JP6858994B1 - Severity, medical / nursing necessity management system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a severity, medical / nursing necessity management system and a program for facilitating input and management of information on the severity of inpatients and the medical / nursing necessity. SOLUTION: In a severity, medical / nursing necessity management system 100, a management server S1 identifies patients P1 to P3 to be evaluated from user terminals T1 and T2, and evaluates the evaluation result related to the nursing necessity and the like. When there is an input request for, it is necessary for the patient identified from the storage unit that stores the patient in association with the evaluation items related to the nursing necessity required for the patient and the evaluation results for the evaluation items. Provide the user terminal with an input screen for receiving the input of the evaluation result for the evaluation item together with the evaluation item and the evaluated result for the evaluation item, the means for acquiring the evaluation item, the acquired evaluation item, and the evaluated result. A means and a means for receiving the evaluation result input via the input screen and outputting the evaluation result to the storage unit M1 in association with the specified patient are provided. [Selection diagram] Fig. 5

Description

The present invention relates to a severity of inpatients and the like in a medical institution, a severity of managing medical / nursing necessity, and a medical / nursing necessity management system.

Severity and medical / nursing need are values that represent the amount of nursing needs that should be provided to individual patients, in order to properly allocate nurses in medical institutions and wards, or in patients' beds. It is a value that serves as an index for properly arranging. In addition, the percentage of patients whose severity and medical / nursing necessity meet the prescribed criteria is set as one of the facility criteria in the calculation of the basic hospitalization fee. It is necessary to continuously and appropriately record and manage information on medical / nursing needs.

Severity and medical / nursing necessity are evaluated based on a prescribed evaluation form set by the Ministry of Health, Labor and Welfare, for example, as shown in Fig. 10. March 5, 2018, 0305 No. 2 issued by the nurse. Based on the result of observing the patient's condition or the result of nursing for the patient, the nurse is in charge of the evaluation result for all the evaluation items described in the evaluation sheet. Must be filled in. As shown in FIG. 10, the number of evaluation items required of nurses is very large. In addition, since the required evaluation items differ depending on the ward classification assigned to each patient, the nurse can use the evaluation sheet for the general ward, the specific intensive care unit (ICU), or the high care unit (HCU). An appropriate evaluation sheet must be selected for each patient and evaluated for the prescribed evaluation items. It is a heavy burden for nurses to fill in the evaluation results for these evaluation items every day without omission while performing normal nursing work.

On the other hand, since the information on the severity and medical / nursing necessity entered as described above is generally managed for each ward, the severity at the medical institution and the medical / nursing necessity are discussed. The information manager had to periodically collect information on the severity and medical / nursing necessity managed for each ward, which was very troublesome. Even though it takes a lot of effort to evaluate the severity and the need for medical care / nursing, it is even possible to understand which ward, how many patients need nursing, and how many people are hospitalized. It was not easy, and it was difficult to utilize the need for nursing to properly arrange the beds of nurses or patients in the ward.

Various proposals have been made regarding systems that support work related to severity and medical / nursing needs. For example, in Patent Document 1, the evaluation results relating to the severity of the use of the medical device and the necessity of medical care / nursing are automatically calculated based on the signal emitted from the medical device when the medical device is started to be used. A nursing information generation system is disclosed that can reduce the amount of information about the severity and medical / nursing necessity that a nurse must enter by recording in. However, information on severity and medical / nursing needs should be input by the nurse who actually provided nursing care to the patient in order to appropriately reflect the patient's condition. Automatic input with the start of use of the device is not always desirable.

As far as the present inventors know, it assists nurses in inputting information on severity and medical / nursing necessity, makes it easy and accurate to input the information, and also assists nurses in inputting information on severity, medical / nursing throughout the medical institution. There is no severity, medical / nursing necessity management system that enables easy management of information on necessity.

Japanese Unexamined Patent Publication No. 2009-75872

The present invention has been made to solve the above-mentioned inconveniences of the prior art, and facilitates the input and management of information on the severity of inpatients and the necessity of medical care / nursing in medical institutions. The challenge is to provide a severity, medical / nursing need management system and a computer program to realize such a system.

The present invention is a severity, medical / nursing necessity management system for managing the severity of a patient and medical / nursing necessity in a medical institution.
The management system includes a management server.
The management server
When a patient to be evaluated is identified from a user terminal connected via a network and a request is made to input evaluation results regarding severity and medical / nursing necessity, the patient and the patient are required. The evaluation items required for the specified patient from the storage unit that stores the evaluation items related to the severity, the medical / nursing necessity, and the evaluation results for the evaluation items in association with each other, and the evaluation items thereof. An information acquisition means for acquiring an evaluated result already stored in the storage unit for an evaluation item,
A screen providing means for providing the user terminal with an input screen for receiving input of the evaluation result for the evaluation item together with the acquired evaluation item and the already evaluated result, and
An output means that receives an evaluation result input via the input screen from the user terminal and outputs the evaluation result to the storage unit in association with the specified patient.
The above-mentioned problems are solved by providing a severity and medical / nursing necessity management system characterized by being equipped with.

Further, the present invention, in a preferred embodiment thereof,
A means for the information acquisition means to further acquire an already-determined result already stored in the storage unit from a storage unit that stores the reason for determination of the evaluation result and the evaluation result in association with each other.
The screen providing means is a means for providing the user terminal with an input screen for receiving input of the evaluation result and the judgment reason for the evaluation item together with the acquired evaluation item, the evaluated result and the reason for the judgment.
The output means is an output means that receives an evaluation result and a reason for determination input via the input screen from the user terminal and outputs the evaluation result and the reason for determination to the storage unit in association with the specified patient.
The above-mentioned problems are solved by providing a severity and medical / nursing necessity management system characterized by the above.

Further, the present invention, in a preferred embodiment thereof,
The management server further
On the input screen provided to the user terminal when there is an unevaluated item for which the evaluation result is not yet described in the storage unit among the evaluation items required for the specified patient acquired from the storage unit. Or a means for displaying the evaluation item separately from other evaluation items and / or a means for displaying the number of the unevaluated items on another screen.
The above-mentioned problems are solved by providing a severity and medical / nursing necessity management system characterized by being equipped with.

Further, the present invention, in a preferred embodiment thereof,
The management server further
From the storage unit that stores the patient, its ward classification, the severity required for each patient, the evaluation items related to the medical / nursing necessity, and the evaluation results for the evaluation items in association with each other, the patient and the patient , A means for obtaining information on the ward classification, evaluation items required for individual patients, and unevaluated items among the evaluation items whose evaluation results are not yet stored in the storage unit, and
A means for providing the user terminal with an evaluation implementation status confirmation screen that displays an evaluation implementation status confirmation screen for each ward category by associating a patient with information on the presence or absence of unevaluated items for the patient based on the acquired information.
The above-mentioned problems are solved by providing a severity and medical / nursing necessity management system characterized by being equipped with.

Further, the present invention, in a preferred embodiment thereof,
The management server further
A storage unit that stores patients, their ward classifications, evaluation items related to the severity required for each patient, medical / nursing necessity, evaluation results for the evaluation items, and corresponding dates. Therefore, for each ward classification, the number of patients who are assigned the ward classification for each date and have evaluation items that require evaluation of severity and medical / nursing necessity. And / or the number of evaluated patients whose evaluation results for all of the required severity and medical / nursing necessity evaluation items are already stored in the storage unit among the patients requiring evaluation. Regarding the evaluation items of required severity and medical / nursing necessity among the evaluated patients, information on the number of unevaluated patients whose evaluation results are not yet stored in the storage unit is acquired.
Based on the acquired information, the ward classification, the number of patients requiring evaluation for each of the ward classifications, and the number of evaluated patients and / or the number of unevaluated patients are associated with each other for each date. A means for providing the evaluation implementation status list screen to be displayed to the user terminal,
The above-mentioned problems are solved by providing a severity and medical / nursing necessity management system characterized by being equipped with.

Further, the present invention, in a preferred embodiment thereof,
The management server further
Correspond the patient, the ward classification and / or ward, the evaluation items related to the severity required for each patient, the medical / nursing necessity, the evaluation results for the evaluation items, and the corresponding dates. From the memorized storage unit, the patient, its ward classification and / or ward, the evaluation items required for each individual patient, and among the evaluation items, the evaluation results are not yet stored in the storage unit. And the means to obtain information about the corresponding date and
Based on the acquired information, the unrated item list screen is displayed for each ward category and / or for each ward by associating the patient with the unevaluated item with the unevaluated item and the corresponding date. Means to provide to user terminals,
The above-mentioned problems are solved by providing a severity and medical / nursing necessity management system characterized by being equipped with.

Further, the present invention, in a preferred embodiment thereof,
The management server further
Patients, their ward classifications, evaluation items related to the severity required for each patient, medical / nursing necessity, evaluation results for the evaluation items, and dates of the evaluation results are stored in association with each other. In addition, a storage unit that stores information on the item categories of each evaluation item, the points given to each evaluation result of each evaluation item, the severity predetermined for each ward category, and the criteria for medical / nursing necessity. Therefore, the patient, its ward classification, the evaluated item whose evaluation result is already stored in the storage unit for each patient, the item classification, the evaluation result, the date, and the evaluation result of the evaluated item. And the means to obtain information about the criteria,
A means for obtaining a score for each evaluation item and / or for each item category of an evaluation item corresponding to each evaluation result already stored in the storage unit based on the acquired information, for each date and for each patient.
A means for comparing the obtained score with the criteria for severity and medical / nursing necessity, and a means for determining whether or not the criteria are met for each patient, and
The score for each evaluation item and / or the item category of the evaluation item, and / or the number and / or the ratio of patients judged to meet the criteria are displayed for each ward category and / or date. A means for providing the number of people screen to the user terminal,
The above-mentioned problems are solved by providing a severity and medical / nursing necessity management system characterized by being equipped with.

Further, the present invention, in one preferred embodiment thereof,
One or more of the user terminals are bedside terminals arranged on the patient's bedside.
A storage unit that stores information about the correspondence between the bedside terminal and the patient when the management server receives an input request for evaluation results regarding the severity and medical / nursing necessity from the bedside terminal. A means for acquiring information about a patient corresponding to the bedside terminal based on the identification information of the bedside terminal and identifying which patient the input request is for.
The above-mentioned problems are solved by providing a severity and medical / nursing necessity management system equipped with the above.

The present invention also solves the above problems by providing a computer program that describes a procedure for operating one or more computers as the management server in a severity / medical / nursing necessity management system. ..

According to the severity, medical / nursing necessity management system and computer program of the present invention, when a nurse or the like registers evaluation information regarding the severity and medical / nursing necessity of a patient at a medical institution, the patient concerned Since the required evaluation items are displayed on the screen of the user terminal, there is an advantage that the information input work by the nurse is facilitated and the risk of omission of input of the evaluation result is reduced. Further, according to the present invention, since the information on the severity and the medical / nursing necessity in the medical institution is collectively managed by the management server, the person in charge of the medical institution needs the severity and the medical / nursing from each ward. There is an advantage that it is not necessary to collect information on the degree, and it is easy to manage information on the severity and medical / nursing necessity of the entire medical institution.

It is a conceptual diagram which shows the whole structure of an example of the severity, medical care / nursing necessity management system of this invention. It is a figure which shows the evaluation implementation status list screen, and an example of the information displayed there. It is a figure which shows an example of the evaluation implementation status confirmation screen, and the information displayed there. It is a figure which shows an example of the nursing necessity degree input screen and the information displayed there. It is a figure which shows the nursing necessity degree input screen, and another example of the information displayed there. It is a figure which shows the unevaluated item list screen, and an example of the information displayed there. It is a figure which shows an example of the total number of people screen and the information displayed there. It is a figure which shows an example of the H file creation screen and the information displayed on it. It is a conceptual diagram which shows the whole structure of another example of the severity, medical care / nursing necessity management system of this invention. It is a figure which shows the information described in the evaluation sheet of the severity for a general ward, and the medical / nursing necessity.

Hereinafter, the present invention will be described with reference to the drawings, but it goes without saying that the contents of the present invention are not limited to those illustrated.

<System configuration>
FIG. 1 is a conceptual diagram showing an overall configuration of an example of a severity and medical / nursing necessity management system of the present invention. As shown in FIG. 1, the severity and medical / nursing necessity management system 100 (hereinafter, also referred to as “management system 100”) of the present invention includes a management server S ₁ , and the management server S ₁ mainly includes a management server S 1. severity medical staff such as nurses, and the user terminal T _1, T ₂ to be used to enter information about medical and nursing necessity, are connected via an appropriate network N. In this example, the user terminal T ₁ is a terminal exclusively used by _{the nurse K 1} who is in charge of the _{ward W 1} classified into the ward classification "general ward", for example _{, and the nurse K 1} is hospitalized in the ward W _1. It is a user terminal used when inputting information on the severity of the patient and the necessity of medical care / nursing. On the other hand, the user terminal T ₂ is a terminal exclusively used by _{the nurse K 2} who is in charge of the _{ward W 2} classified into the ward classification "ICU ward" _{, and the nurse K 2} is hospitalized in the ward W _2. It is a user terminal used when inputting information on the severity of a patient and the necessity of medical care / nursing. The user terminals T ₁ and T ₂ may be terminals located at the nurse station of each ward, and the nurse K ₁ or the nurse K ₂ may reach the patient's room or bedside at the treatment destination. It may be a portable terminal.

In this example, the storage unit M ₁ of the management server S ₁ is associated with the patient identification information such as the patient number that identifies the patient, and the patient's name, gender, ward classification, and the severity required for the patient. , Evaluation items related to medical / nursing necessity, evaluation results for the evaluation items, judgment reasons for the evaluation results, and the evaluation results and dates corresponding to the judgment reasons are stored.

In the present specification, the ward means a unit of a ward for managing a patient set in a medical institution, for example, a clinical department unit, and does not necessarily refer to one building. For example, it may be a "first floor ward", a "second floor ward", a "third floor ward", etc. that exist for each floor in one building, or may exist over a plurality of floors.

On the other hand, in the present specification, the ward classification is a ward that defines the required severity, evaluation items of medical / nursing necessity, and criteria of severity, medical / nursing necessity, etc. in the calculation of hospital charges. For example, "general ward", "community comprehensive care ward", "specific intensive care room (ICU)", "high care unit (HCU)", "convalescent rehabilitation ward" and the like are included. The severity required for each patient, the evaluation items related to the need for medical care / nursing, and the criteria for the severity and the need for medical care / nursing are determined in advance according to the ward classification assigned to each patient. ("Regarding the handling of the facility standards for basic medical fees and procedures related to their notification," March 5, 2018, No. 0305 No. 2 issued by the nurse.) The ward and ward division do not necessarily have to have a one-to-one correspondence, and one ward may be assigned a plurality of ward divisions, or a plurality of wards may be assigned one ward division. For example, the "first floor ward" and the "second floor ward" may be divided into general wards, and the "third floor ward" may be divided into ICU wards.

Storage unit M ₁ is severity, and stores medical and nursing and each evaluation item which is defined on the need of the evaluation form, selectable Findings association with a predetermined for each evaluation item It is desirable to have. Further, the storage unit M _1, in association with a selectable evaluation results for each evaluation item, the severity corresponding to the evaluation result, that stores a number of medical and nursing necessity desirable.

By the way, the evaluation results for each evaluation item related to the severity and the need for medical care / nursing, and the scores for the severity and the need for medical care / nursing corresponding to the individual evaluation results are all the above-mentioned "severity," It is stipulated in the "Evaluation Sheet for Medical / Nursing Necessity" ("Facility Standards for Basic Medical Fees and Handling of Procedures for Notification", March 5, 2018, No. 0305 No. 2 issued by Hoken). Yes, this corresponds to the information regarding the points given to each evaluation result of each evaluation item as referred to in the present specification. When the content of the above-mentioned "evaluation sheet for severity and medical / nursing necessity" is revised, it goes without saying that the points given to each evaluation result of each evaluation item as referred to in the present specification. Of course, the information is also changed.

In this example, the storage unit M ₁ is provided in the management server S _1, storage unit M ₁ is not necessarily required to have the management server S _1, via the management server S ₁ directly or network N connected, may be a single or two or more storage devices exist independently of the management server S _1. Further, a management server S ₁ is connectable, when the other storage devices in the network by the medical institution is provided there may be used a part or all of the storage device as the storage unit M ₁ .. For such a storage device and / or a storage unit, for example, a database, a storage, a server, or the like can be used. The above information may be stored in a database or the like, or may be described as a source code of a program or the like.

<Basic operation>
Hereinafter, the basic operation of the severity and medical / nursing necessity management system 100 of the present invention will be described. In FIG. 1, B _{1 to} B ₄ are beds, and except for _{bed B 4} , patients P _{1 to} P ₃ are assigned to _{beds B 1 to} B _{3, respectively.} Patients _P 1, _{P 2,} and _{P 3} are each patient number "0001", "0002", and a patient specified by "0003", patient name is "patient Ichiro", "patient Jiro", and " Patient Saburo ". Patient _{P 1} and the patient _{P 2} is ward _{W 1,} the patient _{P 3} are admitted to the ward _{W 2.} Ward W ₁ and ward W ₂ are, for example, a ward that is partitioned into each ward category "general wards" and "ICU ward".

Nurse K ₁ is a nurse in charge of patients P _{1 to} P _2. Nurse K ₁ was carried out to "gauze exchange" to the patient P _1. By the way, "gauze exchange" corresponds to "wound treatment (excluding pressure ulcer treatment)" defined in item A "monitoring and treatment, etc." among the evaluation items related to severity and medical / nursing necessity. It is a treatment to be done. Therefore, the nurse K _1, which was carried out "gauze exchange" for a patient P ₁ is, the severity of the patient P _1, the evaluation results of the medical and nursing necessity, as you try to register via the user terminal T ₁ There is. In this example, the operation date is assumed to be "January 8, 2020".

<Sending request for input of evaluation results related to severity and medical / nursing necessity-Part 1->
First, the nurse K ₁ launches the evaluation implementation status list screen, which is the top page of the severity / medical / nursing necessity management system 100, from the user terminal T _1. FIG. 2 shows an example of the evaluation implementation status list screen that has been started up. As can be seen in FIG. 2, on the evaluation implementation status list screen 101, the target ward divisions such as "general ward" and "ICU ward" and each of the ward divisions are displayed in calendar format for each date. The number of patients who are assigned to the ward division and have evaluation items that require evaluation of severity and medical / nursing needs, and the number of patients who require evaluation and the required severity among the patients who require evaluation. time, the number of previously evaluated patients evaluation results for all the evaluation items of medical and nursing necessity is already stored in the storage unit M ₁ is, the denominator of the former (the number of main evaluation patients), the latter (previously The number of evaluated patients) is displayed in a molecular format.

The storage unit M _1, severity is the patient list, and ward section of each patient, required for each patient, is already stored in the evaluation items of the medical and nursing necessity, for each of the evaluation items since information for each date in the presence or absence of the evaluation result is stored, when a login request from the user terminal T ₁ to the management system 100, the management server S ₁ retrieves the necessary information from the memory unit M ₁ Te, can be transmitted to the user terminal T ₁ in the form of the evaluation implementation list screen 101.

The form of the evaluation implementation status list screen 101 shown in FIG. 2 is only an example, and the form of the evaluation implementation status list screen is not limited to this. The evaluation implementation status list screen 101 may display information sufficient to identify the _{target patient P 1 , or narrowing down information to identify the target patient P 1,} and as a result, the patient P _{1 may be displayed.} The type of information displayed on the evaluation implementation status list screen 101 and the display format thereof may be any as long as it can be specified.

For example, the number of patients requiring evaluation may be displayed as the numerator and the number of evaluated patients as the denominator, or the required severity, medical care / nursing may be required instead of the number of evaluated patients. it may be displayed the number of unrated patient evaluation result is not stored yet in the storage unit M ₁ for all degrees evaluation items. Furthermore, the number of patients requiring evaluation that have evaluation items that require evaluation of severity and medical / nursing necessity may not be displayed, but only the number of unrated patients may be displayed. Furthermore, as will be described later, the memory unit M ₁ is the number of patients each evaluation when storing the determined reason for the results, with a main evaluation item no input for both evaluation results and determining reasons, Alternatively, the number of patients who have input of evaluation results but do not have input of judgment reason, or the number of patients who have input of evaluation results and judgment reasons among the evaluation items are displayed together. You may try to do it.

The content displayed on the evaluation implementation status list screen may be further narrowed down by using arbitrary narrowing down information set by the person in charge of the medical institution. For example, when a ward is used as narrowing down information, the nurse who is the information input person and the person in charge of the ward can easily grasp the evaluation implementation status of the ward of their own interest and are targeted. There is an advantage that the patient can be identified more easily. Incidentally, in such a case, the storage unit M _{1 accessed by the management server S 1} of the management system 100 of the present invention at any time further stores the patient and the ward in association with each other. When a request for providing the evaluation implementation list screen by specifying the ward from the user terminal T _1, the management server S ₁ from the storage unit M _1, further obtains the information associating the patient and the ward Based on the information that associates the acquired patient with the ward, the number of patients requiring evaluation among the patients requiring evaluation, and the number of patients associated with the ward designated, and among the evaluated patients, designated. Provided with means for providing an evaluation implementation status list screen that displays the number of patients associated with the ward and / or the number of patients associated with the designated ward among the unevaluated patients. It means that there is.

In this way, the evaluation implementation status list screen 101 shows the evaluation of the severity and medical / nursing necessity of the patients assigned to each ward division by date and by ward division in a calendar format. the number of main evaluation patients with evaluation items required, the severity required, previously evaluated patients evaluation results for all the evaluation items of medical and nursing necessity is already stored in the storage unit M ₁ Since the number of patients is displayed, the person in charge of inputting information on the severity and the need for medical care / nursing and the person in charge of management should evaluate the patient in which ward category, the degree of severity, and the need for medical care / nursing. It is possible to grasp whether or not there exists extremely efficiently.

Next, nurse K ₁ is, look at the evaluation implementation status list screen 101, from the date of which are trying to enter the evaluation results "January 8, 2020", is the ward section of the patient P ₁ as an object Select "General Ward". In this example, the ward sections are displayed in the evaluation implementation list screen 101 functions as a narrowing information of the patient P ₁ of interest. The ward classification selection signal performed on the evaluation implementation status list screen 101 is transmitted _{from the user terminal T 1} to the management server S _{1 together with information about the selected date “January 8, 2020”.} The management server S ₁ which receives the selection signal, for example, when the ward classification selected was general ward, for patients assigned to the ward division, nursing need for "January 8, 2020" It transmits the evaluation implementation confirmation screen displaying the evaluation implementation of degrees such as to the user terminal T _1. 3 shows an example of the evaluation implementation confirmation screen 102 displayed on the user terminal T _1.

As shown in FIG. 3, on the evaluation implementation status confirmation screen 102, the patients assigned to the general ward selected as the evaluation implementation status such as the degree of nursing necessity on “January 8, 2020” and their respective patients. The evaluation implementation status such as the degree of nursing necessity is displayed as a list. This corresponds to the display for each ward category in which the patient and the information regarding the presence or absence of unevaluated items for the patient are associated with each other in the present invention.

In the case of this example, as seen in FIG. 3, there are two patients assigned to the general ward, a patient with patient number "0001" and a patient with patient number "0002", and a patient with patient number "0002". It can be seen that the evaluation is "completed" for all of the items A, B, and C, which are the items requiring evaluation, and the evaluation results have already been input. On the other hand, for the patient with the patient number "0001", the evaluation of the degree of nursing necessity and the like is "not performed" for all of the items A, B, and C. Patient of patient number "0001", now, is a patient P ₁ of interest.

As described above, the storage unit M _1, patients and their ward division, and the severity needed for each patient, evaluation items according to the medical and nursing necessity, and, and the evaluation results for the evaluation items , by date, since it is in association with each other, from the user terminal T _1, when a selection of wards classified by specifying the date, the management server S ₁ can obtain the appropriate information from the storage unit M ₁ , it is possible to provide an evaluation implementation confirmation screen 102 to the user terminal T _1.

Note that when displayed on the evaluation implementation confirmation screen 102 provided to the user terminal T _1, patients with non-evaluation items still evaluation result in the storage unit M ₁ is not stored evaluation items required (e.g. , patients patients) patient number "0001", which is the evaluation result is stored in the already stored unit M ₁ for all the evaluation items required, patients without unrated item (e.g., patient number "0002" ) And should be displayed separately. The method of distinguishing on the display is not particularly limited. It suffices if patients with unevaluated items can be displayed separately from other patients to whom the same ward division is assigned. For example, a part of the display area (frame or margin) on the screen for patients with unevaluated items. The display color and / or the display brightness may be changed with time. By displaying the patients with unevaluated items and the patients without unevaluated items separately on the evaluation implementation status confirmation screen 102, the nurse or the like who is the information inputter can identify who the patients have unevaluated items. Since it can be seen immediately, there is an advantage that the evaluation result can be input more easily.

The nurse K ₁ may select _{the patient P 1} having the patient number “0001” by looking at the evaluation implementation status confirmation screen 102 displayed on the user terminal T _1. Selection of patients P ₁ of the patient number "0001", for example on the evaluation implementation status confirmation screen 102, by clicking on the button of the "registration" which is displayed in the nursing needs of the item for a patient number "0001" Will be done. On evaluation implementation confirmation screen 102, the patient P ₁ patient number "0001", when the "Register" button is clicked, the signal is subject patients identified as patients P ₁ patient number "0001" were made Te, severity, as an input request for results of the evaluation of the medical and nursing necessity, together with identification information sufficient to identify the patient P ₁ patient number "0001" is sent to the management server S _1.

Incidentally, means for identifying a patient P ₁ to be evaluated, the method is not limited in particular, as described above, to perform the operation using a link on the screen that is displayed on the user terminal T ₁ Of course, other means and methods may be used. For example, enter the patient ID as information for identifying the patient on a screen displayed on the user terminal T _1, by reading or inputting a patient number via an appropriate input device connected to the user terminal T ₁ , may be specified patient P ₁ to be evaluated.

<Provision of input screen>
From the user terminal T _1, the patient of interest has been made in particular that the patient P ₁ patient number "0001", severity, upon receiving an input request of the results of the evaluation of the medical and nursing necessity, management server S ₁ can either read the necessary information from the memory unit M _1, and acquires, severity to the user terminal T _1, the input screen of the medical and nursing necessity (hereinafter, simply referred to as "nursing required degree input screen" There is also).

Figure 4 is a diagram showing an example of a management server S ₁ from the user terminal T ₁ Nursing necessity input screen 103 that is provided to. As shown in FIG. 4, already nursing necessity input screen 103, together with evaluation items required for the patient P _1, already stored in the storage unit M ₁ for each evaluation items required for the patient P ₁ The presence or absence of the evaluation result is displayed. In the illustrated example, "Treatment of wounds" as the evaluation items required for the patient P _1, "Respiratory Care", "drip line simultaneous three or more management", and "Managing ECG monitor" is displayed, the for any, the corresponding "answer" column are displayed as "not", thereby, nurse K _1, for each evaluation item which is required for the patient P _1, stored in the storage section M ₁ It can be understood that the evaluated result is "none".

An input field for "evaluation result" is provided to the right of the evaluation item such as "wound treatment". In this example, the input field of "evaluation result" is provided with a radio button for selecting "none" or "yes", which is a predetermined evaluation result. Instead of providing the radio button for selecting one of the predetermined evaluation results in the "evaluation result" input field, the evaluation result may be input in free text. Alternatively, by clicking the "evaluation result" column, a list of selectable evaluation results may be displayed in a pull-down menu. By the way, the evaluation results that can be selected for each evaluation item are "Regarding the handling of the facility standards for basic medical fees and the procedures for notification thereof (March 5, 2018, 0305 No. 2 issued by the nurse)" by the Ministry of Health, Labor and Welfare. It is predetermined in the "evaluation sheet of severity, medical / nursing necessity" described in, and as of January 2020, it is determined in the evaluation sheet of severity, medical / nursing necessity for general wards. The contents are as shown in FIG.

Further, on the nursing necessity input screen 103 of FIG. 4, an input field for "determination reason" is provided to the right of the "evaluation result". In the "judgment reason" input field, a plurality of standard judgment reasons may be prepared in advance, and a radio button for selecting an appropriate one may be provided. Alternatively, by clicking the "Reason for determination" column, a list of selectable standard reasons for determination may be displayed in a pull-down menu.

For patient P _1, if already present evaluation result or determination reason stored in the storage unit M ₁ is the column or the column of the "determination reason" in "Evaluation Results" nursing necessity input screen 103, already evaluation result or determination reason stored in the storage unit M ₁ is of course to be displayed, respectively.

Incidentally, the evaluation items displayed in the nursing care required degree input screen 103 in FIG. 4, as the evaluation items required for patients P ₁ which is selected, is stored in association with the patient P ₁ in the storage unit M ₁ It is an evaluation item. Thus, the storage unit M ₁ to which the management system 100 is utilized for each of the patient of interest, evaluation items are needed, through the ward classification of each patient to be directly or target storage When there is an input request from the _{user terminal T 1 , it is read by the management server S 1} and displayed on the nursing necessity input screen 103, so that the person who inputs the evaluation result such as the _{nurse K 1} However, there is no need to check or confirm the required evaluation items for the target patient each time, and there is an advantage that the input work can be performed extremely easily.

If there are more evaluation items required for the target patient other than the four items displayed on the nursing necessity input screen 103 of FIG. 4, scroll the nursing necessity input screen 103 or the next page. by moving, that all evaluation items required for the patient P ₁ is displayed in the input screen 103 necessity care course.

Incidentally, in nursing necessity input screen 103 in FIG. 4, the "number of remaining items" in the upper right corner, about the patient P _1, among the evaluation items required, not input yet evaluation (not stored in the storage unit M ₁₎ indicates the number of unrated item. In this example, the patient P _1, evaluation items required is 19. A total, (not stored in the storage unit M ₁₎ also evaluates not entered for any of the evaluation items of the condition Because it is in, "Number of remaining items: 19" is displayed. The means or method for displaying the number of unevaluated items is not limited to this. For example, the number of evaluation items required for the denominator is the number of evaluation items for which the evaluation result is not input to the numerator. The number may be displayed and displayed as "Number of remaining items: 19/19". In addition, an appropriate display method can be used as long as the number of unevaluated items can be easily grasped. For example, the number of evaluation items required for the denominator may be displayed as "number of evaluated items: 0/19" by displaying the number of evaluation items for which the evaluation result has already been input to the numerator.

In this way management system 100, the nursing necessity input screen 103, the patient P ₁ to be input to the evaluation results, such as nursing necessity, the evaluation items required, already stored unit for the respective evaluation items The presence or absence of the evaluated result stored in M ₁ is displayed, and the number of unevaluated items is displayed for _{patient P 1.} Therefore, the nurse K ₁ has an advantage that it is extremely easy to grasp whether or not there are unevaluated items for the patient P _{1 and which evaluation item should be evaluated.}

The management server S ₁ can provide the nursing necessity input screen 103 in an arbitrary format that can be recognized by the user terminal T _1. For example, it can be provided in a format such as HTML (HyperText Markup Language) for a user terminal equipped with a browser function.

<Input of evaluation result and judgment reason from the nursing necessity input screen>
Then, for example, to the nurse K ₁ patient P _1, severity, among the evaluation items of medical and nursing necessity, evaluation items included in the A item "treatment of wounds (except measures of pressure sores)" The procedure for inputting the evaluation result and the reason for judgment will be described for the case where "gauze exchange", which is a measure corresponding to the evaluation result "Yes", is performed.

The nursing necessity input screen 103 shown in FIG. 4, the radio button is displayed to allow selection from predetermined options are predetermined evaluation results for each evaluation item, the nurse K ₁ is actually based on the condition of the patient P ₁ that contents or observed nursing actions were performed on the patient P _1, it may be performed an appropriate selection from the radio buttons. That is, the nurse K ₁ selects "Yes" from the radio button for the item "Wound treatment (excluding pressure ulcer treatment)" on the nursing necessity input screen 103 displayed on the user terminal T _1. do it. In this way, since it is only necessary to select the corresponding button from the displayed radio buttons, the work of inputting the evaluation result becomes very easy.

On the other hand, regarding the reason for the judgment, "gauze exchange" is displayed on the nursing necessity input screen 103 as the reason why the evaluation result for the evaluation item "wound treatment (excluding pressure ulcer treatment)" is "yes". You can enter it in the "Reason for judgment" field. In addition, because the nurse K ₁ is "treatment of pressure sores" is not performed on a patient P _1, with respect to the "treatment of pressure sores" in the "treatment of the wound", select "None" in the "evaluation item" .. As described above, the method for inputting the reason for determination is not particularly limited, and an appropriate method can be used. For example, a nurse K ₁ is the information inputting person may be allowed to freely enter free text, may be registered determination reasons which will be assumed in advance for each evaluation item in the storage unit M _1, the decision reason It may be possible to select from a pull-down menu or the like.

From this state, further, nurse K ₁ is, by clicking the "Save" button displayed on the nursing necessity input screen 103, the input on the user terminal T _1, the displayed results of evaluation and judgment reasons but together with the information on the evaluation item for the information and the subject sufficient to identify the patient P ₁ of interest, is transmitted to the management server S _1. On the other hand, when the management server S ₁ receives the input evaluation result and the reason for judgment from the user terminal T ₁ together with the information sufficient to identify the target patient P ₁ and the information regarding the target evaluation item, the evaluation is performed. results and judgment reasons associated with the patient P ₁ and the corresponding evaluation item is output to the storage unit M _1, a storage unit M ₁ is stored. At the same time, the management server S ₁ updates the nursing necessity input screen 103 shown in FIG. 4 based on the information stored in the storage unit M _1.

In this way, in the management system 100, the evaluation results for each evaluation item related to the severity and the medical / nursing necessity level and the judgment reason that is the basis of the evaluation results are collectively managed. As a result, management staff such as the chief nurse can check whether the evaluation results registered for each evaluation item are correct, which has been done retroactively to electronic medical records and nursing records, each time. There is an advantage that it can be confirmed quickly without going back to the nursing record.

The updated nursing necessity input screen 104 is shown in FIG. As shown in FIG. 5, on the updated nursing necessity input screen 104, "Yes" was input for the evaluation result, and "Gauze exchange" was input for the judgment reason as well. "Wound treatment (excluding pressure ulcers)" ) ”Is displayed in the answer column, and“ Done ”is also displayed in the answer column of“ Pressure ulcer treatment ”where“ None ”was entered for the evaluation result. Further, in the previous input, there is an input of the evaluation results for the evaluation items 2 items, the patient P _1, of the total evaluation items required, the number of evaluation items that evaluate not input "17" On the nursing necessity input screen 104, "the number of remaining items: 17" is displayed in the "number of remaining items" section on the upper right.

In the above explanation, on the nursing necessity input screen 103 or 104, the evaluation items for which the evaluation results have not been input are displayed as "not yet" on the left side, and the evaluation items for which the evaluation results have already been input are displayed. , to distinguish between the two is displayed as "completed" in the left-hand side, the nurse K ₁ is an input person, in any evaluation items already input, so that any evaluation item can be intuitively grasp whether the non-input However, the method of distinguishing between the already-input evaluation item and the non-input evaluation item is not limited to the above. The display colors of the already-input evaluation item and the non-input evaluation item on the screen may be partially or completely different so as to distinguish between the two on the display, or a part of the non-input evaluation item or the already-input item Alternatively, all display colors and / or display brightness may be changed over time to distinguish between the two on the display. However, if you want to draw the attention of the nurse K _1, which is the input person that there is a non-input evaluation item, towards the display of non-input evaluation item, to those that stand out than the display of the already input evaluation items Is desirable.

<Sending request for input of evaluation results related to severity and medical / nursing necessity-Part 2->
In the above example, the date of the nurse K ₁ is, on the evaluation implementation status list screen 101 of the management system 100, which is displayed on the user terminal T _1, evaluation trying to enter the results "January 8, 2020" from, select the ward section of patient P ₁ as an object, the management server S _1, based on the selection signal, for patients assigned to the selected ward division, "January 2020 8 the evaluation implementation status confirmation screen 102 for displaying an evaluation implementation status of nursing required level, and the like of the day "was sent to the user terminal T _1. Alternatively, nurse K ₁ is, for example, by clicking on the button of "Unrated items" on the evaluation implementation status list screen 101, and the date, patient, among the evaluation items that are required for that patient , it is possible to display the unrated item list screen still evaluation result in the storage unit M ₁ is displayed in association with the unrated item and its contents that is not stored in the user terminal T _1.

Figure 6 is a diagram showing an example of unrated item list screen 105 displayed on the user terminal T ₁ as described above. As shown in FIG. 6, on the unevaluated item list screen 105, the unevaluated items of "January 2020" and their "contents" for the ward classification "general ward" are associated with the corresponding patients and dates. Is displayed. Looking at this, as described in the "Content" column, for example, for the patient with patient number "0001", the nursing necessity of "January 7, 2020" is an evaluation item. Of these, "the evaluation result of item A is unregistered", the unregistered evaluation item is "1 item", and the content of the unregistered evaluation item is "management of syringe pump". You can see that. Similarly, for the patient with patient number "0001", regarding the nursing necessity of "January 8, 2020", among the evaluation items required, "the evaluation result of item A is unregistered" and is not registered. It can be seen that the evaluation items are "17 items" and that the contents of the unregistered evaluation items are "respiratory care (excluding the case of sputum aspiration only)" and the like. Similarly, the unregistered evaluation items of items B and C and their contents can be taken from the unevaluated item list screen 105.

As described above, the storage unit M _1, a patient, a ward division to which the patient is assigned an evaluation items required for the patient, and the evaluation results and determining reasons already input for each of the evaluation items a date corresponding to the evaluation result and the determination reason, for example, as shown in FIG. 10 since "severity, medical and nursing required degree evaluation form" is stored for each ward classification, from the user terminal T ₁ For example, when there is a request to provide the unevaluated item list screen by designating the target ward classification and period on the evaluation implementation status list screen 101 and clicking the "unevaluated item" button, The management server S ₁ can appropriately refer to the storage unit M ₁ to collect necessary information and provide it to _{the user terminal T 1} as an unevaluated item list screen 105.

In another preferred embodiment of the management system 100 according to the present invention, the unevaluated item list screen displays a patient having an unevaluated item, the unevaluated item, and a date corresponding to the unevaluated item. It may be associated and displayed for each ward. In such a case, the storage unit M _{1 accessed by the management server S 1} of the management system 100 according to the present invention at any time includes the patient, the ward, the severity required for each patient, and the medical / nursing necessity. and evaluation items according to the evaluation result for the evaluation items, and the corresponding date is stored in association with the management server S ₁ from the storage unit M _1, and the patient, and the ward, the individual It is provided with a means for acquiring information on the evaluation items required for the patient, the unevaluated items in which the evaluation results are not yet stored in the storage unit, and the corresponding dates. When the management system 100 according to the present invention has such an aspect, the person in charge of information input such as a nurse does not input which evaluation item of which patient for the ward he / she is in charge of. There is an advantage that it is highly convenient because it can be grasped extremely easily.

Note that in the unrated item list screen 105 shown in FIG. 6, the number of unrated items displayed in the column of the content of the non-evaluation items, an evaluation items required are stored in the storage unit M ₁ , it is obvious that evaluation results for it reflects the number of unrated item that has not yet been stored in the storage unit M _1.

Further, on the unevaluated item list screen 105 shown in FIG. 6, if the page is scrolled upward, the unevaluated items and their contents retroactively dated within the specified period for the patient with the patient number "0001" are displayed. And if you scroll down the page, you will see the unevaluated items on the latest date within the specified time period for the patient with patient number "0001" and their contents, and then for the patient with the next patient number. The unevaluated items within the specified period and their contents are displayed in chronological order. The same applies to the patient with the next patient number.

Moreover, from the user terminal T _1, for example, on evaluation implementation list screen 101, without specifying the period for the ward section and subject, by button "unevaluated items" is clicked, ward section and object when there is a request for providing without specifying Unrated item list screen the period to the management server S ₁ is, as a default value, for the "general ward" in the month of the day there was a provision request, not rated items and it is also possible to provide the contents of each date, the non-evaluation item list screen 105 arranged for each patient to the user terminal T _1. When there is a request to provide the unevaluated item list screen without specifying the ward classification and the target period, the user terminal T sets the unevaluated item list screen 105 for the entire period and all wards as a default value. _It may be provided in 1.

To select or change the target ward classification, click the "▼" button displayed on the right side of "General ward" on the provided unrated item list screen 105 to select the ward classification. Display the pull-down menu and select the desired ward classification from the menu. Similarly, to select or change the target period, click the "▼" button displayed on the right side of "January 2020" to display the period selection pull-down menu. You can select the desired period.

Without specifying a period in which the ward section and subject, when a request for providing unrated item list screen from the top ratings implementation list screen 101, the management server S ₁ can ward section and interest based on the default value Instead of displaying information about the period on the evaluated item list screen 105, the ward classification and date are blank, and the unevaluated item list for each date and patient and the display part about the contents are also blank. screen may be provided to the user terminal T _1. Input person such as a nurse K ₁ is, unevaluated item list on the screen that has been provided, click the "▼" button that is displayed on the right side of the ward division is blank, the pull-down menu of the ward division selection Display it and select the desired ward classification from it. Similarly, by clicking the "▼" button displayed on the right side of the blank target period, a pull-down menu for selecting the period can be displayed, and the desired period can be selected from the pull-down menu. When the selection signal is sent to the management server S _1, the management server S _1, based on the selection signal sent, the unrated item list in the selected period of ward segment selected and its contents the may be provided to the user terminal T _1.

Thus, the management system 100, ward division basis, by date, and for each patient, evaluating items required, the evaluation result is not stored is not yet input (evaluation result in the storage unit M ₁ ) when provided with a means for providing a non-evaluation item list screen that displays evaluation item and its contents to the user terminal T ₁ is nursing chief nurses, or appropriate medical staff to oversee nurse, or nurse However, for example, for each ward category, patients who have unevaluated items among the required evaluation items and the contents of the unevaluated items can be listed and grasped on a daily or monthly basis. There is an advantage that it is possible to effectively prevent omission of input of evaluation results for required evaluation items.

Further, as shown in FIG. 6, the date, the patient, and the unevaluated items are displayed in association with each other on the unevaluated item list screen 105, and the "nursing necessity" column corresponding to each unevaluated item is displayed. Is provided with a "register" button. Select the target date, patient, and unevaluated item, and click the "Register" button in the corresponding column to display the nursing necessity input screen. For example, on unevaluated item list screen 105 shown in FIG. 6, of the patient P ₁ of the patient number "0001", "January 8, 2020", corresponding to the column labeled a non-evaluation items for the A item "Nursing When you click the "register" button in the column of necessity ", nursing necessary degree input screen for the" a item "of the" January 8, 2020 "of a patient P _1, ie, nursing must be shown in FIG. 5 earlier The degree input screen 104 is displayed. Subsequent procedures are the same as described above. It should be noted, shown in FIG. 6, on unevaluated item list screen 105, "January 8, 2020" of a patient P ₁ of the patient number "0001", corresponding to the display the field to unevaluated item for the B item " When you click the "register" button in the field of nursing necessity ", is nursing necessary degree input screen for the" B item "of the" January 8, 2020 "of a patient P ₁ is displayed.

As described above, according to the unevaluated item list screen 105 provided by the management system 100, the information input person such as a nurse is a patient who has an unevaluated item among the required evaluation items and the unevaluated item. Not only can the contents of the above be easily grasped, but also the input screen of the need for nursing care for patients with the grasped unevaluated items can be quickly called up, which has an advantage of high convenience.

<Acquisition and display of scores for severity and medical / nursing needs>
On the other hand, regarding the evaluation results related to the severity and medical / nursing necessity entered and registered (memorized) as described above, the "evaluation sheet for severity and medical / nursing necessity" shown in FIG. 10 as an example. As can be seen in, for each evaluation result, the correspondence relationship between the evaluation result and the score of severity and medical / nursing necessity is determined in advance. The sum of the points given to the individual evaluation results for the evaluation items corresponding to the A item specified in the evaluation form is the "A score", and the individual evaluations for the evaluation items corresponding to the B item. The sum of the points given to the results is the "B score", and the sum of the points given to the individual evaluation results for the evaluation items corresponding to the C item is the "C score". ing.

In a preferred embodiment, the storage unit M _{1 accessed by the management server S 1} of the management system 100 at any time is provided with individual evaluation results, the severity attached to the evaluation results, and the points of medical / nursing necessity. Information about the correspondence relationship is stored, and the management server S ₁ stores the storage unit S 1 on the screen provided to the _{user terminal T 1} based on the information about the correspondence relationship stored in _{the storage unit M 1.} The score corresponding to the evaluation result already stored in _{M 1 can be displayed.}

The scores of "A score", "B score", and "C score" displayed slightly above the middle stage of the nursing necessity input screen 103 or 104 shown in FIG. 4 or FIG. 5 described above are for the patient. it is already points corresponding to the evaluation result stored in the storage unit M _1. The storage unit M _1, severity for each patient, in addition to the evaluation results of medical and nursing necessity, the evaluation result and severity, the correspondence between the number of medical and nursing necessity stored Therefore, the management server S ₁ can easily obtain a score corresponding to the evaluation result already stored in the storage unit M _1. In the nursing necessity input screen 103 shown in FIG. 4, since the evaluation results have not yet been input for any of the evaluation items for the patient with the patient number "0001", "A score" and "B score" , And "C score" are all displayed as "0 points".

On the other hand, in the nursing necessity input screen 104 shown in FIG. 5, the evaluation result for the evaluation item "wound treatment" is input for the patient with the patient number "0001", so that treatment is supported. Then, "A score" is displayed as "1 point".

The "Severity, Medical / Nursing Needs I" and "Severity, Medical / Nursing Needs II" listed to the left of "A Score" are evaluation sheets for severity and medical / nursing needs. Similarly, the degree of nursing necessity specified separately in the Ministry of Health, Labor and Welfare's "Handling of Basic Medical Fee Facility Standards and Procedures Related to Notification (March 5, 2018, No. 0305 No. 2 issued by Hoken)" a certification criterion, the management server S ₁ includes information about the certification standards of care required degree in the storage unit M ₁ is stored, "a score", based on the number of "B score", and "C score" Therefore, it is provided with a means for determining whether or not the patient meets the criteria defined in "Severity, Medical / Nursing Necessity I" and "Severity, Medical / Nursing Necessity II".

Further, the management server S ₁ is provided with means for displaying the determination result on the nursing necessity input screen 103 or 104, and the determination result is, for example, on the nursing necessity input screen 103 or 104, the determination result is "C score". It is displayed in the "Target" column on the right side. For the patient with the patient number "0001", even if the nursing necessity input screen 104 is viewed, the input of the evaluation result is only for "wound treatment", and the corresponding score is only "A score" for "1 point". Therefore, it is judged that the criteria defined in "Severity, Medical / Nursing Necessity I" and "Severity, Medical / Nursing Necessity II" cannot be met, and the Nursing Necessity Input Screen 104 is displayed. In the "Target" column, "-" (not applicable) is displayed. If the score corresponding to the evaluation result meets the criteria defined in "Severity, Medical / Nursing Necessity I" and "Severity, Medical / Nursing Necessity II", the "Target" In the column, for example, the target "○" is displayed.

As described above, the management server S ₁ of the management system 100 according to the present invention, based on the evaluation result stored in the storage unit M _1, a means for obtaining a corresponding number for each patient, the obtained score Based on this, a means for determining whether or not each patient meets the criteria of "severity, medical / nursing necessity I" and "severity, medical / nursing necessity II", and the required scores and / or a determination result, if provided with means for displaying on a screen to be provided to the user terminal T ₁ is or examines a score corresponding based on the evaluation result of the input or the like of the administrator or the evaluation result is inputted The time and effort required for tabulation is reduced, and the risk of calculation errors and judgment errors is also reduced.

<Display of the number or proportion of patients who meet the criteria of severity and medical / nursing necessity>
The management server S ₁ of the management system 100 according to the present invention, for each segment each ward, "severity, medical and nursing necessity I" and "severity, medical and nursing Necessity II" criteria (hereinafter, together both equipped with means for providing a total number screen for displaying the rate and / or the number thereof patient to the user terminal T ₁ satisfying may be referred to as "severity criteria for medical and nursing necessity degree") On the other hand, the user terminal T ₁ is provided with means for displaying the total number of people screen provided by the management server S _1. FIG. 7 shows a total number of people screen and an example of the information displayed on the screen.

As shown in FIG. 7, the total number of people screen 106 displays the severity of the ward classification “general ward”, the proportion of patients who meet the criteria for medical / nursing necessity, and the number of patients in a calendar format. Has been done. From the total number of people screen 106, for example, the ward manager or the person who inputs the evaluation result can see the points of "A score", "B score", and "C score" for each patient, the total number of patients, and the "severity". , The total number of patients who meet the "Criteria for Medical / Nursing Necessity" can be viewed in a list by date.

In addition, the management server S _1, for each ward category has been selected, also in each selected period, total number of hospitalized patients, "the severity, medical and nursing needs of I" and "severity, medical care and necessary nursing total number of patients meet the criteria of degree II ", and acquires information related ratio total number of inpatients total number of patients meeting the criteria from the memory unit M _1, and provided to the user terminal T _1, A means for displaying on the total number of people screen 106 is provided. The number of people displayed to the right of the "total number of inpatients" and the "total number of patients who meet the criteria" displayed slightly above the middle of the total number of people screen 106 is the "total number of inpatients", respectively. And "total number of patients who meet the criteria". The management server S _1, further comprising a means for determining and displaying the ratio of "total number of patients meet the criteria" for "total number of hospitalized patients", the total number screen 106 to be provided to the user terminal T ₁ ing. The number displayed to the right of the "percentage of patients who meet the criteria" displayed slightly above the middle of the total number of people screen 106 is the "total number of patients who meet the criteria" relative to the "total number of inpatients". Corresponds to the ratio.

To change the target ward classification, click the "▼" button displayed on the right side of "general ward" on the total number of people screen 106 to display the ward classification selection pull-down menu. You can select the desired ward classification from the list. The ward segment in choice can be left to provide a classification of "all wards", in which case, the management server S ₁ from the storage unit M _1, and total number of hospitalized patients in entire medical institution, and total number of patients meeting the criteria to provide information on the percentage of the total number of the hospitalized patients, and provided to the user terminal T _1, would be equipped with means for displaying the total number screen 106.

Incidentally, the information displayed on the total number of people screen may be narrowed down by using arbitrary narrowing down information. For example, when the ward is used as narrowing down information, the person in charge of the medical institution, etc., is assigned the number of patients assigned to each ward division in the ward of interest, the severity of each ward division, and medical / nursing needs. It is convenient because the number of patients who meet the criteria of degree and the ratio thereof can be easily grasped. In such a case, the storage unit M _{1 accessed by the management server S 1} of the management system 100 of the present invention at any time further stores the patient and the ward in association with each other. When a request for provision of a total number screen by specifying the ward from the user terminal T _1, the management server S ₁ obtains information associating the patient and the ward from the storage unit M _1, obtained patient and ward Based on the information associated with, the total number of inpatients associated with the designated ward and the patients who meet the criteria are associated with the designated ward. and total number of patients, to obtain information about the percentage of both total number and provided to the user terminal T _1, would be equipped with means for displaying the total number screen.

Similarly, to change the target period, click the "▼" button displayed on the right side of "December 2019" on the total number of people screen 106 to display the pull-down menu for period selection. You can select the desired period from. This "12 May 2019" in the pull-down menu, it is possible to determine the period of January units such as "January 2020", in which case the period management server S ₁ from the storage unit M _1, which has been designated and total number of hospitalized patients in, or total number of patients meeting the criteria to provide information on the percentage of the total number of the hospitalized patients, and provided to the user terminal T _1, comprising means for displaying the total number screen 106 It will be. The period that can be used as the above-mentioned target period is not limited to the monthly period, and depending on the convenience of the person in charge of the medical institution, for example, a yearly period or a plurality of monthly periods, Alternatively, a weekly period may be used.

As described above, according to the management system 100 of the present invention, the person in charge of the medical institution satisfies the criteria of severity and medical / nursing necessity for each ward division or all ward divisions for a desired period. The proportion of patients and their number can be grasped very easily.

Incidentally, according to the management system 100 of the present invention, throughout the medical institutions, severity, information about the medical and nursing necessity, is managed by the management server S _1. Thus, even from the user terminal T ₁ present in ward W _1, even from the user terminal T ₂ present in ward W _2, severity, freely can be performed input and management of information relating to medical and nursing necessity, It is also possible to immediately view the updated contents in one ward in the other ward. That is, the person in charge of the medical institution does not have to collect information on the severity and the medical / nursing necessity from each ward, as has been done in the past, and the severity and the medical / nursing necessity of the entire medical institution are related. It has the advantage of facilitating the management of information.

<Output of evaluation result>
Further, in the management system 100 according to the present invention, the storage unit M _{1 accessed by the management server S 1 at} any time includes the evaluation results of the patient and the individual evaluation items of the evaluation sheet related to the severity and the medical / nursing necessity. , since the association with each date corresponding to the evaluation result, the management server S _1, the patient and, already severity stored in the storage unit M _1, the evaluation results according to the medical and nursing Necessity And the date corresponding to the evaluation result can be associated with each other and output in a predetermined format.

In a file that describes the information on the evaluation results related to the severity and medical / nursing necessity output in this way in a predetermined format, DPC (Comprehensive Medical Expense Payment System) target hospitals, DPC preparation hospitals, etc. Contains the H file submitted by. As of January 2020, the H file contains the facility code, ward code, hospital-specific code, data identification number, discharge date, hospitalization date, implementation date, and severity, medical care / nursing. The score for each evaluation item of the evaluation sheet related to the degree of necessity, and the information indicating whether the evaluation sheet is subject to the judgment of the severity and the degree of medical / nursing necessity are described, and one file contains one month. Information for minutes is listed.

According to the management system 100 according to the present invention, the person in charge of the medical institution can output the H file as follows, for example. When the "H file" displayed at the top of the screen on any of the screens displayed on the screen of the user terminal T ₁ , for example, the evaluation implementation status list screen 101, is clicked, the H file is displayed on the user terminal T _1. The creation screen is displayed. FIG. 8 shows an example of the H file creation screen 107 displayed in this way. On the H file creation screen 107, "December 2019" is selected as the output target period of the H file. If you click the "Download" button in this state, an H file for the selected "December 2019" will be created, and the created H file will be placed in any location specified by the person in charge at the medical institution. It will be saved. To change the period for which the H file is output, click the "▼" button displayed in the middle of the H file creation screen 107 to display the pull-down menu for selecting the period, and then select the desired period. You just have to select the period to do. The target period does not necessarily have to be one month, and depending on the convenience of the person in charge of the medical institution, for example, a yearly period, a plurality of monthly periods, or a weekly period may be used.

<Information input from bedside terminal>
FIG. 9 is a conceptual diagram showing the overall configuration of the severity and medical / nursing necessity management system 200 (hereinafter, also referred to as “management system 200”), which is another example of the present invention, and is a conceptual diagram showing the overall configuration of a patient as a user terminal. It is the same as the management system 100 shown in FIG. 1 except that a bedside terminal arranged on the bedside is added.

As shown in FIG. 9, the management system 200, the severity, and a management server S ₁ as medical and nursing necessity management device, T _1, T ₂ is the severity nurse etc., medical and require nursing It is a user terminal used when inputting information about a degree, and BS _{1 to} BS ₄ are bedside terminals arranged on the bedside of beds B _{1 to} B _{4, respectively.} The management server S ₁ , the user terminals T ₁ , T ₂ , and the bedside terminals BS _{1 to} BS ₄ are connected to an appropriate network N. The IP address (Internet Protocol Address) of the bedside terminal BS _{1 is assumed to be "192.168.0.1".}

Bedside terminals BS ₁ is disposed beside the bed B ₁ patient P _1, exclusively, a terminal that is used to display and manage the medical information, etc. about the use or patient P ₁ by the patient P _1, for example, in order to display clinical information about vital signs such as for a patient P _1, a terminal disposed on the bedside of the patient P _1. Such a bedside terminal is usually associated one-to-one with the patient who is the user by the information that associates the patient with the bedside terminal, and in this example, it is the information that identifies the patient. and patient number, the correspondence table is stored in the storage device or the storage unit M ₁ is not shown in the hospital information system association with each IP address of the bedside terminal is information for specifying a bedside terminal used by the patient There is. For example, a patient _{P 1} patient number "0001", and the IP address of the bedside terminal BS ₁ "192.168.0.1" are stored in association. The correspondence information between the patient P ₁ and the bedside terminal BS ₁ does not necessarily have to be the correspondence information between the patient number of the _{patient P 1} and the IP address of the _{bedside terminal BS 1 , and the patient P 1} is specified. Appropriate information and appropriate information _{for identifying the bedside terminal BS 1} can be used in combination. Further, the correspondence information of the patient and bedside terminal management unless the management server S ₁ of the management system 200 is available, may be stored in any storage device, e.g., a bedside terminal BS ₁ like If another system has already been introduced and the correspondence information between the patient and the bedside terminal is stored in a storage device or the like owned by the other system, this can be used.

If by the management system 200, the severity of the patient P _1, nurse K ₁ to the desired input of the evaluation result according to medical and nursing necessity, from the bedside terminal BS ₁ disposed bedside patient P ₁ , severity, may be transmitted to the input request of the results of the evaluation of the medical and nursing necessary degree of management server S _1. To enable this transmission, on the screen of the bedside terminals BS _1, it is sufficient to provide a button for transmitting a request for inputting evaluation results to the management server S _1.

At this time, the nurse K ₁ does not need to specify the _{patient P 1} on the screen displayed on the bedside terminal BS ₁ , and the nurse K 1 requests the management server S ₁ to input the evaluation result _{from the bedside terminal BS 1.} All you have to do is send it. Severity transmitted from the bedside terminal BS _1, to the input requirements of the evaluation results according to the medical and nursing necessity, as the information for identifying the bedside terminal BS _1, for example, bedside terminal BS ₁ of the IP address "192 since .168.0.1 "is included, the IP address, as the information for identifying the patient to be input request evaluation results, together with the input requirements of the evaluation results are transmitted to the management server S ₁ It will be.

The management server S ₁ is based from bedside terminal BS _1, severity, when receiving the input request of the results of the evaluation of the medical and nursing necessity, IP address, bedside terminals BS ₁ to be received from the bedside terminal BS ₁ Te, by referring to the correspondence table between the patient and bedside terminals stored and the storage device of the storage unit M ₁ or other systems, on the basis of the IP address transmitted, from bedside terminal BS ₁ severity severity, the evaluation result of the input request for medical and nursing necessary degree, and identified as the input request for the patient P _1, which is identified by the patient number "0001", is needed for the patient P _1, evaluation items according to the medical and nursing necessity, and obtains the evaluation result for the evaluation item from the storage unit M _1, together with the acquired evaluation items and the evaluation results, accepts an input of the evaluation result for the evaluation items An input screen is provided to the bedside terminal BS _1. At this time, the _{evaluation result input screen provided to the bedside terminal BS 1} is the same as the nursing necessity input screen 103 or 104 previously shown in FIG. 4 or 5.

Nurse K ₁ from been nursing necessity input screen 103 or 104 provided for patients of interest, the evaluation results and enter a judgment reason, may be transmitted to the management server S _1. The management server S ₁ is, and outputs the evaluation result and the determination reason received in the storage unit M _1, it is also the same as in the example described above to be stored in the storage unit M _1.

As described above, when a bedside terminal associated with a patient who is the main user of the user terminal is used in advance as a user terminal, a nurse or the like evaluates the evaluation items required for the patient. When entering the result and the reason for judgment, it is not necessary to enter the identification information that identifies the patient, which saves time and effort, and at the very bedside of the target patient, while checking the patient's condition, the patient It is possible to input the evaluation result and the reason for judgment for the required evaluation item, and further, by displaying the unevaluated item list screen 105 shown in FIG. 6, for example, on the bedside terminal, what is unevaluated. The advantage is that it is possible to immediately grasp whether it is an item. Incidentally, from bedside terminal, when a display request unevaluated item list screen 105, the management server S ₁ extracts only the information about the patient that is linked to the bedside terminal, bedside terminal May be provided to.

Recording and management of information on the severity of inpatients, etc. at medical institutions and the necessity of medical care / nursing imposes a heavy burden on nurses, etc. in the medical field. The severity and medical / nursing necessity management system of the present invention facilitates the input of information on the severity and medical / nursing necessity, frees the nurse or the like who is the information inputter from an excessive burden, and is a medical institution. By facilitating the management of information on the overall severity and medical / nursing necessity, it is possible to effectively use the evaluation results of the severity and medical / nursing necessity for proper placement of nurses. , It is expected that the quality of medical care that medical institutions can provide to inpatients will be improved. Therefore, it can be said that the industrial applicability of the present invention is great.

100, 200 Severity, medical / nursing necessity management system 101 Evaluation implementation status list screen 102 Evaluation implementation status confirmation screen 103, 104 Input screen 105 Unevaluated item list screen 106 Total number of people screen 107 H File creation screen B ₁ , B ₂ , B ₃ , B ₄ bed BS ₁ , BS ₂ , BS ₃ , BS ₄ bedside terminal K ₁ , K ₂ nurse M ₁ storage N network P ₁ , P ₂ , P ₃ patient S ₁ management server T ₁ , T ₂ user terminal W ₁ , W ₂ ward

Claims (8)

It is a severity, medical / nursing necessity management system that manages the severity of patients and medical / nursing needs in medical institutions.
The management system includes a management server.
The management server
When a patient to be evaluated is identified from a user terminal connected via a network and a request is made to input evaluation results regarding severity and medical / nursing necessity, the patient and the patient are required. The evaluation items required for the specified patient from the storage unit that stores the evaluation items related to the severity, the medical / nursing necessity, and the evaluation results for the evaluation items in association with each other, and the evaluation items thereof. An information acquisition means for acquiring an evaluated result already stored in the storage unit for an evaluation item,
A screen providing means for providing the user terminal with an input screen for receiving input of the evaluation result for the evaluation item together with the acquired evaluation item and the already evaluated result, and
An output means that receives an evaluation result input via the input screen from the user terminal and outputs the evaluation result to the storage unit in association with the specified patient.
And, in addition
A storage unit that stores patients, their ward classifications, evaluation items related to the severity required for each patient, medical / nursing necessity, evaluation results for the evaluation items, and corresponding dates. Therefore, for each ward classification, the number of patients who are assigned the ward classification for each date and have evaluation items that require evaluation of severity and medical / nursing necessity. And / or the number of evaluated patients whose evaluation results for all of the required severity and medical / nursing necessity evaluation items are already stored in the storage unit among the patients requiring evaluation. Regarding the evaluation items of required severity and medical / nursing necessity among the evaluated patients, information on the number of unevaluated patients whose evaluation results are not yet stored in the storage unit is acquired.
Based on the acquired information, the ward classification, the number of patients requiring evaluation for each of the ward classifications, and the number of evaluated patients and / or the number of unevaluated patients are associated with each other for each date. A means for providing the evaluation implementation status list screen to be displayed to the user terminal,
Severity, medical / nursing necessity management system characterized by being equipped with. Means the information acquisition means, a determination reason for further evaluation result, to retrieve from a storage unit that stores an association with the evaluation result, the already determined why stored in the storage unit in the already,
The screen providing means is a means for providing the user terminal with an input screen for receiving input of the evaluation result and the judgment reason for the evaluation item together with the acquired evaluation item, the evaluated result and the reason for the judgment.
The output means is an output means that receives an evaluation result and a reason for determination input via the input screen from the user terminal and outputs the evaluation result and the reason for determination to the storage unit in association with the specified patient.
The severity, medical / nursing necessity management system according to claim 1, wherein the system is characterized by the above. The management server further
On the input screen provided to the user terminal when there is an unevaluated item for which the evaluation result is not yet described in the storage unit among the evaluation items required for the specified patient acquired from the storage unit. Or a means for displaying the evaluation item separately from other evaluation items and / or a means for displaying the number of the unevaluated items on another screen.
The severity, medical / nursing necessity management system according to claim 1 or 2, wherein the system is provided with. The management server further
From the storage unit that stores the patient, its ward classification, the severity required for each patient, the evaluation items related to the medical / nursing necessity, and the evaluation results for the evaluation items in association with each other, the patient and the patient , A means for obtaining information on the ward classification, evaluation items required for individual patients, and unevaluated items among the evaluation items whose evaluation results are not yet stored in the storage unit, and
A means for providing the user terminal with an evaluation implementation status confirmation screen that displays an evaluation implementation status confirmation screen for each ward category by associating a patient with information on the presence or absence of unevaluated items for the patient based on the acquired information.
The severity, medical / nursing necessity management system according to any one of claims 1 to 3, wherein the system is provided with. The management server further
Correspond the patient, the ward classification and / or ward, the evaluation items related to the severity required for each patient, the medical / nursing necessity, the evaluation results for the evaluation items, and the corresponding dates. From the memorized storage unit, the patient, its ward classification and / or ward, the evaluation items required for each individual patient, and among the evaluation items, the evaluation results are not yet stored in the storage unit. And the means to obtain information about the corresponding date and
Based on the acquired information, the unrated item list screen is displayed for each ward category and / or for each ward by associating the patient with the unevaluated item with the unevaluated item and the corresponding date. Means to provide to user terminals,
The severity, medical / nursing necessity management system according to any one of claims 1 to 4, wherein the system is provided with. The management server further
Patients, their ward classifications, evaluation items related to the severity required for each patient, medical / nursing necessity, evaluation results for the evaluation items, and dates of the evaluation results are stored in association with each other. In addition, a storage unit that stores information on the item categories of each evaluation item, the points given to each evaluation result of each evaluation item, the severity predetermined for each ward category, and the criteria for medical / nursing necessity. Therefore, the patient, its ward classification, the evaluated item whose evaluation result is already stored in the storage unit for each patient, the item classification, the evaluation result, the date, and the evaluation result of the evaluated item. And the means to obtain information about the criteria,
A means for obtaining a score for each evaluation item and / or for each item category of an evaluation item corresponding to each evaluation result already stored in the storage unit based on the acquired information, for each date and for each patient.
A means for comparing the obtained score with the criteria for severity and medical / nursing necessity, and a means for determining whether or not the criteria are met for each patient, and
The total number of people who display the score for each evaluation item and / or for each item category of the evaluation item, and / or the number and / or the ratio of patients judged to meet the criteria for each ward category and / or date. A means for providing a screen to the user terminal,
The severity, medical / nursing necessity management system according to any one of claims 1 to 5, wherein the system is provided with. One or more of the user terminals are bedside terminals arranged on the patient's bedside.
A storage unit that stores information about the correspondence between the bedside terminal and the patient when the management server receives an input request for evaluation results regarding the severity and medical / nursing necessity from the bedside terminal. A means for acquiring information about a patient corresponding to the bedside terminal based on the identification information of the bedside terminal and identifying which patient the input request is for.
The severity, medical / nursing necessity management system according to any one of claims 1 to 6, wherein the system is provided with. A computer program describing a procedure for operating one or a plurality of computers as the management server in the severity, medical / nursing necessity management system according to any one of claims 1 to 7.

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