JP2011008543A - Nursing instruction notification device and nursing instruction notification program - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a nursing instruction notification device and a nursing instruction notification program, allowing proper narrow-down of a notification destination of a nursing instruction, and also allowing avoidance of inexecution of the nursing instruction.SOLUTION: A basic configuration of this nursing instruction notification device includes a storage part, an instruction reception part, a determination part, a notification part, a possibility/impossibility reception part, and a notification control part. The storage part stores a business sharing table, and the instruction reception part receives instruction data representing contents of the nursing instruction. The determination part determines a nurse notifying the nursing instruction based on the business sharing table, a patient, and a rule. The notification part notifies the nurse about the nursing instruction through a mobile machine. The possibility/impossibility reception part receives possibility/impossibility data returned from the mobile machine. The notification control part makes the determination part determine a next notification destination when it is not received that instruction reception is possible, and makes the notification part notify the determined nurse about the nursing instruction.

Description

  The present disclosure relates to a nursing instruction notification device and a nursing instruction notification program.

  Conventionally, notification devices and systems for notifying information are known in various fields.

  For example, an apparatus is known that assigns a task to a person in charge of a plurality of persons in charge and notifies the task to the assigned person (see, for example, Patent Document 1 and Patent Document 2).

  There is also known an apparatus in which a specific person to be notified and a priority order are specified in advance, and information is notified to the specified person in charge according to the priority order (see, for example, Patent Document 3). .

JP 2007-241592 A Japanese Patent Application Laid-Open No. 2002-237892 Japanese Patent No. 3570908

  By the way, in the case of notification of nursing instructions in the medical field, it is dangerous to fix the notification destination in view of the fact that nurses' labor share in the ward is fluid and avoiding non-execution due to oversight of nurses. is there. For this reason, it is difficult to divert the notification system described in Patent Document 3 to notification of nursing instructions.

  Therefore, it may be possible to notify a nursing instruction to a ward without specifying a nurse. However, since the individual nurse is not specified as the notification destination, any nurse has a weak feeling that he / she has an obligation to perform the operation. For this reason, it is necessary to prevent non-implementation of nursing instructions through human operation on the ward side.

  In addition, it is conceivable to notify a nurse who is free of nursing instructions using the notification methods described in Patent Documents 1 and 2. However, since the implementation of nursing instructions is often performed as part of ongoing medical practice, not all nurses with free hands can do so, and notifications can be narrowed down to appropriate nurses. is necessary.

  In view of the above circumstances, it is an object of the present invention to provide a nursing instruction notification device and a nursing instruction notification program that can appropriately narrow down notification destinations of nursing instructions and avoid non-execution of nursing instructions.

  The basic form of the nursing instruction notifying apparatus that achieves the above object includes a storage unit, an instruction receiving unit, a determining unit, a notifying unit, an availability receiving unit, and a notification control unit.

  The said memory | storage part memorize | stores the work assignment table in which the work assignment of each nurse in a ward was described.

  The instruction receiving unit receives instruction data created by a doctor and representing the content of a nursing instruction specifying a patient.

  The determining unit determines a nurse who notifies the nursing instruction when the instruction data is received by the instruction receiving unit. The determination of the nurse by the determination unit is performed based on the work assignment table stored in the storage unit, the patient specified by the nursing instruction, and the rule for determining the preferential person in charge for each patient. Is called.

  The notification unit notifies the nursing instruction received by the instruction receiving unit to the nurse determined by the determination unit via a portable device. The portable device is carried by the nurse and outputs an output that stimulates one of the five senses of the nurse when a nursing instruction is notified to the nurse. Further, the portable device receives an input indicating whether or not an instruction can be received by the nurse, and returns whether or not the input is possible.

  The availability receiving unit receives the availability data returned from the portable device.

  The notification control unit causes the determination unit to determine the next notification destination from among unreported nurses when the availability data indicating acceptance of an instruction is not received by the availability reception unit. Then, the notification control unit causes the notification unit to notify the determined nurse to the nursing instruction received by the instruction receiving unit.

  The basic form of the nursing instruction notification program that achieves the above object is executed on the computer, and the instruction receiving unit, the determination unit, the notification unit, the availability receiving unit, and the computer are executed on the computer. Build a notification controller.

  According to the above-described basic form of the nursing instruction notification device and the nursing instruction notification program, it is possible to appropriately narrow down notification destinations of nursing instructions and to avoid non-execution of nursing instructions.

It is a figure which shows 1st Embodiment of a nursing instruction notification apparatus. It is a figure which shows 1st Embodiment of a nursing instruction notification program. It is a figure which shows the electronic medical record server which has a function part as 2nd Embodiment of a nursing instruction notification apparatus. It is a figure which shows the client connected to the electronic medical record server. It is a figure which shows the electronic medical record program which has a program part as 2nd Embodiment of a nursing instruction notification program. It is a figure which shows the image of nursing instruction management. It is a flowchart of nursing instruction management. It is a figure which shows the example of input of an order (nursing instruction | indication) when there exists input of scheduled execution time. It is a figure which shows the example of input of order (nursing instruction | indication) when there is no input of scheduled execution time. It is a figure which shows the example of the management information registered into instruction | indication management BD. It is a figure which shows the image of the normal instruction | indication issuing in an electronic medical chart system. It is a figure which shows the example of a display screen of an incharge sheet. It is a figure which shows an example of a business assignment table. It is a figure which shows the notification screen in an emergency notification. It is a figure which shows the example of the information registered into worker DB. It is a figure which shows a notification screen when notifying to a primary notification destination again.

  Specific embodiments of the nursing instruction notification device and the nursing instruction notification program described above for the basic form will be described below with reference to the drawings.

  FIG. 1 is a diagram illustrating a first embodiment of a nursing instruction notification device.

  The nursing instruction notification device 1 shown in FIG. 1 includes a storage unit 2, an instruction reception unit 3, a determination unit 4, a notification unit 5, a permission / rejection reception unit 6, and a notification control unit 7.

  The said memory | storage part 2 memorize | stores the work assignment table in which the work assignment of each nurse in a ward was described.

  The instruction receiving unit 3 receives instruction data created by a doctor and representing the contents of a nursing instruction specifying a patient.

  The determining unit 4 determines a nurse who notifies the nursing instruction when the instruction data is received by the instruction receiving unit 3. The determination of the nurse by the determination unit is based on the task assignment table stored in the storage unit 2, the patient specified by the nursing instruction, and the rules for determining the preferential person in charge for each patient. Done. This rule may be set by the user as a table in the storage unit 2 or the like, or may be incorporated in advance in a nursing instruction notification program described later.

  The notification unit 5 notifies the nursing instruction received by the instruction receiving unit 3 to the nurse determined by the determination unit 4 via the portable device 8. The portable device 8 is carried by the nurse and outputs an output that stimulates one of the five senses of the nurse when a nursing instruction is notified to the nurse. In addition, the portable device 8 receives an input indicating whether or not an instruction can be received by the nurse, and returns whether or not the input is possible.

  The availability receiving unit 6 receives availability data returned from the portable device 8.

  The notification control unit 7 causes the determination unit 4 to determine the next notification destination from among the unreported nurses when the availability data indicating acceptance of the instruction is not received by the availability reception unit 6. The notification unit 5 transmits notification data to the determined nurse. Here, “when the availability data indicating that the instruction can be received is not received” includes both the case where the availability data indicating other than the instruction is received and the case where no availability data is received.

  In the nursing instruction notification device 1, the determination unit 4 can narrow down the nurses who are suitable for carrying out the nursing instruction based on the target patient of the nursing instruction and the work assignment table. And since a nursing instruction is notified to such a narrowed-down nurse, the nurse who receives the notification recognizes the notification as important information. That is, the accuracy of notification is high.

  On the other hand, this nursing instruction notification device 1 avoids non-execution by sending a notification to the next appropriate person when the instruction is not accepted.

  Thereby, both appropriate narrowing down of the notification destination in the nursing instruction and avoidance of non-execution of the nursing instruction can be realized.

  FIG. 2 is a diagram showing a first embodiment of a nursing instruction notification program.

  The nursing instruction notification program 10 shown in FIG. 2 is stored in the storage medium 9. This nursing instruction notification program 10 is taken into the computer from the storage medium 9.

  The storage medium 9 may be anything as long as it stores the nursing instruction notification program 10. The storage medium 9 may be, for example, a portable medium typified by a CD or a DVD, or a fixed medium typified by a magnetic disk built in a hard disk device. The storage medium 9 may be a solid-state storage element represented by a USB memory.

  The nursing instruction notification program 10 may be taken into a computer from the telecommunications network without going through the storage medium 9.

  The nursing instruction notification program 10 is executed on the incorporated computer to construct the nursing instruction notification apparatus 1 shown in FIG. 1 on the computer. However, the nursing instruction notification program 10 constructs an instruction receiving unit 3, a determining unit 4, a notification unit 5, a permission / rejection receiving unit 6, and a notification control unit 7 among the components shown in FIG. Specifically, the nursing instruction notification program 10 includes an instruction reception unit 11, a determination unit 12, a notification unit 13, a permission / rejection reception unit 14, and a notification control unit 15. Each of the instruction receiving unit 11, the determining unit 12, the notification unit 13, the availability receiving unit 14, and the notification control unit 15 includes the instruction receiving unit 3, the determining unit 4, the notification unit 5, and the availability receiving unit illustrated in FIG. 6 and the notification control unit 7 are each constructed on a computer.

  This is the end of the description of the first embodiment, and the second embodiment will be described below.

  FIG. 3 is a diagram showing an electronic medical record server having a functional part as a second embodiment of the nursing instruction notification device. FIG. 4 is a diagram illustrating a client connected to the electronic medical record server. 3 and 4 are related to each other and will be described together.

  In the second embodiment, an electronic medical record system is constructed. This electronic medical record system is a comprehensive system including a function for creating and confirming an electronic medical record and an order (instruction), and a management function for nursing work in a ward.

  This electronic medical record system includes an electronic medical record server 100 and a client 200. This electronic medical chart system includes a plurality of clients 200 for doctors, wards, and the like. As hardware appearances of the electronic medical record server 100 and the client 200, as shown in FIG. 6, the client 200 is a personal computer, and the electronic medical record server 100 is a large general-purpose server device. Since the hardware structures of these personal computers and general-purpose server devices are well known, description thereof is omitted here. Further, the internal configuration of the electronic medical record server 100 shown in FIG. 3 is constructed by a program stored in the CD-type medium 400 in the second embodiment. This program will be described later with reference to FIG.

  Returning to FIG.

  The electronic medical record server 100 shown in FIG. 3 includes a medical record database (DB) group 110 that stores data related to electronic medical records and orders, and a ward management DB group 120 that stores data related to work management in the ward. These DB groups 110 and 120 are mainly responsible for hard disk devices incorporated in the electronic medical record server 100 as hardware.

  The electronic medical record server 100 includes an order update unit 131, an instruction reception instruction confirmation unit 132, and an instruction general-purpose search unit 133 as processing units related to creation and reference of the electronic medical record and order. In addition, the electronic medical record server 100 includes a patient list search process 141 and a ward general-purpose search unit 142 as processing units related to creation and reference of data related to business management. These processing units are mainly responsible for the CPU and RAM of the electronic medical record server 100 as hardware.

  The electronic medical record server 100 includes a mail box 153, and also includes a notification destination determination processing unit 151, a mail transmission processing unit 152, and a reply confirmation processing unit 154 as processing units related to emergency notification of nursing instructions. These processing units are mainly responsible for CPU and RAM as hardware. The mailbox 153 is mainly handled by a hard disk device as hardware.

  On the other hand, the client 200 shown in FIG. 4 roughly includes an electronic medical record management process and various masters. The client 200 includes, as masters, an order master 211, an operation condition master 212, a nursing master 231, and a business information master 232. These masters are mainly responsible for the hard disk device incorporated in the client 200 as hardware.

  The client 200 includes an order request processing unit 210, an incharge sheet unit 220, and a nurse business assignment processing unit 230 as an electronic medical record management process. Each of the functions 210 to 230 of the electronic medical chart management process has an input function for receiving an input operation, a display function for displaying information, and a processing function for internally processing information. The input functions of the functions 210 to 230 of the electronic medical record management process are mainly performed by the keyboard and mouse of the client 200 as hardware. Moreover, the display function which each of these functions 210-230 has is mainly borne by the display which the client 200 has as hardware. Further, the processing functions of these functions 210 to 230 are mainly handled by the CPU and RAM of the client 200 as hardware.

  Here, a program for constructing the internal configuration of the electronic medical record server 100 shown in FIG. 3 will be described.

  FIG. 5 is a diagram showing an electronic medical record program having a program portion as a second embodiment of the nursing instruction notification program.

  As described above, the electronic medical record program 500 is stored in the CD-type medium 400. This electronic medical record program 500 includes a program portion corresponding to the second embodiment of the nursing instruction notification program described above with respect to the basic form. When the CD type medium 400 storing the electronic medical record program 500 is loaded into the general-purpose server device as shown in FIG. 6, the electronic medical record program 500 is incorporated into the general-purpose server device. And the internal structure of the electronic medical record server 100 shown in FIG. 3 is constructed | assembled by running the electronic medical record program 500 on the general purpose server apparatus.

  The storage medium for storing the embodiment of the nursing instruction notification program may be a DVD, a flexible disk (FD), a magnetic disk built in a hard disk device, or a USB memory. A solid-state memory element represented by Moreover, as an embodiment of the nursing instruction notification program, there may be a form of supplying to a computer via a telecommunication network.

  5 includes an order update unit 510, an instruction reception instruction confirmation unit 520, an instruction general-purpose search unit 530, a notification destination determination processing unit 540, an email transmission processing unit 550, a reply confirmation processing unit 560, and a patient list search process. 570, and a ward general-purpose search unit 580. The instruction reception instruction confirmation unit 520 includes an urgent level confirmation unit 521, an instruction confirmation processing unit 522, and an instruction reception processing unit 523.

  Among these elements, the order update unit 510, the urgency confirmation unit 521 of the instruction reception instruction confirmation unit 520, the notification destination determination processing unit 540, the mail transmission processing unit 550, and the reply confirmation processing unit 560 are included in the nursing instruction notification program. It corresponds to a program part as the second embodiment.

  The order update unit 510 of the electronic medical record program 500 of FIG. 5 constructs the order update unit 131 of the electronic medical record server 100 of FIG. In addition, the instruction reception instruction confirmation unit 520 and the instruction general-purpose search unit 530 of the electronic medical record program 500 construct the instruction reception instruction confirmation unit 132 and the instruction general-purpose search unit 133 of the electronic medical record server 100. Further, the notification destination determination processing unit 540 of the electronic medical record program 500 constructs the notification destination determination processing unit 151 of the electronic medical record server 100. In addition, the mail transmission processing unit 550 and the reply confirmation processing unit 560 of the electronic medical record program 500 construct the mail transmission processing unit 152 and the reply confirmation processing unit 154 of the electronic medical record server 100. The patient list search process 570 and the ward general-purpose search unit 580 of the electronic medical record program 500 construct the patient list search process 141 and the ward general-purpose search unit 142 of the electronic medical record server 100.

  Note that the urgency confirmation unit 521, the instruction confirmation processing unit 522, and the instruction reception processing unit 523 provide an instruction reception instruction confirmation unit 132 of the electronic medical record server 100 with an instruction confirmation process, an instruction reception process, and an urgency confirmation function described later. Is to execute.

  Hereinafter, returning to FIGS. 3 and 4, various functions of the electronic medical record server 100 and the client 200 provided in the electronic medical record system will be described generally and entirely.

  First, functions related to creation and reference of electronic medical records and orders will be described. The order request processing unit 210 of the client 200 creates order data representing various orders (instructions) such as injection, prescription, and treatment according to an input operation by a doctor. At this time, the doctor selects a patient and an order type by a selection operation. Then, the order data created by the order request processing unit 210 is sent to the order update unit 131 of the electronic medical record server 100. This order data corresponds to an example of instruction data in the basic form described above. In addition, the order request processing unit 210 also creates instruction book data representing creation and editing of an instruction book in which orders are collected into a book according to an input operation by a doctor. This instruction book data is also sent to the order update unit 131. Further, the order request processing unit 210 also creates chart data representing creation and editing of a document body in a so-called chart document in which a medical examination result and the like are described according to an input operation by a doctor. This chart data is also sent to the order update unit 131.

  By the way, when starting up the client 200, the doctor performs authentication based on his / her ID. For this reason, the various input operations described above by the doctor are recognized by the order request processing unit 210 of the client 200 as input operations by the authenticated doctor. The order request processing unit 210 sends the doctor's ID as input information when sending each of the above-described chart data, instruction book data, and order data to the order update unit 131.

  The order request processing unit 210 refers to the order master 211 and the operation condition master 212 when performing these input operations by the doctor. As the order-type master 211, there is prepared a master for converting codes such as medicines and instruction types used in injection, prescription, and treatment orders into normal medicine names and instruction terms. As the operating condition system master 212, a master that defines an input format or the like for each type of document (that is, medical record, order, or instruction book) is prepared. The order request processing unit 210 uses these masters to translate codes and words, display an input screen, and the like, thereby preparing an environment in which a doctor can input information without a sense of incongruity. Since this input screen and the like are conventionally well-known, further explanation is omitted.

  When chart data, instruction book data, or order data is sent from the order request processing unit 210 to the order update unit 131, the order update unit 131 updates the data in the chart DB group 110 using these data. To do. The medical record DB group 110 includes a cardex DB 111, an instruction book DB 112, a document DB 113, and an instruction management DB 114. In the cardex DB 111, nursing instruction information among various orders (instructions) is simplified and registered for search. Information on the instruction book is registered in the instruction book DB 112. The main part of the medical record document is registered in the document DB. In the instruction management DB 114, nursing instruction management information is registered. Information registered in each DB in the medical record database group 110 is associated with each other by an order number, a patient ID, or the like. In addition, some information is registered redundantly between DBs as necessary. As a result, a so-called electronic medical record is formed with the entire information registered in the medical record database group 110.

  The electronic medical record system constructed in the present embodiment is provided with a function for a doctor to refer to the electronic medical record and the like. However, since it is a well-known function and is not the subject of this case, description thereof will be omitted.

  The incharge sheet 220 of the client 200 is a tool for the nurse to confirm or receive an instruction in the ward of the order (instruction) issued by the doctor to the ward. The client 200 is installed in each ward. The incharge sheet 220 is commonly used by nurses belonging to the ward. When this incharge sheet 220 is activated by the operation of a nurse, it requests the instruction receiving instruction confirmation unit 132 and the instruction general-purpose search unit 133 of the electronic medical record server 100 to search for instructions based on default search conditions.

  In addition, when another search condition is input by the operation of the nurse, the incharge sheet 220 is searched for one of the instruction receiving instruction confirmation unit 132 and the instruction general-purpose search unit 133 according to the search condition. Request a search for instructions by condition.

  Upon receiving a search request, the instruction general-purpose search unit 133 accesses the cardex DB 111 to search for instructions at high speed. In addition, the instruction general-purpose search unit 133 also checks whether there are duplicate instructions or the like when searching. Although two cardex DBs 111 are shown for convenience of explanation, they are the same DB. Upon receiving a search request, the instruction reception instruction confirmation unit 132 obtains detailed information on the instruction from the instruction book DB 112 by the search. The process for obtaining detailed information on the instruction in this way is the instruction confirmation process. Information obtained by the search by the instruction receiving instruction confirmation unit 132 and the instruction general-purpose search unit 133 is sent to the incharge sheet 220, and the sent information is displayed as a search result by the incharge sheet 220. The nurse confirms the order status by viewing the display result on the incharge sheet 220.

  When the instruction reception information for the order is input by the operation of the nurse, the incharge sheet 220 requests the instruction reception instruction confirmation unit 132 of the electronic medical record server 100 to update the information based on the information. In addition, since the nurse is also authenticating with his / her ID when starting the client 200, the incharge sheet 220 recognizes the nurse who is the operator. When the incharge sheet 220 requests the instruction reception instruction confirmation unit 132 to update the information, the incharge sheet 220 sends the nurse's ID as a part of the instruction reception information. When receiving an update request, the instruction reception instruction confirmation unit 132 registers instruction reception information in the instruction book DB 112 and the instruction management DB 114. The process of registering this instruction reception information is the instruction reception process.

  Next, of the various functions of the electronic medical record server 100 and the client 200 provided in the electronic medical record system, functions related to creation and reference of management data for ward operations will be described. Examples of information represented by such management data include a nurse's work assignment table and a list of inpatients in the ward.

  The nurse task assignment processing unit 230 of the client 200 is used to create and refer to the nurse task assignment table and also to create and refer to the list of inpatients in the ward. The ward management DB group 120 of the electronic medical record server 100 includes a ward DB 121, a patient basic DB 122, a task assignment DB 123, and a worker DB 124. In the ward DB 121, information on a list of inpatients is registered. Information on individual patients is registered in the patient basic DB 122. In the task assignment DB 123, information on the task assignment table of the nurse is registered. The worker DB 124 is registered with information of workers (including doctors, nurses, and clerks) who work at the hospital.

  The nurse business assignment processing unit 230 of the client 200 creates list data representing the inpatient list in response to an input operation for creating the inpatient list by the nurse. When performing this input operation, the nurse work assignment processing unit 230 displays hospital room or bed selection candidates with reference to the hospital room master included in the work information system master 232. In addition, the nurse work assignment processing unit 230 obtains patient information from the patient basic DB 122 of the ward management DB group 120 via the patient list search processing unit 141 of the electronic medical record server 100 at the time of this input operation. Then, the nurse work assignment processing unit 230 displays the obtained information as selection candidates or reference information for creating the inpatient list. In this way, the nurse work assignment processing unit 230 reduces the burden of the input operation by the nurse by displaying the information obtained from the work information system master 232 and the patient basic DB 122. The list data created by the nurse work assignment processing unit 230 in response to the input operation by the nurse is sent to the patient list search processing unit 141 of the electronic medical record server 100. When the list data is sent, the patient list search processing unit 141 updates the information in the ward DB 121 using the list data. When the nurse performs a search operation in the nurse task assignment processing unit 230, such information in the ward DB 121 is stored in the nurse task assignment processing unit 230 through a search by the patient list search processing unit 141 and the ward general-purpose search unit 142. To be acquired. The nurse work assignment processing unit 230 displays the information thus acquired in the form of an inpatient list for the nurse.

  When the nurse manager or the like performs an operation for starting the function of creating the work assignment table, the nurse work assignment processing unit 230 requests the ward general-purpose search unit 142 of the electronic medical record server 100 to search for information on the ward DB 121 and the worker DB 124. To do. The ward general-purpose search unit 142 obtains information on inpatients in the ward where the client 200 is installed from the ward DB 121 by searching. In addition, the ward general-purpose search unit 142 acquires information on the nurses belonging to the ward where the client 200 is installed from the worker DB 124 by searching. Then, the ward general-purpose search unit 142 sends the acquired information to the nurse business assignment processing unit 230. The nurse business assignment processing unit 230 refers to the nursing master 231 while receiving the inpatient information and the nurse information sent thereto. This nursing master 231 is a PHS number master that represents a list of PHS numbers prepared in the ward for carrying by the nurse, and a duty (Special Duty) that represents a list of duties given by the hospital to the nurse. ) Master etc. are included. The nurse task assignment processing unit 230 displays selection candidates and reference information for creating the task assignment table using the information sent from the ward general-purpose search unit 142 and the information obtained from the nursing master 231. . The nurse chief or the like creates a task assignment table to be described later by performing selection operation or input operation using the information displayed in this way. The nurse task assignment processing unit 230 is also responsible for displaying the task assignment table. In addition, the nurse work assignment processing unit 230 reduces the operation burden of the nurse chief by displaying the selection candidates and the reference information as described above. When the task assignment table is created on the task assignment table screen, the nurse task assignment processing unit 230 creates assignment table data representing the task assignment table. This sharing table data is sent to the patient list search process 141 of the electronic medical record server 100. When the assignment table data is sent, the patient list search process 141 updates the information in the task assignment DB 123 using the assignment table data. When the nurse head or a general nurse performs an operation for referring to the work assignment table, the nurse work assignment processing unit 230 obtains information from the work assignment DB 123 in the patient list search process 141 of the electronic medical record server 100. Request. Then, the patient list search process 141 obtains information on the work assignment table from the work assignment DB 123 and sends the obtained information to the nurse work assignment processing unit 230. When the task assignment table information is sent, the nurse task assignment processing unit 230 displays the task assignment table on the task assignment table screen described above based on the information.

  Next, among the various functions of the electronic medical record server 100 and the client 200 provided in the electronic medical record system, functions related to emergency notification of nursing instructions will be described.

  As described above, the electronic medical record server 100 includes the notification destination determination processing unit 151, the mail transmission processing unit 152, and the reply confirmation processing unit 154 as processing units related to emergency notification of nursing instructions. Is also responsible for some of the processing related to this emergency notification.

  The instruction receiving instruction confirmation unit 132 has an urgency confirmation function for determining the urgency of a new nursing instruction when information related to the new nursing instruction is registered in the medical record database group 110 by information update by the order updating unit 131. Have. The nursing instruction with low urgency is notified to the ward via the incharge sheet 220 described above. This notification to the ward is executed by registering a nursing instruction in the medical record database group 110 as information searched when the incharge sheet 220 is activated. On the other hand, for a highly urgent nursing instruction, an emergency notification using a PDA, which will be described later, carried by the nurse is performed. In the case of emergency notification, the notification destination determination processing unit 151 determines a notification destination nurse using information in the task assignment table registered in the task assignment DB 123. Then, a notification mail addressed to the determined nurse is created by the mail transmission processing unit 152, and the created notification mail is stored in the mail box 153.

  The PDA carried by the nurse is equipped with an automatic mail reception function. When the notification mail is stored in the mail box 153, the PDA calls the nurse with a ringing tone to prompt confirmation of the notification mail. The nurse who confirmed the notification mail performs a reply operation as will be described later. The reply confirmation processing unit 154 confirms the presence or content of a reply mail.

  In accordance with the confirmation result by the reply confirmation processing unit 154, the information on receiving the instruction is registered in the instruction book DB 112 and the instruction management DB 114, or the next notification destination is determined by the notification destination determination processing unit 151.

  Among the elements of the electronic medical record server 100, the task assignment DB 123, the order update unit 131, the instruction reception instruction confirmation unit 132, the notification destination determination processing unit 151, the mail transmission processing unit 152, and the reply confirmation processing unit 154 include a nursing instruction notification device. It bears the functional part as the second embodiment. Of these elements, the business assignment DB 123 corresponds to an example of the storage unit in the basic form described above. Further, the order update unit 131 of the electronic medical record server 100 corresponds to an example of the instruction receiving unit in the basic form described above. The notification destination determination processing unit 151 of the electronic medical record server 100 corresponds to an example of the determination unit in the basic form described above. The mail transmission processing unit 152 of the electronic medical record server 100 corresponds to an example of the notification unit in the basic form described above. In addition, the reply confirmation processing unit 154 of the electronic medical record server 100 corresponds to an example of serving as the availability receiving unit and the notification control unit in the basic form described above.

  The details of the functions of the electronic medical record system will be described below, focusing on the nursing instruction management function including the above-described functions related to emergency notification of nursing instructions. In the following description, the elements shown in FIGS. 3 and 4 may be referred to without particularly referring to the figure numbers.

  FIG. 6 is a diagram showing an image of nursing instruction management. FIG. 7 is a flowchart of nursing instruction management.

  In FIG. 6, for convenience of explanation, the instruction management DB 114 and the mailbox 153 are described outside the electronic medical record server 100, but actually, as shown in FIG. 3, the instruction management DB 114 and the mailbox 153 are electronic It exists in the chart server 100.

  The doctor P1 operates the client 200 to input a nursing instruction to the order request processing unit 210 in order to register the nursing instruction in the electronic medical record (step 1 in FIG. 6). At this time, the doctor P1 is required to input information on either the scheduled execution time or the urgency level.

  FIG. 8 is a diagram illustrating an input example of an order (nursing instruction) when there is an input of the scheduled execution time.

  The nursing instruction 610 shown in FIG. 8 is an injection order. The doctor P1 can create a nursing instruction 610 in the format shown here on the screen of the client 200. In this example, the time “13:00” is input as the scheduled execution time 611.

  FIG. 9 is a diagram illustrating an input example of an order (nursing instruction) when no scheduled execution time is input.

  The nursing instruction 620 shown in FIG. 9 is also an injection order. When the doctor P1 creates a nursing instruction on the screen of the client 200, the doctor P1 can also create a nursing instruction 620 in the format shown here. In this type of nursing instruction 620, an emergency level selection column 621 is prepared instead of no entry of the scheduled execution time. In this example, the urgency level “within 3 hours” is selected.

  The doctor P1 selects either the format shown in FIG. 8 or the format shown in FIG. The doctor P1 inputs a nursing instruction to the order request processing unit 210 of the client 200 in the selected format as shown in Step 1 of FIG. The order request processing unit 210 of the client 200 sends data representing a nursing instruction to the order update unit 131 of the electronic medical record server 100. As described above, since the doctor P1 has selected the patient and the order type, the order request processing unit 210 also sends the slip name corresponding to the patient ID and the order type in the data. Further, the order request processing unit 210 issues an order number for distinguishing each nursing instruction, and sends the order number in the data. The order update unit 131 of the electronic medical record server 100 registers the management information of nursing instructions in the instruction management DB 114 (step 2 in FIG. 6).

  FIG. 10 is a diagram illustrating an example of management information registered in the instruction management BD 114.

  The management information 800 includes a request date and time 801, a patient ID 802, an order number 803, a scheduled execution date and time 804, an emergency instruction flag 805, and a slip name 806 as information items. These items are items registered based on the data sent from the order request processing unit 210 to the order update unit 131 as described above. In the emergency instruction flag 805, the urgency level inputted by the doctor when the doctor selects the format shown in FIG. 9 is registered. In addition, in the scheduled execution date and time 804, the time is also registered only when the doctor inputs the scheduled execution time. The examples shown in FIG. 10 are examples when the doctor selects the format shown in FIG. 9, and therefore only the date is registered in the scheduled execution date and time 804.

  The management information 800 further includes an instruction reception flag 807, an instruction reception date / time 808, an instruction receiver ID 809, tracking information 810, a mail notification date / time 811, and a mail receiver ID 812 as information items. Among the information items of the management information 800, the instruction reception flag 807 has a value “0” indicating that the instruction reception has not been completed when the management information 800 is newly registered. The instruction reception date and time 808 and the instruction receiver ID 809 are registered when an instruction is received by the nurse. The tracking information 810, the mail notification date / time 811 and the mail recipient ID 812 are registered as described later in the emergency notification of the nursing instruction. FIG. 10 shows the management information for five levels. As can be seen from the item of order number 803, the three levels from the top correspond to one nursing instruction. Management information. Of the three levels of management information corresponding to one nursing instruction, the lower two levels are added as described later in the emergency notification of the nursing instruction.

  When new nursing instruction management information is registered in the instruction management DB 114 as shown in step 2 of FIG. 6, the instruction receiving instruction confirmation unit 132 of the electronic medical record server 100 determines the urgency of the nursing instruction (FIG. 6). Step 3). More specifically, the instruction reception instruction confirmation unit 132 first confirms whether or not the time is registered in the scheduled execution date and time 804 of the management information 800 registered in the instruction management BD 114 (step S101 in FIG. 7). .

  If the time has been registered (step S101 in FIG. 7: present), the instruction reception instruction confirmation unit 132 determines the urgency level by obtaining the time difference between the request date 801 and the scheduled execution date 804 (FIG. 7). Step S102). Here, it is assumed that the degree of urgency is high when the time difference is within one hour.

  On the other hand, when the time is not registered in the scheduled execution date and time 804 (step S101 in FIG. 7: none), the urgency level is determined based on the contents of the emergency instruction flag 805 in the management information 800 (step S103 in FIG. 7). . Here, when the registered content of the emergency instruction flag 805 is “within 1 hour”, it is determined that the degree of urgency is high.

  When the urgency level of the nursing instruction is determined by the instruction receiving instruction confirmation unit 132 as described above, in the case of a nursing instruction that is not a target of urgent notification because the urgency level is low (step S104: N in FIG. 7), an incharge is performed. Normal instruction issuance (notification) via a sheet.

  FIG. 11 is a diagram showing an image of normal instruction issuance in the electronic medical chart system.

  As described above, the doctor P1 operates the doctor client 200 to input a nursing instruction for injection or treatment into the electronic medical record (step 1).

  The ward nurse P2 activates the incharge sheet on the ward client 200 and confirms the nursing instruction issued by the doctor at a predetermined time. Then, a nurse who can receive an instruction performs an instruction receiving operation on the incharge sheet (step 2). When actually practicing nursing instructions, the nurse P2 confirms the contents instructed by the doctor using the electronic medical record system, and carries out injection and treatment of the confirmed instruction contents (step 3).

  FIG. 12 is a diagram illustrating an example of a display screen of an incharge sheet.

  The incharge sheet display screen 700 is provided with a user field 730 indicating the name of the nurse who activated the incharge sheet, and a date selection field 740 for selecting a date for searching for a nursing instruction.

  The incharge sheet display screen 700 is provided with an instruction content list portion 710 for displaying a list of nursing instructions found by the search and an instruction detail list portion 720 for displaying the detailed contents of the nursing instructions.

  The nurse selects a patient in the instruction content list portion 710. The name of the selected patient is displayed in the patient name field 750, and the detailed contents of the nursing instruction issued by the doctor regarding the patient are displayed in the instruction detail list portion 720. The nurse confirms the content of the nursing instruction by looking at the instruction detail list portion 720. In particular, by checking the patient name column 750, the slip name 722, the scheduled execution date column 723, and the slip details 724, it is determined whether or not the nursing instruction can be practiced. The order number column 725 displays an order number for distinguishing each nursing instruction.

  In the instruction content list portion 710, a nursing instruction with a high degree of urgency and a nursing instruction with a low degree of urgency are displayed without distinction. However, the nurse mainly starts the instruction scheduled date column of the instruction content list portion 710 and the slip details 724. Determine the degree of urgency by checking the date and time items. Here, if the doctor has not entered the scheduled execution time in the scheduled execution date field of the instruction content list portion 710 or the instruction start date / time item of the slip details 724, the electronic medical record system calculates the implementation time. To add. This execution time is calculated from the registered contents of the request date 801 and the emergency instruction flag 805 shown in FIG. For example, when the registered content of the emergency instruction flag 805 is “within 1 hour”, the time obtained by adding 1 hour to the time registered in the request date 801 is the execution time.

  When the nurse determines that the nursing instruction whose contents are displayed can be put into practice, the nurse selects the nursing instruction in the instruction receiving field 721. Then, when the nurse clicks the reception selection button 760, instruction reception for the nursing instruction is selected. For the nursing instruction for which the nurse has selected to receive the instruction, the instruction reception date / time field 711 of the instruction content list portion 710 displays the instruction reception date / time. In the instruction receiver column 712, the name of the nurse who has selected the instruction receiver is displayed.

  The instruction reception selected in this manner is canceled when the nurse operates the instruction reception column 721 and the reception release button 770. The selected instruction is registered in the instruction book DB 112 and the instruction management DB 114 when the nurse clicks the button 780 for confirming the instruction reception. In the management information 800 shown in FIG. 10, the value of the instruction reception flag 807 is “1” indicating completion of instruction reception, and the instruction reception date and time 808 and the instruction receiver ID 809 are registered.

  The above is the normal instruction issuance (notification) procedure via the incharge sheet.

  Here, the following application forms are suitable for the basic form described above. In this preferred application mode, a second notification unit for notifying a nursing instruction represented by the instruction data received by the instruction receiving unit to an instruction confirmation device shared by a plurality of nurses and used for confirming a nursing instruction. It has. Further, in this preferred application mode, the instruction receiving unit also includes urgent level information added to the nursing instruction by the doctor that can determine at least the urgent level of implementation of the nursing instruction when receiving the instruction data. It will be accepted. Furthermore, this suitable application form is provided with the notification selection part. When the urgency level determined from the urgency level information received by the instruction receiving unit has reached a predetermined level, the notification selection unit executes the first notification via the notification unit. Moreover, this notification selection part performs the 2nd notification via the said 2nd notification part, when the urgency level has not reached the predetermined level.

  According to such a preferred application form, appropriate notification according to the degree of urgency is performed, so the accuracy of notification is further increased. The normal instruction issuance (notification) via the incharge sheet described above corresponds to an example of the second notification in this application mode. Further, the emergency notification, which is outlined above and described in detail below, corresponds to an example of the first notification in this application mode. In addition, as an example of the urgency level information in this application mode, the urgency level selected in the selection column 621 corresponds to the order type shown in FIG. In the case of the order type shown in FIG. 8, the scheduled execution time 611 corresponds to an example of the urgency level information in this application mode.

  The explanation of the management function for nursing instructions will be continued below.

  As described above, when the instruction receiving instruction confirmation unit 132 determines the urgency level of the nursing instruction, if the urgent level is high and the nursing instruction is an emergency notification target (step S104: Y in FIG. 7), an e-mail is sent. The emergency notification is instructed by (Step 3 in FIG. 6).

  In this emergency notification, the notification destination determination processing unit 151 first determines the primary notification destination from the work assignment table (step 4 in FIG. 6 and step S105 in FIG. 7).

  FIG. 13 is a diagram illustrating an example of a work assignment table.

  The task assignment table referred to by the notification destination determination processing unit 151 for the emergency notification is a task assignment table registered in the task assignment DB 123. Here, for convenience of explanation, a task for the nurse to confirm the task assignment table. This is explained using the image on the sharing screen.

  In the task assignment table 900, patient information 910 and nurse information 920 are recorded in association with each other. The nurse associated with the patient is the person in charge of the patient. Since the work assignment table 900 is created for each date and business category, the person in charge can also change for each date and business category. Is fixed. However, because the nurse's work in the ward is very fluid, it cannot be completely fixed, and may actually be close to being in charge of a team of multiple nurses. Some patients need to fix their teams. Therefore, the assignment team column 930 is also prepared in the work assignment table 900.

  The notification destination determination processing unit 151 selects the nurse in charge of the target patient as the first notification destination by comparing the task assignment table 900 with the target patient of the nursing instruction. In other words, in the present embodiment, a rule of “the nurse in charge of the patient who is the subject of the nursing instruction” is given to the notification destination determination processing unit 151 as a rule for determining the primary notification destination. The method of giving rules to the notification destination determination processing unit 151 is not particularly limited here. For example, the electronic medical record program 500 may be incorporated, or may be set as a table by an administrator of the electronic medical record system. In the example shown in FIG. 13, the nurse “Noriko Mizoguchi” is determined as the primary notification destination of the nursing instruction for the patient “Tatsuo Nakano” in the “02” bed of the “553” room. As described above, the notification destination is determined by the business assignment table and the predetermined rule, so that the notification destination of the emergency notification is flexibly and appropriately narrowed down according to the current status of the business.

  In this way, when the primary notification destination nurse is determined in step 4 of FIG. 6 and step S105 of FIG. 7, a notification mail addressed to the nurse is created by the mail transmission processing unit 152. Then, the created notification mail is stored in the mail box 153. Also, tracking information 810 of the management information 800, a mail notification date and time 811, and a mail recipient ID 812 are registered in the instruction management DB 114. At this time, “reply incomplete” is registered in the tracking information 810.

  Here, each nurse in the ward carries a PDA 300. The PDA 300 is carried by each nurse for use in inputting various information in a hospital room. The information input by the PDA 300 includes the patient's meal status, body temperature, the type of medicine used for the patient, and the like. Information input via the PDA 300 is sent to the order update unit 131 described above. The order update unit 131 updates the information in the electronic medical record based on the information sent as such.

  As described above, this PDA 300 is equipped with an automatic mail reception function. And when starting this PDA300, since the nurse is authenticating by own ID, PDA300 has recognized the carrier. When the notification mail addressed to the nurse who is the portable person is stored in the mail box 153, the PDA 300 makes a ringing tone and calls the portable person. Up to this point, the process is executed in step 4 of FIG. 6 and step S105 of FIG.

  Since each nurse has previously explained the meaning of the emergency notification by the PDA 300, the nurse called by the PDA 300 recognizes that there is a nursing instruction that is designated as an individual and that is important to him / her. In addition, the nurse is not bothered by unnecessary notifications. That is, the notification accuracy is high in this emergency notification.

  Since the notification using the PDA 300 and the email is an urgent notification, the reply confirmation processing unit 154 checks whether the reply from the nurse has arrived in the mail box 153 and compares the current time with the email notification date 811. To check the elapsed time from notification.

  When a reply operation is not performed for a certain period of time (for example, 5 minutes in this case) because the nurse called by the PDA 300 is busy and cannot be released, step 5 in FIG. 6 and step S107 in FIG. 7; N) The reply confirmation processing unit 154 cannot confirm the reply even after a predetermined time. In this case, the reply confirmation processing unit 154 requests the notification destination determination processing unit 151 to determine the next notification destination (step 5 in FIG. 6 and step S108 in FIG. 7). The notification destination determination processing unit 151 determines the next notification destination nurse from the work assignment table. In the present embodiment, a rule “team leader of the team to which the nurse of the primary notification destination belongs” is given as a rule for determining the secondary notification destination. In the case of the example shown in FIG. 13, the nurse “Riko Yamada” is determined as the second notification destination. When the notification destination determination processing unit 151 determines the next notification destination nurse as described above, a notification mail addressed to the nurse is created by the mail transmission processing unit 152. Then, the created notification mail is stored in the mail box 153 (step 5 in FIG. 6 and step S108 in FIG. 7). Further, the management information 800 is added to the instruction management DB 114 for the nursing instruction to be notified. Information of each item in the original stage of the nursing instruction is copied to the request date / time 801 to the slip name 806 in the added stage. In addition, a value “0” indicating that the instruction reception has not been completed is registered in the instruction reception flag 807, and “reply incomplete” is registered in the tracking information 810. The mail notification date 811 and the mail recipient ID 812 are also registered.

  Thereafter, in step S109 of FIG. 7, it is determined whether the notification destination is less than the fourth order, and if it is less than the fourth order, the process returns to step S107.

  The PDA 300 carried by the second and subsequent notification destination nurses also calls the carrier with a ringing tone when a notification mail addressed to the nurse who is the carrier is stored in the mail box 153.

  A nurse called by the PDA 300 confirms the notification by operating the PDA 300 unless there is a reason as described above. Then, a reply operation to the notification is performed (step 6 in FIG. 6, step S107 in FIG. 7; Y).

  FIG. 14 is a diagram showing a notification screen in the emergency notification.

  FIG. 14 shows a notification screen 310 at the primary notification destination and a notification screen 320 at the secondary and subsequent notification destinations as examples of the notification screen. The above-described notification mail created by the mail transmission processing unit 152 is a mail representing such notification screens 310 and 320.

  The notification screen 310 at the primary notification destination includes an urgent level display field 311 and a reply selection field 312. In the urgency level display column 311, the urgency level or scheduled execution date and time input by the doctor is displayed. The nurse can confirm the urgent level of the nursing instruction by looking at the urgent level displayed in the urgent level display field 311. Then, the nurse selects a reply to the confirmed nursing instruction in the reply selection column 312 in consideration of the busyness of work. In this embodiment, three types of responses, “Received”, “Not possible”, and “Receiving hold”, are prepared as selectable responses. The reply “Received” represents an instruction received for a nursing instruction. A reply of “impossible” indicates that it is impossible to receive an instruction due to busy work. The reply “pending receipt” indicates that it is not impossible to receive the instruction, but that it is desired that other nurses receive the instruction if possible. In the notification screen 310 shown in the middle part of FIG. 15, “reception hold” is selected as an example.

  The notification screen 320 at the second and subsequent notification destinations is provided with an urgent level display column 321 and a reply selection column 323 as in the notification screen 310 at the first notification destination, and the second and subsequent notification destinations. In the notification screen 320, a status column 322 is also provided. In the status column 322, the registered content of the tracking information 810 described above is displayed as the status of the notified nurse. The second and subsequent notification destination nurses confirm the urgent level of the nursing instruction by looking at the urgent level displayed in the urgent level display column 321, and also check the status column 322 to see the status of the notified nurse. Check the response status. Then, a reply is selected in the reply selection field 312.

  When a reply is selected by the nurse in this way, the PDA 300 sends a reply mail representing the selected reply to the mail box 153. This reply mail corresponds to an example of the availability data in the basic form described above.

  The reply confirmation processing unit 154 confirms the contents of such a reply and registers the confirmed contents in the instruction management DB 114 (step 7 in FIG. 6, step S107 in FIG. 7; Y). Specifically, the tracking information 810 included in the management information 800 having the structure shown in FIG. 10 is updated with the reply contents. When the reply content is “receive” (step S110; Y in FIG. 7), the reply confirmation processing unit 154 sets the value of the instruction reception flag 807 of the management information 800 to a value “1” indicating completion of instruction reception. Update. If the reply content is “Received”, the reply confirmation processing unit 154 also registers the instruction reception date and time 808 and the instruction receiver ID 809, and further registers the instruction reception information in the instruction book DB 112 described above. (Step 7 in FIG. 6 and Step S111 in FIG. 7). Thereby, the instruction receiving process for the nursing instruction is completed.

  On the other hand, when the reply content is “impossible” or “reception pending”, the reply confirmation processing unit 154 requests the notification destination determination processing unit 151 to determine the next notification destination (step S108 in FIG. 7). . The notification destination determination processing unit 151 determines the next notification destination nurse from the work assignment table.

  In the present embodiment, the rule that determines the third and subsequent notification destinations is given as a rule that “the nurse who is the first notification destination nurse and the same team nurse has a long experience (year of service)”. ing. Information on the experience (year of service) of the nurse is obtained by the notification destination determination processing unit 151 referring to the worker DB 124.

  FIG. 15 is a diagram illustrating an example of information registered in the worker DB.

  This figure illustrates nurse information 950 out of worker information registered in the worker DB.

  The nurse information 950 includes information items such as a user ID 951, a user name 952, a job type code 953, a job type name 954, and a service year 955. The notification destination determination processing unit 151 confirms each nurse's experience (year of service) by referring to the user ID 951 and the length of service 955. Then, the notification destination determination processing unit 151 determines third and subsequent notification destinations according to the above rules using the experience (year of service) confirmed in this way. In the case of the example shown in FIG. 13, the nurse “Toshimi Kudo” is determined as the third notification destination. When the third and subsequent notification destinations are determined in this way, a notification mail addressed to the nurse of the determined notification destination is stored in the mail box 153. In addition, each time a notification mail is sent to the third and subsequent notification destinations, one level of management information 800 is added to the instruction management DB 114 for the nursing instruction to be notified.

  In this way, the notification is automatically routed to the next notification destination, so that it is possible to avoid non-execution of nursing instructions due to oversight or the like.

  In this embodiment, such an emergency notification is executed up to the fourth notification destination (step S109 in FIG. 7). When a “received” reply is obtained from the fourth notification destination (step S109 in FIG. 7; “instruction received”), the reply confirmation processing unit 154 performs exactly the same processing as in step S111 described above. Then, an instruction reception process for the nursing instruction is performed (step S112 in FIG. 7).

  On the other hand, if a reply “receive” is not obtained from the fourth notification destination (step S109 in FIG. 7; “no instruction received”), the notification is returned to the first notification destination and notified again (in FIG. 7). Step S113). This “no instruction received” means that both a case where a reply other than “received” is obtained and a case where the above-mentioned fixed time has passed with “reply not completed”.

  Here, the following application forms are preferable to the basic form described above.

  In this application mode, the notification control unit determines the upper limit of the number of notification destinations. Then, even if the number of notification destinations reaches the upper limit, the notification control unit sends the notification unit to the nurse first determined by the determination unit when the approval / rejection data indicating that the instruction can be received is not received. The notification is performed again. Thus, it is preferable that an upper limit is set for the number of notification destinations because the notification destinations are limited to those who are appropriate as a person who executes a nursing instruction. In addition, since the first notification destination is returned after reaching the upper limit, the nurse who is the first notification destination can respond such as when he / she is busy but receives it once again. As a result, it is possible to avoid receiving the pressure of decision at the time of notification. In addition, although the example in which the upper limit of the notification destination is the fourth order is shown in the flowchart of FIG. 7, the upper limit in this application form may be the third order or lower, Good.

  FIG. 16 is a diagram showing a notification screen when the primary notification destination is notified again.

  The notification screen 330 shown in FIG. 16 is provided with a status column 331 for displaying the statuses of the notification destinations from the second to the fourth that have already been notified. Since such a status column 331 is shown, the nurse who has received the notification can easily recognize that the notification is a second notification.

  This means that when the notification unit in the basic mode described above performs the notification addressed to the nurse first determined by the determination unit again, re-notification information indicating that the notification is a second notification is also transmitted. This means that the application form is preferable. The status column 331 provided on the notification screen 330 shown in FIG. 16 corresponds to an example of re-notification information in this preferred application mode.

  The status column 331 also displays the name 332 of the nurse who has already been notified. By confirming the name 332 displayed in this way, the nurse who is the primary notification destination can know who has been notified and returned, so the final decision on whether or not to receive the instruction can be made. It is easy to make a decision.

  This means that when the notification unit in the basic form described above performs the notification addressed to the nurse first determined by the determination unit, it also transmits nurse information representing the notified nurse. It means that the application form is preferable. The name 332 displayed on the notification screen 330 shown in FIG. 16 corresponds to an example of nurse information in this preferred application mode.

  This notification screen 330 is also provided with a reply selection field 333, and the nurse as the primary notification destination selects the reply again. In the example shown in FIG. 16, “Receive” is selected.

  As described above, even when the primary notification destination is notified again, if it is “no instruction received”, the team of the team to which the primary notification destination nurse belongs is not shown in the flowchart of FIG. A re-notification is sent to the reader, and the emergency notification process ends. When such a re-notification is sent, the team leader decides the appropriate nurse to execute the nursing instruction as the authority of the leader, and makes the decided nurse receive the nursing instruction. .

  Above, description of specific embodiment is complete | finished.

  In the above description, a PDA is shown as a specific example of the portable device in the basic mode described above, but a PHS may be used as the portable device in the basic mode described above. When a PHS is used as a portable device, the number of the PHS carried by the nurse is confirmed on the work assignment table shown in FIG. Then, a notification mail is sent to the PHS of the confirmed number.

  In the above description, a ringing tone is shown as an example of the output from the portable device in the basic form described above, but the output from the portable device in the basic form described above may be vibration or light. There may be.

  DESCRIPTION OF SYMBOLS 1 ... Nursing instruction notification apparatus, 2 ... Memory | storage part, 3 ... Instruction reception part, 4 ... Determination part, 5 ... Notification part, 6 ... Notification receiving part, 7 ... Notification control part, 10 ... Nursing instruction notification program, 100 ... Electronic Medical record server, 110 ... medical record DB group, 120 ... ward management DB group, 131 ... order update part, 132 ... instruction reception instruction confirmation part, 133 ... instruction general-purpose search part, 141 ... patient list search process, 142 ... ward general-purpose search part 151 ... Notification destination determination processing unit, 152 ... Mail transmission processing unit, 153 ... Mail box, 154 ... Reply confirmation processing unit, 200 ... Client, 210 ... Order request processing unit, 220 ... Incharge sheet unit, 230 ... Nurse Business assignment processing unit, 300 ... PDA, 310, 320, 330 ... notification screen, 500 ... electronic medical record program, 610,620 ... nursing instruction, 700 ... incharge Over the door of the display screen, 800 ... management information, 900 ... business sharing table

Claims (6)

A storage unit for storing a work assignment table in which the work assignment of each nurse in the ward is described;
An instruction receiving unit that receives instruction data representing the contents of nursing instructions specifying a patient;
When instruction data is received by the instruction receiving unit, the nurse that notifies the nursing instruction is assigned to the task assignment table stored in the storage unit, the patient specified by the nursing instruction, and the priority for each patient. A determination unit that is determined based on rules for determining a representative person in charge,
When the nurse is instructed to receive instructions, the nurse gives an output that is carried by the nurse and stimulates one of the five senses of the nurse. A notification unit for notifying a nursing instruction received by the instruction receiving unit to a nurse determined by the determination unit, via a portable device that returns whether or not the data is input or received;
An availability receiving unit for receiving availability data returned from the portable device;
In a case where the availability data indicating acceptance of the instruction is not received by the availability reception unit, the determination unit is allowed to determine the next notification destination from among the unreported nurses, and the notification unit is configured to determine the determined nursing A nursing instruction notifying apparatus comprising: a notification control unit for notifying a nurse of a nursing instruction received by the instruction receiving unit. A second notification unit for notifying a nursing instruction represented by the instruction data received by the instruction receiving unit, on an instruction confirmation device shared by a plurality of nurses and used for confirming a nursing instruction;
When the instruction receiving unit receives the instruction data, it can also determine the urgent level of implementation of the nursing instruction, and can also receive the urgent level information added to the nursing instruction by a doctor.
When the urgency level determined from the urgency level information received by the instruction receiving unit has reached a predetermined level, the first notification is executed via the notification unit, and the urgency level has not reached the predetermined level. The nursing instruction notification device according to claim 1, further comprising a notification selection unit that executes a second notification via the second notification unit.   When the notification control unit determines the upper limit of the number of notification destinations, and the number of notification destinations reaches the upper limit, if the propriety data indicating acceptance of the instruction is not received, the notification unit The nursing instruction notification apparatus according to claim 1 or 2, wherein the notification for the nurse first determined by the determination unit is performed again.   The said notification part transmits the re-notification information which shows that it is a re-notification, when performing the notification addressed to the nurse determined by the determination part first, The re-notification information is also transmitted. Nursing instruction notification device.   5. The notification unit also transmits nurse information indicating a notified nurse when the notification for the nurse first determined by the determination unit is performed again. 5. The nursing instruction notification device described. On the computer by being executed on the computer,
An instruction receiving unit for receiving instruction data representing the contents of nursing instructions;
When instruction data is received by the instruction receiving unit, a nurse that notifies the nursing instruction includes a task assignment table that describes the task assignment of each nurse in the ward, and a patient identified by the nursing instruction. A decision unit that is determined on the basis of rules for determining a preferential person in charge for each patient;
When the nurse receives an instruction on whether or not to receive the instruction given to the nurse, an output that is carried by the nurse and stimulates one of the five senses of the nurse is received. A notification unit for notifying a nursing instruction received by the instruction receiving unit to a nurse determined by the determination unit, via a portable device that returns whether or not the data is input or received;
An availability receiving unit for receiving availability data returned from the portable device;
In the case where the availability data representing acceptance of the instruction is not received by the availability receiving unit, the determination unit is caused to determine the next notification destination from among the unreported nurses, and the notification unit is configured to determine the determined nursing A nursing instruction notification program for constructing a notification control unit for notifying a nurse of a nursing instruction received by the instruction receiving unit.

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