display device 64. A subjective information input window 290 is displayed, and the nurse uses the operation device 62 to input subjective information.

  Returning to FIG. The input control unit 50 receives the customer information (O) via the operation device 62 (S182). The received customer information is recorded in the recording unit 60. A screen similar to FIG. 34 is displayed on the display device 64. The input control unit 50 receives the input of the evaluation information (A) via the operation device 62 (S184). The received evaluation information is recorded in the recording unit 60. FIG. 35 shows an input screen for evaluation information displayed on the display device 64. An evaluation information input window 300 is displayed on the screen. The evaluation information input window 300 includes a free description column 302 and an evaluation / variance factor column 304. The nurse uses the operation device 62 to input evaluation information in the free description field 302. Returning to FIG. If the input control unit 50 receives the input of the variance factor (Y in S186), the recording unit 60 records the received variance factor in association with the evaluation information (S188).

  On the other hand, if the input control unit 50 does not accept the input of the variance factor (N in S186), the process proceeds to the next step. The variance factor is input by selecting one of a plurality of candidates such as “patient / family” in the evaluation / variance factor column 304 of FIG. Returning to FIG. When the input control unit 50 receives an instruction to end the nursing plan (P) (Y in S190), the process ends. On the other hand, if the input control unit 50 does not receive an instruction to end the nursing plan (N in S190) and receives an instruction to change the nursing plan (Y in S192), the management unit 56 or the plan creation support unit 34 The change is reflected in the nursing plan (S194). The recording unit 60 records the changed nursing plan. If the instruction for changing the nursing plan is not accepted (N in S192), the management unit 56 or the plan creation support unit 34 reflects the continuation in the nursing record (S196).

  Such termination, continuation, and change of the nursing plan are made by selecting one of “Solution”, “Continue”, and “Change” in the evaluation / variance factor column 304 of FIG. FIG. 36 shows a screen after the evaluation information displayed on the display device 64 is input. The figure corresponds to the case where continuation of the nursing plan is instructed. In FIG. 35, when “continuation” is selected, “continuation” is displayed in “A” of the nursing record column 234. “Continue” is also displayed in “evaluation” in the nursing plan column 232. Returning to FIG. The input control unit 50 receives an input of a nursing plan via the operation device 62 (S198). The accepted nursing care plan is recorded in the recording unit 60. Furthermore, if the input control unit 50 receives an instruction to add the input nursing plan via the operation device 62 (Y in S200), the management unit 56 or the plan creation support unit 34 executes the addition.

  That is, the added nursing plan is reflected in the nursing plan column 232 displayed on the display device 64. On the other hand, if the input control unit 50 does not receive an instruction to add the input nursing plan via the operation device 62 (N in S200), the process is terminated. FIG. 37 shows a nursing plan input screen displayed on the display device 64. A nursing plan window 310 is displayed on the screen. The nursing plan window 310 includes a free description field 312 and a selection field 314. The nurse inputs a nursing plan in the free description field 312 using the operation device 62. Furthermore, when the input content is added to the nursing plan column 232, a predetermined item included in the selection column 314 is checked. FIG. 38 shows a screen after the nursing plan is displayed displayed on the display device 64. The contents described in the free description column 312 in FIG. 37 are reflected in “P” in the nursing record column 234. In addition, “Add plan” is displayed in the nursing plan column 232.

  FIG. 39 shows a graph for explaining the effect of the variance analysis according to the present embodiment. The horizontal axis of the graph shows the patient's hospitalization progress, which shows the number of hospitalization days. The vertical axis of the graph indicates the degree of recovery of the patient, and the higher the level, the higher the degree of recovery. The standard course shown by the dotted line is the course that is targeted when inputting the variance factor. For the sake of clarity, the standard course is shown here by straight lines. The discharge timing is indicated by an arrow. On the other hand, positive variance corresponds to the case where the discharge timing is earlier than the standard course. On the other hand, negative variance corresponds to the case where the discharge timing is later than the standard course.

  For patients, shorter hospital stays are preferred. Moreover, if the patient's hospitalization period is shortened, the cost in the hospital is also reduced. As a result, it is desired to improve nursing content so that the hospitalization period is shortened. If the current variance is a negative variance, analyze the variance factor at that time, and improve the nursing content to approach the standard course. In addition, when the current course is a standard course, the variance factors at that time are analyzed, and the nursing content is improved so as to approach the positive variance. Such analysis of the variance factor is performed by a medical institution or an external institution based on the aggregation result in the aggregation unit 58. Ultimately, hospital stay can be shortened by bringing the current standard course closer to positive variance.

  The operation of the PC 20 having the above configuration will be described. The nurse uses the operation device 62 to input an evaluation on the nursing result according to the SOAP format. The nurse also inputs a variance factor using the operation device 62. Further, the nurse inputs a new nursing plan using the operation device 62 in cooperation with the input evaluation. These pieces of information are stored in the recording unit 60 while being associated by the management unit 56. Moreover, the totaling unit 58 performs totaling for the variance factor.

  According to the above configuration, since a nursing plan can be added in relation to the evaluation, the contents of the evaluation can be reflected in the nursing plan. Moreover, recovery of the patient can be promoted by adding a nursing plan more suitable than the nursing plan already created. The added nursing plan is also displayed in the area where the nursing plan is to be displayed, so that the correspondence with the already displayed content can be clarified. Further, since completion or continuation of the nursing plan can be input in relation to the evaluation, it can be reflected in the nursing plan while confirming the contents of the evaluation. In addition, when continuation is selected, a message to that effect is displayed, and the content of the selection becomes clear. Moreover, since the change of the nursing plan can be input in relation to the evaluation, the nursing plan can be corrected to a more appropriate one. Also, by reflecting the contents of the evaluation in the nursing plan, the nursing plan can be made suitable for the patient. In addition, patient recovery can be accelerated. Moreover, the hospitalization period of a patient can be shortened. Further, when displaying the evaluation, since the combination of S and O and the combination of A and P are displayed separately, the difference between them can be clarified. Further, since the combination of S and O and the combination of A and P are displayed in association with each other, their correspondence can be clarified.

  In addition, when the result of the nursing item is different from the goal of the nursing item instructed to be performed, the factor is input, so that the factor can be analyzed. Moreover, the contents of nursing can be improved by analyzing the factors. Moreover, since the content of nursing is improved, the hospitalization period of the patient can be shortened. In addition, hospital costs can be reduced. Moreover, when inputting the factors, the factor candidates are presented in advance, and the nurse is made to select the factors from among them, so that the factors can be easily input. In addition, since the factor candidates are defined in advance, the factor can be easily analyzed. In addition, when the factors that have been input are aggregated, the aggregation is performed by paying attention to the relationship with the implementation results, so that the positioning of the factors becomes clear and the feedback of the factors becomes appropriate. Moreover, since the input factors are tabulated separately into positive variances and negative variances, it is possible to specify a nursing improvement method according to the situation.

  In the above, this invention was demonstrated based on the Example. This embodiment is an exemplification, and it will be understood by those skilled in the art that various modifications can be made to the combination of each component and each processing process, and such modifications are also within the scope of the present invention. .

  In the embodiment of the present invention, the holding unit 48 holds a predetermined condition, and the selection unit 46 selects an execution result satisfying the predetermined condition from the execution results stored in the recording unit 60, and the result Is output to the screen creation unit 44. However, the present invention is not limited to this, and the selection of the execution result may be made manually. In that case, the operation device 62 receives an instruction from the nurse regarding a list of implementation results to be displayed in a partial area of the screen, and the selection unit 46 sets the received instruction as a predetermined condition in the recording unit 60. An execution result selection process is executed on the recorded execution result. This corresponds to checking the implementation result to be selected in the implementation result window 280 shown in FIG. 28 and displaying the result in the nursing record column 234. According to this modified example, the will of the nurse can be reflected on the implementation result to be displayed. That is, the required implementation result may be selected.

  In the embodiment of the present invention, the problem creation support unit 30 outputs a nursing problem code corresponding to the selected nursing problem item to the plan creation support unit 34, and the plan creation support unit 34, based on the nursing problem code, A nursing plan is selected from the second database 36. However, the present invention is not limited to this. For example, the problem creation support unit 30 outputs the selected nursing problem item to the plan creation support unit 34. A nursing plan may be selected. Alternatively, the problem creation support unit 30 and the plan creation support unit 34 may perform all processing using a nursing problem code and a code corresponding to a nursing plan item (hereinafter referred to as “nursing plan code”). In this case, for example, the screen creation unit 44 converts the nursing problem code or nursing plan code into a message. According to this modification, the degree of freedom of the configuration of the problem creation support unit 30 and the plan creation support unit 34 is improved. That is, the plan creation support unit 34 may derive a nursing plan corresponding to a nursing problem item.

  In the embodiment of the present invention, the configuration of the PC 20 has been mainly described, but this may be the configuration of the server 12. In the present embodiment, the distinction between the PC 20 and the server 12 is for the sake of convenience, and it is sufficient that the object connected to the PDA 22 has the configuration described. According to this modification, the degree of freedom of the configuration of the PC 20 and the server 12 included in the nursing information management system 10 is improved.

The features of the invention described in the embodiments may be defined by the following items.
(Item 1-1)
A nursing information management device that prescribes the symptoms that should be the subject of nursing as a nursing problem, and prescribes the nursing policy for the patient as a nursing plan,
A problem creation support department that assists patients in creating nursing problem items;
Based on the items of nursing problems created, the plan creation support department that supports the creation of nursing plans,
A first input unit for inputting an implementation result of a nursing item included in the created nursing plan;
A second input unit for inputting an evaluation on the implementation result of the nursing item;
A recording unit for recording the input execution result and the input evaluation;
A nursing information management device comprising:

(Item 1-2)
The nursing information management apparatus according to (Item 1-1), wherein the second input unit receives an input of a new nursing plan in cooperation with the inputted evaluation.
(Item 1-3)
The second input unit receives instructions on the completion or continuation of the nursing plan,
The nursing care information management apparatus according to (Item 1-1) or (Item 1-2), wherein the plan creation support unit reflects the received instruction on nursing items included in the created nursing plan.

(Item 1-4)
The instruction regarding the continuation of the nursing plan accepted in the second input section also includes an instruction regarding whether or not to change the nursing plan,
The plan creation support unit reflects the received instruction on the nursing items included in the created nursing plan. The nursing information management device according to (Item 1-3).
(Item 1-5)
A screen creation unit for displaying each GUI to be provided for the problem creation support unit, the plan creation support unit, the first input unit, and the second input unit on the screen of the display device;
The screen creation unit is characterized in that each GUI to be provided for the problem creation support unit, the plan creation support unit, the first input unit, and the second input unit is configured in a single screen (Item 1). The nursing information management apparatus according to any one of (-1) to (Item 1-4).

(Item 1-6)
The screen creation unit displays the GUI to be provided for the second input unit in a part of the area for displaying the GUI to be provided for the first input unit (Item 1-5) The nursing information management device described.
(Item 1-7)
The evaluation input to the second input unit also includes information on the current state of the patient,
In the screen creation unit, the region for displaying the GUI to be provided for the second input unit is divided into a region corresponding to information related to the patient state and a region corresponding to evaluation other than information related to the patient state. The nursing information management device according to (Item 1-5) or (Item 1-6), wherein the nursing information management device is configured.

(Item 1-8)
An instruction unit for instructing implementation of nursing items included in the created nursing plan,
The instruction unit supports generation of an order for an instruction based on a nursing item in an area in the screen displayed by the screen creation unit, and outputs the generated order (Item 1-5) ) Nursing information management device.
(Item 1-9)
The nursing information management apparatus according to (Item 1-8), wherein the instruction unit notifies the instruction after an input of an operator's confirmation operation.
(Item 1-10)
The evaluation input to the second input unit is performed by the operator based on the first information corresponding to the subjective information about the patient, the second information corresponding to the objective information about the patient, and the first information and the second information. Including at least third information corresponding to the evaluation and fourth information corresponding to a future nursing plan based on the third information,
The screen creation unit divides the screen into at least two areas, displays the first information and the second information in the first area among the areas divided into at least two areas, and displays the first information displayed in the second area. The nursing information management apparatus according to claim 1 (item 1-5), wherein the third information and the fourth information are displayed while corresponding to the information and the second information.
(Item 1-11)
A communication unit that communicates with the mobile terminal device;
The nursing information management apparatus according to (Item 1-8) or (Item 1-9), wherein the instruction unit transmits an implementation instruction to the mobile terminal device via the communication unit.

(Item 1-12)
A management unit is further provided for associating items corresponding to each other among a created nursing problem item, a nursing item included in the created nursing plan, and an input evaluation by a series of identifiers (Item 1- The nursing information management apparatus according to any one of 1) to (Item 1-4).
(Item 1-13)
A correction unit for receiving corrections for at least one of the items of the created nursing problem, the nursing items included in the created nursing plan, and the input evaluation;
The correction unit manages the correction history so that it cannot be deleted. The nursing information management apparatus according to any one of (Item 1-1) to (Item 1-4).

(Item 1-14)
A nursing information management device for prescribing nursing policies for patients as a nursing plan,
Based on the nursing plan created for the patient, an instruction unit that instructs the implementation of the nursing items included in the nursing plan,
An input unit for inputting an evaluation on the result of the nursing item,
A nursing information management device, wherein the input unit inputs a new nursing plan in cooperation with the inputted evaluation.
(Item 1-15)
The nursing information management apparatus according to (Item 1-14), wherein the input unit receives an instruction regarding completion or continuation of the nursing plan.

(Item 1-16)
It is a nursing information management method that prescribes the symptoms that should be the subject of nursing as a nursing problem, and specifies the nursing policy for patients as a nursing plan,
Steps to help the patient create items for nursing problems;
Steps that support the creation of nursing plans based on the nursing problem items created,
A step of inputting an implementation result of nursing items included in the created nursing plan;
Inputting an evaluation of the result of the nursing item;
Recording the entered implementation results and the entered assessments;
A nursing information management method comprising:

(Item 1-17)
A nursing information management system that prescribes the symptoms that should be the subject of nursing as a nursing problem and the nursing policy for patients as a nursing plan,
A nursing information management device that supports the creation of nursing problem items, supports the creation of nursing plans based on the created nursing problem items, and instructs the implementation of nursing items included in the created nursing plans When,
A portable terminal device for inputting the implementation result of the nursing item and transmitting the input implementation result to the nursing information management device;
A nursing information management system is characterized in that an evaluation for an implementation result of a nursing item is input, and the input evaluation and an implementation result input via a portable terminal device are recorded.

According to (Item 1-1), nursing is divided into a plurality of stages, and each stage is associated and managed. Therefore, nursing that solves the nursing problem that is the starting point can be carried out, and appropriate nursing actions are taken. Can be provided.
According to (Item 1-2), since the input evaluation can be reflected in the nursing plan, a more appropriate nursing plan can be created.
According to (Item 1-3), since the received instruction is reflected in the nursing plan, the nursing plan can be maintained in the latest state.
According to (Item 1-4), since the nursing plan can be changed, the nursing plan can be changed to more appropriate contents.

According to (Item 1-5), since the GUI for providing a plurality of stages in the nursing item is configured in a single screen, the relevance of the plurality of stages can be clarified.
According to (Item 1-6), the GUI to be provided for the first input unit and the GUI to be provided for the second input unit are displayed in one area. Can be clarified.
According to (Item 1-7), since one area is divided and information other than information related to the patient's condition and information related to the patient's condition is displayed, the relationship between the two can be clarified.
According to (Item 1-8), since an order is created based on nursing items, mistakes in order creation can be reduced.

According to (Item 1-9), since the instruction is not notified until the confirmation operation is input, the instruction can be corrected until then.
According to (Item 1-10), since the combination of the first information and the second information and the combination of the third information and the fourth information are displayed in different areas, the relationship between the two is clearly shown. Can be.
According to (Item 1-11), since the instruction is transmitted to the mobile terminal device, the instruction can be confirmed on the mobile terminal device.
According to (Item 1-12), since a series of identifiers is assigned to a predetermined item that covers a plurality of contents, management thereof becomes easy.
According to (Item 1-13), since the correction history is managed so as not to be deleted, tampering can be prevented.
According to (Item 1-14), since the input evaluation can be reflected in the nursing plan, a more appropriate nursing plan can be created.
According to (Item 1-15), since the received instruction is reflected in the nursing plan, the nursing plan can be maintained in the latest state.

(Item 2-1)
A nursing information management device that prescribes the symptoms that should be the subject of nursing as a nursing problem, and prescribes the nursing policy for the patient as a nursing plan,
Based on nursing problem items created for patients, nursing is searched by searching a nursing information database that includes nursing plan items associated with each of a plurality of types of items that should be included in nursing problems. A plan creation support department that supports the creation of a plan;
A storage unit for storing the created nursing plan;
A nursing information management device comprising:

(Item 2-2)
The system further includes a problem creation support unit that supports the creation of nursing problem items for the patient and provides the created nursing problem items to the plan creation support unit.
The problem creation support department stores multiple types of items that should be included in nursing problems in advance across multiple departments, and presents the items to the operator in an integrated manner, and selects the items of nursing problems for the operator. The nursing information management device according to (Item 2-1), characterized in that:

(Item 2-3)
The problem creation support unit associates a plurality of diseases to be handled by each department in advance with each of a plurality of departments, and further includes a plurality of types of items to be included in a nursing problem for each of the plurality of diseases. Are stored in advance,
Presenting multiple departments to the operator, then presenting the operator with multiple diseases corresponding to the department selected by the operator, and presenting multiple types of items corresponding to the disease selected by the operator to the operator The nursing information management apparatus according to (Item 2-2), further including means for causing an operator to select a nursing problem item.

(Item 2-4)
The problem creation support unit displays on the screen a first area where a plurality of medical departments should be displayed, a second area where a plurality of diseases should be displayed, and a third area where a plurality of types of items to be included in a nursing problem should be displayed And
When one of the plurality of departments displayed in the first area is selected, a means for displaying a plurality of diseases corresponding to the selected department in the second area, and a plurality of areas displayed in the second area And a means for displaying a plurality of types of items corresponding to the selected disease in the third area when any of the diseases is selected. .

(Item 2-5)
The question creation support department stores multiple types of items that should be included in nursing problems as standard sentences.
Means for allowing the operator to select a fixed sentence; means for presenting a free description field to the operator; and means for associating the contents of the free description field input by the operator with the selected fixed sentence The nursing information management apparatus according to any one of (Item 2-2) to (Item 2-4).

(Item 2-6)
The plan creation support section defines the area where nursing plans should be displayed on the screen, and searches the nursing information database based on the nursing problem items created for the patient. The nursing information management device according to any one of (Item 2-1) to (Item 2-5), wherein
(Item 2-7)
The nursing information database searched by the plan creation support department includes nursing plan items as standard sentences.
The plan creation support unit searches the nursing information database based on the nursing problem items created for the patient, and selects a fixed sentence corresponding to the nursing plan item and a free description column. Any one of (Item 2-1) to (Item 2-6) including means for presenting to an operator and means for associating the contents of the free description field input by the operator with the selected fixed sentence The nursing information management device described in Crab.

(Item 2-8)
A nursing plan creation method that prescribes the symptoms that should be the subject of nursing as a nursing problem and the nursing policy for the patient as a nursing plan,
Based on nursing problem items created for patients, nursing is searched by searching a nursing information database that includes nursing plan items associated with each of a plurality of types of items that should be included in nursing problems. A nursing plan creation method characterized by supporting the creation of a plan.

(Item 2-9)
A nursing information management system that prescribes the symptoms that should be the subject of nursing as a nursing problem and the nursing policy for patients as a nursing plan,
Based on nursing problem items created for patients, nursing is searched by searching a nursing information database that includes nursing plan items associated with each of a plurality of types of items that should be included in nursing problems. A nursing information management device that supports the creation of a plan and instructs the implementation of nursing items included in the created nursing plan;
A portable terminal device that inputs the implemented nursing items and transmits the entered nursing items to the nursing information management device;
A nursing information management system records nursing items inputted via a portable terminal device.

According to (Item 2-1), the nursing plan is derived from the prepared nursing problem by using the relationship between the nursing problem and the nursing plan that are defined in advance. Can provide nursing care.
According to (Item 2-2), when creating a nursing problem, the nursing problem item is selected from a plurality of types of items that should be included in the previously stored nursing problem. Can be reduced.
According to (Item 2-3), when creating a nursing problem, the selection of the department, disease, and item in multiple stages is executed sequentially, so the process leading to the selection of the item becomes clear and the nursing problem is solved. Errors during creation can be reduced.

According to (Item 2-4), when creating a nursing problem, the department, disease, and item are sequentially selected from multiple stages, so the process leading to the selection of the item becomes clear and the nursing problem is resolved. Errors during creation can be reduced.
According to (Item 2-5), a nursing problem corresponding to each patient can be created by adding the contents of the free description column.
According to (Item 2-6), when a nursing problem search is executed, the search result is displayed as a nursing plan, so errors in creating a nursing plan can be reduced.
According to (Item 2-7), a nursing plan corresponding to each patient can be created by adding the contents of the free description column.

(Item 3-1)
A nursing information management device for prescribing the contents of nursing to patients as nursing items,
An input unit for inputting results of nursing items for the patient;
A recording unit for recording the input implementation results;
A selection unit that selects an implementation result that satisfies a predetermined condition from the implementation results recorded in the recording unit;
A display unit for displaying a list of implementation results selected in the selection unit in a partial area of the screen assigned to display the list;
A nursing information management device comprising:

(Item 3-2)
It further includes a reception unit that receives an instruction from the operator regarding a list of implementation results to be displayed in a partial area of the screen,
The selection unit performs an execution result selection process on the execution result recorded in the recording unit, using the instruction received in the reception unit as a predetermined condition. (Item 3-1) Nursing information management device.
(Item 3-3)
A holding unit that holds the predetermined condition in the selection unit in advance;
The selection unit performs an execution result selection process on the execution result recorded in the recording unit according to the conditions held in the holding unit. The nursing information management described in (Item 3-1) apparatus.

(Item 3-4)
The holding unit defines a condition for a difference between an implementation result recorded in the past and a newly recorded implementation result in the recording unit,
The nursing information management apparatus according to (Item 3-3), wherein the selection unit selects the newly recorded execution result if the newly recorded execution result satisfies a condition.
(Item 3-5)
The nursing information management apparatus according to (Item 3-3) or (Item 3-4), wherein the holding unit receives an instruction to change the held condition and updates the condition according to the received instruction.
(Item 3-6)
The implementation result input to the input unit corresponds to one of a plurality of types of nursing items defined in advance,
The holding unit holds conditions for each of a plurality of types of nursing items defined in advance, and the nursing information management apparatus according to any one of (Item 3-3) to (Item 3-5).

(Item 3-7)
A nursing information management method for prescribing nursing contents for patients as nursing items,
Entering the results of nursing items for the patient, recording them in the memory, and selecting the results that satisfy the specified conditions from the results recorded in the memory and displaying them in a partial area of the screen Nursing information management method.
(Item 3-8)
A nursing information management system that regulates the contents of nursing to patients as nursing items,
A portable terminal device for inputting the result of the implementation of nursing items for the patient;
Nursing that records the result of the operation input via the mobile terminal device in the memory, and displays the result in a part of the screen after selecting the result of the operation satisfying a predetermined condition from the results recorded in the memory. An information management device;
A nursing information management system characterized by comprising:

According to (Item 3-1), even if the area where the list of execution results is to be displayed is a partial area of the screen, a list of execution results satisfying a predetermined condition is selected and displayed. Can display results and provide appropriate nursing practice.
According to (Item 3-2), the selection process is executed in accordance with the operator's instruction, so that the operator's will can be reflected in the selection.
According to (Item 3-3), the selection process is executed according to the held condition, so that the operator's process can be reduced.

According to (Item 3-4), conditions are defined for differences, so that it is possible to select an implementation result with a large variation.
According to (Item 3-5), since the condition is updated, even if the already set condition is not appropriate, it can be changed to a more appropriate condition.
According to (Item 3-6), conditions are held for each of a plurality of types of nursing items, so that necessary implementation results can be selected.

It is a figure which shows the nursing information management system which concerns on the Example of this invention. It is a figure which shows the structure of PC of FIG. It is a figure which shows the data structure of the nursing information recorded on the recording part of FIG. It is a flowchart which shows the management procedure of the nursing information in the nursing information management system of FIG. It is a figure which shows the data structure of the patient information recorded on the recording part of FIG. It is a flowchart which shows the selection procedure of the patient information in PC of FIG. It is a figure which shows the screen in the patient selection stage displayed on the display apparatus of FIG. It is a figure which shows the data structure of the nursing problem database contained in the 1st database of FIG. It is a figure which shows the data structure of the nursing plan database contained in the 2nd database of FIG. It is a flowchart which shows the preparation procedure of the nursing problem and nursing plan in PC of FIG. It is a figure which shows the initial screen in the planning stage displayed on the display apparatus of FIG. It is a figure which shows the screen of the nursing problem selection displayed on the display apparatus of FIG. It is a figure which shows the screen after the input of the nursing plan displayed on the display apparatus of FIG. It is a figure which shows the addition screen of the comment of the nursing problem displayed on the display apparatus of FIG. It is a figure which shows the screen after the input of the comment of the nursing problem displayed on the display apparatus of FIG. It is a figure which shows the edit screen of the nursing plan displayed on the display apparatus of FIG. It is a figure which shows the screen after the edit of the nursing plan displayed on the display apparatus of FIG. It is a schematic diagram for showing the process of order issue in the nursing information management system of FIG. It is a figure which shows the data structure of the database for orders contained in the 3rd database of FIG. It is a sequence diagram which shows the process sequence of order issue in the nursing information management system of FIG. It is a flowchart which shows the process sequence of order issue in PC of FIG. It is a figure which shows the screen in the order issue stage displayed on the display apparatus of FIG. It is a figure which shows the conditions hold | maintained at the holding | maintenance part of FIG. It is a sequence diagram which shows the recording and display procedure of the implementation result in the nursing information management system of FIG. It is a figure which shows the input screen of the implementation result displayed by PDA of FIG. It is a figure which shows the transmission screen of the implementation result displayed by PDA of FIG. It is a flowchart which shows the display procedure of the implementation result in PC of FIG. It is a figure which shows the initial screen in the recording and evaluation stage displayed on the display apparatus of FIG. It is a figure which shows the screen after the input of the implementation result displayed on the display apparatus of FIG. 3 is a data structure showing candidates for variance factors stored in the management unit in FIG. 2. It is a figure which shows the total result recorded on the total part of FIG. It is a flowchart which shows the procedure of the feedback process in PC of FIG. It is a figure which shows the initial screen at the time of the evaluation input displayed on the display apparatus of FIG. It is a figure which shows the input screen of the subjective information displayed on the display apparatus of FIG. It is a figure which shows the input screen of the evaluation information displayed on the display apparatus of FIG. It is a figure which shows the screen after the input of the evaluation information displayed on the display apparatus of FIG. It is a figure which shows the input screen of the nursing plan displayed on the display apparatus of FIG. It is a figure which shows the screen after the input of the nursing plan displayed on the display apparatus of FIG. It is a figure which shows the graph for demonstrating the effect of the variance analysis which concerns on a present Example.

Explanation of symbols

  10 nursing information management system, 12 server, 14 PC subsystem, 16 PDA subsystem, 18 LAN, 20 PC, 22 PDA, 24 AP, 30 problem creation support section, 32 first database, 34 plan creation support section, 36 2 database, 38 instruction section, 40 third database, 42 control section, 44 screen creation section, 46 selection section, 48 holding section, 50 input control section, 52 communication section, 54 correction section, 56 management section, 58 counting section, 60 recording units, 62 operating devices, 64 display devices.

Claims (6)

A nursing information management device for managing nursing information for a patient,
An implementation result input unit for inputting the implementation result of nursing for the patient;
A deviation information input unit for inputting information on a nursing plan including a nursing goal for a patient and a factor of deviation from the implementation result;
A deviation information recording unit that records information on the implementation result and the cause of the deviation in association with the nursing plan,
A nursing information management device comprising:   The divergence information input unit presents a plurality of candidates for information related to a divergence factor to an operator, and causes the operator to select one of the plurality of candidates, thereby inputting information related to the divergence factor. The nursing information management apparatus according to claim 1. The deviation information input unit presents a free description field to the operator,
The nursing information management apparatus according to claim 2, wherein the deviation information recording unit records the contents of the free description column described by an operator and any one of a plurality of selected candidates in association with each other. For each of a plurality of candidates related to the divergence factor, further comprising a totaling unit that counts the number of information related to the divergence factor recorded in the divergence information recording unit,
The nursing information management apparatus according to claim 2, wherein the totaling unit performs totaling by paying attention to a relationship between an implementation result and a target. A nursing information management device for prescribing nursing policies for patients as a nursing plan,
Based on the nursing plan created for the patient, an instruction unit that instructs the implementation of the nursing items included in the nursing plan,
An input unit for inputting an evaluation on the result of the nursing item;
A recording unit for recording the input evaluation,
The input unit inputs information about the cause of the divergence when the result of the nursing item and the target of the nursing item instructed to perform are separated, and accepts an instruction regarding completion or continuation of the nursing plan,
The recording unit records input information while associating with the input evaluation,
The nursing information management apparatus, wherein the received instruction is reflected in the nursing plan referred to by the instruction unit. A nursing information management method for managing nursing information for a patient,
Entering the results of nursing care for the patient;
Inputting information regarding a nursing plan including a nursing goal for a patient and a factor of deviation from the implementation result;
Associating with the nursing plan, recording the implementation result and information on the cause of the divergence;
A nursing information management method comprising:

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