JP2016170686A - Medical task support system and warning method thereof - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical task support system capable of issuing a warning under the consideration of the activity condition of a staff in the case of transmitting an instruction in a medical task and a warning method thereof.SOLUTION: A medical task support system includes: an instruction information database 13 for recording instruction information 130 for transmitting the instruction information 130 to a staff involved in a medical task; a client terminal 30 for displaying instruction information by the operation of the staff; a medical staff information database 14 for recording staff information 140 including the activity information of the staff; a fatigue degree calculation part 23 for calculating the fatigue degree of the staff by referring to the staff information 140; and a risk degree determination part 24 for determining the error risk degree of the staff from the fatigue degree. The client terminal 30 is configured to, when a display request of the instruction information is made by the staff, display a warning in accordance with the error risk degree.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a medical service support system and a warning method thereof.

In medical institutions such as hospitals, medical operation support systems that support information processing in medical operations are actively introduced.
Information processing such as computerization of patient charts is generally used as a medical work support system, but in recent years, advanced support for preventing mistakes in medical work has been attempted.

The nursing support system disclosed in Patent Document 1 can promptly display manuals and information on handling of medical devices used in nursing work.
The medical accident prevention system of Patent Document 2 collates medical plan information and medical practice schedule information, and issues a warning when there is an error and records it as medical performance log information. By extracting performance information as necessary, it can be used for analysis of the occurrence tendency of medical accidents.

  The medical risk management system of Patent Document 3 enables risk management by reliably transmitting instructions in medical work and performing evaluation using a risk file or contraindication file. Risk items are quantified, such as the skills of staff such as doctors and nurses, movement of departments, fluctuations due to time zones such as nighttime, places of processing, past events, addition of new models of equipment and new drugs, etc. The risk rate is calculated.

JP 2007-148768 A JP 2004-30554 A JP 2003-44587 A

In Patent Document 3 mentioned above, detailed skills including conditions such as working hours are taken into account for staff such as doctors and nurses in the transmission of instructions in medical work, taking into account personal factors such as skills. Evaluation can be made.
However, even if the situation such as day shift or night shift can be added to the personal attributes of the staff, the actual situation in the medical field is various, and the activity status of the staff is not uniform even in the same time zone.

  An object of the present invention is to provide a medical service support system and a warning method thereof capable of giving a warning in consideration of the activity status of a staff when an instruction in the medical service is transmitted.

  The medical service support system of the present invention is a medical service support system that transmits instruction information to a staff member engaged in medical work, and displays the instruction information by an instruction information database that records the instruction information and operation of the staff. A client terminal; a medical staff information database that records staff information including activity information of the staff; a fatigue level calculator that calculates the fatigue level of the staff with reference to the staff information; and A risk determination unit that determines an error risk, and the client terminal displays a warning on the client terminal according to the error risk when the staff requests the instruction information to be displayed It is characterized by that.

  In the present invention, the staff activity information is recorded in the medical staff information database, the fatigue level for each staff is calculated by the fatigue level calculation unit, and the error risk level associated with fatigue is determined by the risk level determination unit. it can. Therefore, when determining the risk of error, it is possible to consider various activity states of the staff in the actual medical field.

When the staff requests to display the instruction information, the client terminal can display a warning according to the error risk level.
As described above, according to the medical service support system of the present invention, it is possible to give a warning in consideration of the activity status of the staff when transmitting instructions in the medical service.

In the present invention, the instruction information includes various instructions between staffs handled by the medical service support system in addition to prescribing medical practice such as an instruction for medication.
The staff includes various medical staff involved in instruction information in addition to doctors, nurses, and pharmacists.

  As the activity information of the staff, the movement amount in the medical facility, the movement amount at the time of medical treatment, and the like can be used. For example, the staff can carry the monitoring terminal and the travel distance can be accumulated. Alternatively, the travel distance can be integrated without carrying a monitoring terminal or the like by detecting the passage of the staff by optical detection of the staff's name tag or proximity detection of the ID card in each part of the facility.

  In the present invention, the warning display of the client terminal according to the error risk level is not only a request for displaying the instruction information by the staff on the instruction receiving side, but also when the instruction issuing side (mainly a doctor) registers the instruction information. Can also be applied.

  In the medical service support system of the present invention, it is desirable to have a monitoring terminal that is carried by the staff and measures the activity information.

In the present invention, the staff's activity information can be measured by attaching the monitoring terminal to the staff.
Such a monitoring terminal can be easily implemented as a configuration including a momentum measurement unit using a three-dimensional acceleration sensor, and a control unit and a communication unit that accumulates measurement data and transmits it to a server.

  In the medical service support system according to the present invention, the medical staff information database may record the staff history information and work status as the staff information.

In the present invention, in addition to the fatigue level determination based on the staff activity information described above, it is possible to determine the error risk level in consideration of the staff history information and work status.
The career information includes medical work skills, that is, experience and proficiency, as well as past cases. The working status includes working hours such as midnight, and situations such as after-night work where fatigue accumulates.

  A warning method for a medical service support system according to the present invention includes an instruction information database that records the instruction information and a client terminal that displays the instruction information by the operation of the staff in order to transmit the instruction information to a staff engaged in medical work. And a warning method for a medical service support system comprising: recording staff information including activity information of the staff; calculating the fatigue level of the staff with reference to the staff information; and The error risk level is determined, and when the instruction information is requested by the staff, a warning is displayed on the client terminal according to the error risk level.

  According to such a method of the present invention, it is possible to obtain the operational effects as described in the medical work support system described above.

The block diagram which shows one Embodiment of the medical service assistance system of this invention. The figure which shows the processing flow of the monitoring terminal of the said embodiment. The graph which shows the measurement procedure of the active mass of the said embodiment. The graph which shows the calculation procedure of the active mass rank of the said embodiment. The figure which shows the recording state of the activity amount rank in the staff information of the embodiment. The figure which shows the calculation procedure of the fatigue degree of the said embodiment. The figure which shows the calculation procedure of the risk rank of the said embodiment. The figure which shows the registration processing flow of the instruction information in the said embodiment. The figure which shows the registration procedure of the instruction information in the said embodiment. The figure which shows the warning process at the time of registration of the instruction information in the said embodiment. The figure which shows the reference processing flow of the instruction information in the said embodiment. The figure which shows the reference procedure of the instruction information in the said embodiment. The figure which shows the warning process at the time of the reference of the instruction information in the said embodiment.

Hereinafter, an embodiment of the present invention will be described with reference to the drawings.
[Medical service support system]
FIG. 1 shows a configuration of a medical service support system 1 of the present embodiment.
The medical service support system 1 includes a database management server 10, a hospital system management server 20, a plurality of client terminals 30, and a plurality of monitoring terminals 40.

  These database management server 10, in-hospital system management server 20, client terminal 30, and monitoring terminal 40 are configured as computer systems that operate under the control of control units 11, 21, 31, and 41, respectively. , 22, 32, and 42 are connected to the network 2 of the hospital information system.

The database management server 10 includes the control unit 11 and the communication unit 12 described above, and includes an instruction information database 13 and a medical staff information database 14.
A plurality of instruction information 130 is recorded in the instruction information database 13.
The instruction information 130 is mainly an instruction related to medical practice, such as a medication instruction or a treatment instruction for a patient.

A plurality of staff information 140 is recorded in the medical staff information database 14.
The staff information 140 is created for each medical staff engaged in medical work in the hospital where the medical work support system 1 is installed, and the staff history 141 and the work situation 142 are recorded in each of the staff information 140. The activity amount 143 which is the activity information is recorded.

The in-hospital system management server 20 includes the control unit 21 and the communication unit 22 described above, and includes a fatigue level calculation unit 23 and a risk level determination unit 24 according to the present invention.
The fatigue level calculation unit 23 and the risk level determination unit 24 calculate the staff fatigue level based on the present invention and determine the error risk level. Details of these will be described later.

The client terminal 30 includes the control unit 31 and the communication unit 32 described above, and includes an input unit 33 and a display unit 34.
The input unit 33 is for the staff to register instruction information or perform an operation of referring to the instruction information. For example, a character input keyboard, a pointing device, a touch panel, or the like can be used.
The display unit 34 displays information when the staff operates, or displays instruction information by a reference operation. For example, an image display panel using liquid crystal or the like can be used.

Such a client terminal 30 can be configured using a general-purpose personal computer system.
The communication unit 32 in such a client terminal 30 may be wired or wirelessly connected to the network 2.

The monitoring terminal 40 includes the control unit 41 and the communication unit 42 described above, and includes an exercise amount measurement unit 43 and an activity amount calculation unit 44.
The momentum measurement unit 43 measures the momentum of the staff based on the present invention, and is configured by a three-dimensional acceleration sensor in the present embodiment.
The activity amount calculating unit 44 calculates an activity amount from the exercise amount of the staff measured by the exercise amount measuring unit 43. Details thereof will be described later.

The monitoring terminal 40 is accommodated in a small case that can be locked in clothes or stored in a pocket so that the staff can always carry it.
The communication unit 42 of the monitoring terminal 40 is wirelessly connected to the network 2 so that the staff can always carry it.

[Accumulation of activity information]
The accumulation of activity information according to the present invention will be described with reference to FIGS.
In the medical service support system 1 of the present embodiment, the activity information of the staff carrying this is individually recorded by each of the plurality of monitoring terminals 40.

FIG. 2 shows a processing flow in the monitoring terminal 40.
In the monitoring terminal 40, the control unit 41 monitors the exercise amount measurement unit 43. If there is a walking or movement of the staff, the control unit 41 measures this (processing S21) and accumulates the measured exercise amount in the local memory ( Process S22).

The control unit 41 determines whether or not the transmission timing is set in advance (S23), and repeats the monitoring of the exercise amount measurement unit 43 (processing S21 to S22) if it is not the transmission timing.
At the transmission timing, the control unit 41 calculates the activity amount of the staff from the accumulated exercise amount by the activity amount calculation unit 44, and transmits the activity amount data from the communication unit 42 to the medical staff information database 14 (processing S24). ).

FIG. 3 illustrates a procedure for calculating an activity amount from an exercise amount in the activity amount calculation unit 44.
In the monitoring terminal 40, the momentum measured by the momentum measuring unit 43 is an instantaneous value, and the control unit 41 accumulates the instantaneous value along the elapsed time.
When the transmission time comes, the activity amount calculation unit 44 accumulates instantaneous values of the amount of exercise for the time width (total time zone) from the previous transmission time to obtain an activity amount.

In the present embodiment, the accumulated activity amount is further divided into activity amount ranks.
In FIG. 4, the activity amount calculation unit 44 of the present embodiment sets two threshold values corresponding to “5000 steps” and “3000 steps”, and the accumulated current activity amounts are “small” and “medium”. "Large".
That is, if the activity amount is less than 3000 steps, the activity amount rank is “small”, if the activity amount is more than 3000 steps and less than 5000 steps, the activity amount rank is “medium”, and the activity amount is more than 5000 steps. The activity amount rank is “Large”.

Such an activity amount rank is transmitted to the medical staff information database 14 and accumulated in the staff information 140 as an activity amount 143 for each “total time period”.
In FIG. 5, in the present embodiment, the activity amount 143 recorded in the staff information 140 is recorded as an activity amount rank for each staff and for each total time zone.

(Calculation of fatigue)
In the medical service support system 1 of the present embodiment, the fatigue level calculation unit 23 of the in-hospital system management server 20 calculates the current fatigue level of the staff from the amount of activity for each staff.

FIG. 6 shows calculation data of the fatigue level by the fatigue level calculation unit 23.
As the calculation data of the degree of fatigue, the “activity amount rank” (activity amount 143 recorded in the staff information 140) for each staff, as well as the “number of prescriptions”, “congestion time zone”, “ Parameters such as “Attendance schedule”, “Continuous working hours”, and “Working style” are used. The specific gravity at the time of calculation is also set for each parameter.

The fatigue level calculation unit 23 calculates the fatigue level using the calculation data shown in FIG.
"Fatigue" = "activity rank" x 0.7 + "number of prescriptions" x 0.3 +
“Crowded time zone” x 0.2 + “Attendance schedule” x 0.2+
"Consecutive working hours" x 0.4 + "Working style" x 0.2
As an example, if the amount of activity is “Large” (equal to 5000 steps or more), the number of prescribing personnel is 5, and the regular working hours of busy hours are 6 hours of continuous work, 5 × 0.7 + 3 × 0.3 + 1 × 0 .2 + 0 × 0.2 + 2 × 0.4 + 0 × 0.2 = 5.4 is the fatigue level.

[Error Judgment]
In the medical service support system 1 of this embodiment, when the staff registers or refers to the instruction information from the client terminal 30, the risk determination unit 24 determines the risk of error based on the current fatigue level of the staff. Determined.

FIG. 7 shows error risk determination conditions (risk rank) by the risk determination unit 24.
The risk rank is “none” when the “fatigue degree” calculated by the above-described fatigue degree calculation unit 23 is less than 3 points, but the “fatigue degree” is 3 points or more and the risk level is “low”. It is determined as “medium” at 5 points or more and “high” at 8 points or more.

  The client terminal 30 that has received the operation of the staff performs normal display or warning display based on the determination result by the risk determination unit 24 when responding to registration or reference of the received instruction information.

[Register instruction information]
The instruction information registration process will be described with reference to FIGS.
The instruction information registration process is mainly performed when a doctor prescribes a patient.
In FIG. 8, the instructor inputs the instruction information from the client terminal 30 in order to register the instruction information 130 of the instruction information database 13 (process S81).
When the instruction information is input, the control unit 31 of the client terminal 30 requests the in-hospital system management server 20 to determine the error risk level of the instructor who has input the instruction information.

  The in-hospital system management server 20 acquires the staff information 140 of the instructor who has input the instruction information from the database management server 10 (processing S82), and the amount of activity recorded in the staff information 140 of the instructor by the fatigue degree calculation unit 23. Based on 143, the current fatigue level of the instructor is calculated (step S83). Further, based on the instructor's history 141, work status 142, and fatigue level calculated by the fatigue level calculating unit 23 by the risk level determination unit 24, the current error risk level of the instructor is calculated. It determines and returns to the client terminal 30 (process S84).

If the error risk returned from the in-hospital system management server 20 is not “high” (process S85), the control unit 31 of the client terminal 30 uses the instruction information input in process S81 as instruction information 130 in the instruction information database 13. Is registered as (step S86).
On the other hand, if the error risk returned from the in-hospital system management server 20 is “high”, a warning is displayed prior to registration in step S86.

As a warning display, the control unit 31 of the client terminal 30 displays a message for requesting reconfirmation of the instruction information to the instructor and requests confirmation input by the instructor (processing S87).
When an input from the instructor is received (process S88) and the confirmation result is “ok” (process S89), the instruction information is registered as it is (process S86).
On the other hand, if the confirmation result is not “ok”, the registration of the current input content is stopped, and the process returns to step S81 to accept the input of the correct instruction content.

FIG. 9 shows the flow of control when the error risk is not high.
That is, when the instructor inputs instruction information to the client terminal 30 (process S81), the staff information 140 is referred to in the hospital system management server 20 by an inquiry from the client terminal 30 (process S82), and the error risk level Are determined (processing S83, S84).
If it is determined that the error risk is not high (process S85), the instruction information 130 is registered by the client terminal 30 (process S86).

FIG. 10 shows the flow of control when the error risk is “high” and the confirmation result is “ok”.
That is, when the instructor inputs the instruction information to the client terminal 30 (process S81), the in-hospital system management server 20 refers to the staff information 140 by the inquiry from the client terminal 30 (process S82), and the error risk level Are determined (processing S83, S84).

If it is determined that the error risk is not high (process S85), the instruction information 130 is registered by the client terminal 30 (process S86).
When it is determined that the error risk is “high” (process S85), a warning is displayed on the client terminal 30 (process S87). When the instructor inputs a confirmation result in response to the confirmation input request of the client terminal 30 (step S88), the input content is determined (step S89). If the confirmation input of the instructor is “ok”, the client The instruction information 130 is registered by the terminal 30 (process S86). If the confirmation input of the instructor is not “ok”, the registration of the instruction information (processing S86) is omitted.

  As described above, in the medical service support system 1 of the present embodiment, when registering the instruction information, it is possible to display a warning according to the error risk based on the degree of fatigue of the instructor and prompt the instructor to reconfirm.

[Referencing instruction information]
The instruction information reference process will be described with reference to FIGS.
The instruction information reference process is mainly performed when a nurse treats a patient based on the instruction information.
In FIG. 11, the staff performs a reference operation for displaying the instruction information 130 on the client terminal 30 in order to refer to the instruction information 130 in the instruction information database 13 (processing S11).
When the reference operation is performed, the control unit 31 of the client terminal 30 requests the hospital system management server 20 to determine the error risk level of the operated staff.

  The in-hospital system management server 20 acquires the staff information 140 of the staff who performed the reference operation from the database management server 10 (processing S12), and the fatigue level calculation unit 23 adds the activity amount 143 recorded in the staff information 140 of the staff. Based on this, the current fatigue level of the staff is calculated (processing S13). Further, the risk determination unit 24 determines the current error risk level of the staff based on the staff history 141 and the work situation 142 recorded in the staff information 140 and the fatigue level calculated by the fatigue level calculation unit 23. Return to the client terminal 30 (process S14).

If the error risk returned from the in-hospital system management server 20 is not “high” (process S15), the control unit 31 of the client terminal 30 instructs the instruction specified in process S81 among the instruction information 130 of the instruction information database 13. Information is displayed (process S16).
On the other hand, if the error risk returned from the in-hospital system management server 20 is “high”, it is designated in the process S81 in the instruction information 130 of the instruction information database 13 with a notice to alert the staff who has performed the reference operation. The instruction information is displayed (processing S17).

FIG. 12 shows the flow of control when the error risk is not high.
That is, when the staff makes a request for referring to the instruction information to the client terminal 30 (process S11), the staff information 140 is referred to in the in-hospital system management server 20 by the inquiry from the client terminal 30 (process S12). (Steps S13 and S14) are performed.
If it is determined that the error risk is not high (process S15), the client terminal 30 acquires the instruction information 130 to be displayed from the instruction information database 13 and displays it on the client terminal 30 (process S16).

FIG. 13 shows the flow of control when the error risk is “high”.
That is, when the staff makes a request for referring to the instruction information to the client terminal 30 (process S11), the staff information 140 is referred to in the in-hospital system management server 20 by the inquiry from the client terminal 30 (process S12). (Steps S13 and S14) are performed.
When it is determined that the error risk is “high” (process S15), the client terminal 30 acquires the instruction information 130 to be displayed from the instruction information database 13 and displays it on the client terminal 30 (process S17). However, a warning display is added at the time of display on the client terminal 30.

The warning display has contents corresponding to the error risk level.
When the error risk is “low”, a warning message is displayed. For example, “Danger level: Please pay attention to the details of the prescription”.
If the error risk is “medium”, a double check instruction (confirmation input from other staff is required) is given. For example, it waits for confirmation input with “Danger level: Confirmation input of other staff is required”.
When the risk of error is “High”, double check is requested as in the previous section. Further, for a prescription with a high risk, a “change instruction of the person in charge” is displayed. For example, “Please apply another person for this treatment” is displayed. If necessary, a message such as “requires replacement personnel” may be displayed on the display device of the nurse station to notify that replacement is necessary.

As described above, in the medical service support system 1 according to the present embodiment, when referring to the instruction information, it is possible to display a warning according to the error risk based on the fatigue level of the staff.
Then, as warning display (display for prompting attention), in addition to reconfirmation of staff, it is possible to perform confirmation based on the importance of the instruction information 130 such as requesting confirmation from other staff and switching if necessary. .

[Effect of this embodiment]
According to the present embodiment, staff activity information (activity 143) is recorded in the medical staff information database 14, the fatigue level for each staff is calculated by the fatigue level calculation unit 23, and the risk level determination unit 24 causes fatigue. Error risk can be determined. Therefore, when determining the risk of error, it is possible to consider various activity states of the staff in the actual medical field.

When the staff requests to display the instruction information, the client terminal 30 can display a warning according to the error risk level.
As described above, according to the medical service support system 1 of the present embodiment, it is possible to give a warning in consideration of the activity status of the staff when transmitting instructions in the medical service.

In the present embodiment, the staff's activity information can be measured by the staff wearing the monitoring terminal 40.
The monitoring terminal 40 according to the present embodiment can be easily implemented as a configuration including a momentum measurement unit 43 using a three-dimensional acceleration sensor, a control unit 41 that accumulates measurement data, and transmits the measurement data to the server. it can.

  Furthermore, in the monitoring terminal 40 of the present embodiment, the activity amount calculation unit 44 can accumulate the recorded exercise amount and transmit it to the medical staff information database 14 as an activity amount for each total time period. Thereby, the data amount at the time of transmitting to the medical staff information database 14 from the monitoring terminal 40 can be reduced.

In the medical service support system 1 of the present embodiment, the staff history 141 and the work situation 142 are also recorded as the staff information 140 in the medical staff information database 14.
For this reason, the risk level determination unit 24 can determine the error risk level in consideration of the staff history 141 and the work status 142 in addition to the fatigue level based on the activity amount 143 of the staff.

[Modification]
The present invention is not limited to the configuration of the embodiment described above, and modifications and the like within a range in which the object of the present invention can be achieved are also included in the present invention.
For example, in the above-described embodiment, the monitoring terminal 40 is provided with the exercise amount measurement unit 43 and the activity amount calculation unit 44, and the measured exercise amount is aggregated at the time of transmission and calculated as the activity amount and then transmitted to the medical staff information database 14. It was. However, in the monitoring terminal 40, only the exercise amount may be measured by the exercise amount measuring unit 43, and the activity amount may be calculated outside the monitoring terminal 40.

  For example, it may be calculated when registering as an activity amount 143 in the medical staff information database 14 on the database management server 10 side, or may be executed by another processing device. Alternatively, as the activity information of the medical staff information database 14, the momentum measured and transmitted by the momentum measurement unit 43 is recorded as it is, and the fatigue level calculation unit 23 of the hospital system management server 20 calculates the fatigue level. The amount of activity may be calculated.

  In the embodiment described above, the monitoring terminal 40 having the exercise amount measuring unit 43 is carried by the staff to collect the staff activity information. However, staff activity information can be collected by optically detecting staff name tags and sensing proximity of ID cards using monitoring devices and door opening / closing control devices with security installed in each part of the facility. The movement distance may be integrated by detecting the passage of the vehicle or detecting the activity.

  In the above-described embodiment, the risk determination unit 24 refers to the career 141 and the work status 142 recorded in the staff information 140 in addition to the fatigue calculated by the fatigue calculation unit 23. Part or all of the 141 and work status 142 may be omitted. However, with these references, it can be expected that the determination of the risk of error will be more accurate.

  In addition, the contents of the warning display, the display form, the presence / absence of confirmation input, and supplementary notification means such as an alarm sound can be appropriately changed according to the error risk level and the contents of the instruction information.

  DESCRIPTION OF SYMBOLS 1 ... Medical service support system, 10 ... Database management server, 11 ... Control part, 12 ... Communication part, 13 ... Instruction information database, 130 ... Instruction information, 14 ... Medical staff information database, 140 ... Staff information, 141 ... Career, 142 ... Work status, 143 ... Activity, 2 ... Network, 20 ... In-hospital system management server, 21 ... Control unit, 22 ... Communication unit, 23 ... Fatigue level calculation unit, 24 ... Risk level judgment unit, 30 ... Client terminal, DESCRIPTION OF SYMBOLS 31 ... Control part, 32 ... Communication part, 33 ... Input part, 34 ... Display part, 40 ... Monitoring terminal, 41 ... Control part, 42 ... Communication part, 43 ... Exercise amount measurement part, 44 ... Activity amount calculation part.

Claims (4)

A medical work support system that transmits instruction information to staff engaged in medical work,
An instruction information database for recording the instruction information;
A client terminal that displays the instruction information by an operation of the staff;
A medical staff information database for recording staff information including activity information of the staff;
A fatigue level calculation unit that calculates the fatigue level of the staff with reference to the staff information;
A risk determination unit that determines the error risk of the staff from the fatigue level,
The client terminal is configured to display a warning on the client terminal according to the error risk level when the staff requests the instruction information to be displayed. In the medical service support system according to claim 1,
A medical service support system comprising a monitoring terminal that is carried by the staff and measures the activity information. In the medical service support system according to claim 1 or 2,
The medical staff information database records the staff history information and work status as the staff information. In order to transmit instruction information to a staff member engaged in medical work, an instruction information database for recording the instruction information, and a client terminal for displaying the instruction information by operation of the staff, a warning method for a medical work support system There,
Recording staff information including activity information of the staff, calculating the fatigue level of the staff with reference to the staff information, determining the error risk of the staff from the fatigue level,
A warning method for a medical service support system, wherein a warning is displayed on the client terminal according to the error risk level when the staff requests display of the instruction information.

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