JPH04161139A - Patient monitoring system - Google Patents

Abstract

PURPOSE:To reduce the processing burden of a nurse, and also, to obviate the mental of a patient received from an alarm by inputting the contents of a medical treatment instruction to a central monitor, so that a signal of a desease condition alarm, etc., from a bedside monitor, and a treated signal from a slave machine and a handy terminal can be transmitted. CONSTITUTION:By inputting the instruction contents of a medical treatment instruction prepared by a doctor to a central monitor 1, for instance, when the time for prescribing a medicine comes, a call signal is transmitted to a slave machine 7. A nurse can execute such a trestment as a prescription, etc., based on this call signal. Also, from a bedside monitor 8, a disease condition alarm signal or an apparatus alarm signal is sent out to the central monitor 1, therefore, in the central monitor 1, an alarm can be generated on the monitor side at the time of reception, and also, a call signal corresponding to the alarm can be transmitted to the slave machine 7. Moreover, from the slave machine 7 and a handy terminal 17, a treated signal can be transmitted to the central monitor 1, therefore, the central monitor 1 can prepare a progress table, based on this treated signal.

Description

[Detailed Description of the Invention] [Object of the Invention] (Industrial Application Field) The present invention relates to a patient monitoring system that enables efficient intensive monitoring and treatment of critically ill patients, and particularly relates to a patient monitoring system that enables efficient intensive monitoring and treatment of critically ill patients. Regular treatment details such as medication administration can be transmitted to nurses via wireless signals and handheld terminals from a central monitoring device that inputs the patient's vital signs and other information, making it possible to improve the efficiency of nurses' work. Relating to patient monitoring systems.

(Conventional technology) Intensive care systems sequentially extract patient's biological information and provide it to the medical team so that the most appropriate treatment can be performed for critically ill patients whose condition is likely to change, such as emergency patients and post-surgery patients. At the same time, life can be maintained by automatically administering artificial respiration, intravenous fluids, and other treatments to patients.

This intensive care system is an ICU (Intensi
veCare Unit) - best known as
CCU (Coronary) for heart disease patients
Care Unit) and R for patients with respiratory failure.
CIJ (Respiratory Care Unit
), S CU (StrokeCa) for stroke patients
re Unit).

Vital signs are information on the biological functions necessary to maintain a patient's life. In intensive care systems, the patient's electrocardiogram, blood pressure, pulse rate, breathing, body temperature, etc. are continuously monitored 24 hours a day, and these vital signs are monitored. When an abnormal value is detected, a warning is issued by a lamp or a buzzer. Monitors capable of monitoring these high-tal signs are usually placed at the pet side and in a monitoring room such as a nurse's station.

By the way, treatment such as medication for critically ill patients receiving treatment in such an intensive care system is performed by a doctor or a nurse in accordance with a treatment instruction sheet prepared for each patient. FIG. 10 shows the flow of operations for administration of drugs and post-operative treatment for a critically ill patient, for example, patient Pa after surgery.

In this figure, a doctor Or issues a post-operative instruction sheet Y1 and a prescription Y2 according to the surgical procedure for each patient Pa. This postoperative instruction sheet Y1
This includes instructions for post-operative procedures such as periodic blood sampling, respiratory management, position changes, and body cleansing for the patient. Prescription iY2 also includes instructions for administering medication by injection, drip, or oral administration.

The nurse Nυ performs post-operative treatment and drug administration for the patient Pa based on the post-operative instructions Y1, the prescription Y2, and the verbal instructions from the doctor [)r. After the nurse Nu has treated the patient Pa, the nurse Nu records the details of the treatment in the progress table Y3. This progress table y3 allows the doctor Dr to understand the patient Pa's status. Nurse Nu also fills in the unissued prescription @Y2a.

(This is the problem that the invention aims to solve!!) By the way, in the above-mentioned intensive care system, most of the treatments such as administering medication to critically ill patients are routine tasks that are performed at regular intervals. Irregular treatments are also performed based on responses and complaints from patients.It is a great burden for nurses to maintain awareness of the contents of regular treatments while also performing irregular treatments. This can lead to mistakes and cause stress.

In addition, nurses record the details of treatments performed on patients in progress sheets, but this recording work also occupies a large portion of the work, creating a burden on nurses.

Furthermore, from the patient's perspective, the alarm emitted from the bedside monitor when vital signs are abnormal causes alarm pollution to the patient, and has a negative psychological impact on the patient.

The present invention was proposed to solve such problems, and can reduce the processing burden on nurses, and
An object of the present invention is to provide a patient monitoring system in which a patient is not subjected to mental burden due to an alarm emitted from a bedside monitor.

J Structure of the Invention] (Means for Solving the Problems) In order to achieve the above object, the patient monitoring system according to the present invention comprises: a central monitoring device into which data necessary for the treatment instructions indicated in the treatment instructions are input; A bedside monitor that monitors information on the patient's biological functions and the operating status of the treatment equipment, and sends the patient's condition alarm signal and device alarm signal to the central monitoring device when an abnormality occurs, and the pathological condition alarm from the bedside monitor. an alarm generating means for generating an alarm in the central monitoring device upon reception of a signal or a device alarm signal; and an alarm generating means provided in the central monitoring device for generating a call signal corresponding to a treatment item based on input data necessary for the treatment instruction, a transmission means for transmitting a radio signal at the time of day and a radio signal for transmitting a call signal corresponding to the alarm when a disease state alarm or equipment alarm occurs; a handset that issues an alarm corresponding to the type of the call signal and transmits a treated signal to the receiving means of the central monitoring device after completion of the treatment corresponding to the request of the call signal; A handy terminal that can input the treatment instructions shown in the treatment instruction sheet stored in the central monitoring device, and input that the treatment was performed based on the instructions, and a treatment completion signal sent from the slave unit and the handy terminal. The present invention is characterized by comprising a progress chart creation means for creating a progress chart corresponding to a nursing record based on the treatment clear symbols and the received treatment clear symbols.

(Operation) According to the above-described configuration, by inputting the instruction contents of the treatment instruction sheet prepared by the doctor into the central monitoring device, a call signal is transmitted to the slave device when it is time for medication to be administered, for example. The nurse can perform treatments such as administering medication based on the second call signal.

In addition, the bedside monitor sends pathological alarm signals or equipment alarm signals to the central monitoring device.
When the central monitoring device receives an alarm signal, the monitoring device can issue an alarm and also send a call signal corresponding to the alarm to the slave units. Based on this call signal, the nurse can perform treatment corresponding to the disease state alarm or device alarm. Therefore, in the bedside monitor, there is no need to emit an alarm using a buzzer or the like when a disease state alarm or equipment alarm occurs.

Furthermore, the slave units and handy terminals can transmit treatment completion signals to the central monitoring device, and the central monitoring device can create a progress table based on the treatment completion signals.

(Example) Hereinafter, embodiments of the present invention will be described in detail based on the drawings.

The block diagram of FIG. 1 depicts one embodiment of a patient monitoring system according to the present invention.

In this figure, a central monitoring device (central computer) 1 installed in a monitoring room such as a nursing station has a C
A display device 2 such as an RT, a keyboard 3, and a printer 4 such as an XY plotter are connected.

This central monitoring device 1 is equipped with a treatment instruction editor 5 that can create instructions for post-operative patients including prescriptions, instructions for emergency patients, etc. (see Figure 2). For example, when the details of postoperative treatment and prescription for a post-operative patient are entered into the treatment schedule including medication schedule, patient name, and nurse in charge, the treatment instruction editor 5 creates a treatment instruction form. is created, and the input data is stored in the memory 6 within the central monitoring device 1. At this time, the instruction item input screen on the display device 2 has a configuration similar to that of the treatment instruction sheet actually used. Further, the created treatment instruction sheet can be printed out using the printer 4 as appropriate.

Here, the treatment instruction editor 5 is registered in advance with basic instruction contents corresponding to the doctor's base, surgical name, disease name, etc., and inputting the instruction items corresponding to each patient is performed using the basic instructions. This can be done by simply modifying the instructions. Further, the patient name and the name of the nurse who cares for the patient are registered in advance in correspondence with an identification code (ID). The patient's identification code (patient ID) has a one-to-one correspondence with the bed number, and the nurse's identification code (nurse ID> has a one-to-one correspondence with the handset number), and the nurse's identification code (nurse ID> It corresponds to

The bedside monitor 8 includes an electrocardiograph 9, a blood pressure monitor 10, and a respiratory rate measuring needle 11 for obtaining vital signs from the patient.
It also has a built-in core thermometer 12 and a urine volume meter 13.
It is connected to the signal output parts of each measuring instrument, such as, and the control parts of the infusion pump 14, the artificial respirator 15, and the other treatment equipment 16. This bedside monitor 8 monitors vital signs and the operating status of various devices, outputs a pathology alarm signal in the event of a patient's sudden pathology, and also sends each vital sign, pathology alarm signal, alarm signal of each device, etc. online. and sends it to the central monitoring device 1. Sudden changes that can cause a medical condition alarm to occur include ventricular tachycardia, ventricular fibrillation, and cardiac arrest. In addition, as a device alarm, the infusion pump 14
There may be an abnormality in fluid delivery or an abnormality in the ventilator 15. In addition,
In order not to have an adverse psychological effect on the patient, it is possible to prevent the bedside monitor 8 from sounding the alarm even if a disease state alarm or equipment alarm occurs.

Further, when test data, for example after blood collection, is input from the test data terminal 18, this test data is automatically sent to the central monitoring device 1.

Data related to drugs, medication schedules, and other instructions related to devices inputted when creating a treatment instruction sheet are transmitted from the central monitoring device 1 to the handy terminal 18. A portable handy terminal can display this instruction on the display whenever you press the display key, and
It is possible to display the action items on the display section at the relevant time.

In addition, from a transmitting/receiving device 19 connected to the central monitoring device 1, instructions such as medication are transmitted by radio signal to a paging handset (card pager) 7 carried by a nurse at the corresponding treatment time. At the same time, a confirmation signal, a treated signal, etc. transmitted from the handset 7 are received by the transmitting/receiving device 19, and the received signals are sent back to the central monitoring device 1.

Next, the configuration of the central monitoring device 1 shown in the block diagram of FIG. 2 will be explained.

In this figure, a display processing section 21 that controls the display device 2, a keyboard interface 22, and a printer interface 23 are connected to the control section 20.

The instruction data of the treatment instruction sheet created by the treatment instruction sheet editor 5 is read out from the memory 6 and supplied to the time-related alarm generation section 24 and the state recognition-related alarm generation section 25.

The time alarm generation section 24 is a time signal alarm generation section 24a.
and a medication alarm generating section 24b,
The medication alarm generation unit 24b generates a paging medication alarm signal for routine medication treatment based on the medication schedule in the treatment instruction. The time signal alarm generator 24a generates a time signal alarm signal every hour on the hour. The condition recognition system alarm generation section 25 is composed of a treatment instruction sheet corresponding alarm generation section 25a and an @kei alarm generation section 25b. An alarm signal corresponding to the paging instructions for the treatment item is created. As mentioned above, the second treatment includes blood sampling, respiratory management, body position change, and body hygiene for the patient.

Online data such as vital signs and pathological alarm signals inputted online from the bedside monitor 8 to the terminal 26, and offline data inputted to the terminal 27 from the handy terminal 17 and the examination data terminal 18 are input to the input/output interface (manufacturer). 10 interface) 28 to the pathological condition alarm generating section 25b, and a pathological condition alarm signal for paging is created in this alarm generating section 25b. Online data of device information signals such as device alarm signals are supplied to a device information system alarm generating section 29, and this alarm generating section 29 creates a paging device alarm signal. In the equipment information system alarm generation section 29 of the long octopus,
A plot confirmation alarm signal is generated when online data is plotted.

Each alarm signal generated by the alarm generators 24, 25, and 29 is supplied to the controller 20. The control unit 20 sends each alarm signal including time data, the patient ID, and the ID of the nurse in charge to the transmitting/receiving device 19 via the I10 interface 30. In the transmitting/receiving device 19, the nurse I
D. Send the patient ID and each alarm signal to the handset 7 carried by the nurse. FIG. 3 shows the format of a transmission signal transmitted from this transmitting/receiving device 19. In this signal format, DI, D2, D3, D4 are nurses ■D, yI!, respectively. , patient ID, treatment time, and instruction content data areas.

Further, the information on the vital signs that has passed through the alarm generating section 25 is displayed one after another on the screen of the display device 2. When a disease state alarm or device alarm occurs, an alarm message is displayed on the screen and a buzzer sounds to notify the user. FIG. 4 is an example of the display screen 2a when an equipment alarm occurs, and in this example, the occurrence of an abnormality in the infusion pump 14X is indicated by blinking of the block portion representing the infusion pump 14X.

The central monitoring device 1 is also equipped with a progress chart creation section 32, and when a treatment completed signal is issued from the handset 7 after the nurse administers medication, the progress chart creation section 32
In step 2, a progress chart corresponding to a nursing record is created based on this treated signal. The created progress table can be printed by the printer 4 as appropriate.

The handset operation checking unit 33 periodically checks whether each handset 7 is functioning normally, and by starting this handset operation checking unit 33 at regular time intervals, Old handset number that can identify each handset 7 (this is Nursing@I
An operation confirmation signal consisting of a handset response request signal d2 (corresponding to D) and a handset response request signal d2 is issued from the transmitting/receiving device 19 to each handset 7. FIG. 5 shows the signal format of this operation confirmation signal. When each handset 7 receives the operation confirmation signal, it automatically emits the handset number as its own identification code and a response signal, and the response signal from the handset 7 is received by the transmitting/receiving device 19. Then, the handset operation checking unit 33 checks the handset number at the time of transmission and the handset number at the time of reception, and checks whether each handset is functioning normally. If the malfunctioning handset 7X is found through this confirmation operation, the fourth
As shown in the figure, the screen 2a of the display device 2 flashes to indicate that the corresponding slave unit 7X is defective, and
An alarm indicating that X is defective is emitted by the buzzer 31. By providing this handset operation confirmation section 33, it is possible to know in advance whether the handset 7 is running out of battery, communication abnormality, etc.

Next, we will explain the configuration and operation of the handset 7, which will transmit the details of each treatment based on the treatment instructions, @ status alarm, equipment alarm, etc. to the nurse, as well as transmit the response content from the nurse side. First of all, as shown in Fig. 6, the external appearance of the handset 7 is in the form of a small card suitable for carrying.On the surface of the handset 7 are information such as the patient's bed number, treatment details, alarm details, etc. A liquid crystal display unit 34 that can display text in text, a buzzer 35 that emits an alarm sound, a confirmation switch 36 that conveys that the nurse has confirmed the paging when receiving an alarm signal for paging accompanied by treatment, and treatment completed. An indicator light 38 that blinks until the transmission switch 37 is pressed to inform the nurse that no treatment has been completed, and a treatment completion transmission switch 37 that informs the nurse that the treatment has been completed are provided.

FIG. 7 shows a block diagram of this handset 7, in which the CPU
(Central Processing Unit) 39 has
A display drive circuit 40 that drives the liquid crystal display section 34 and a buzzer 3
5, a switch circuit 42 to which the confirmation switch 36 and the treated transmission switch 37 are connected, and a lighting circuit 943 that blinks the indicator light 38 are connected via a pass line 44, respectively. CPU39
A transmitting/receiving circuit 146 is connected to the I,/'O interface 45 which is connected by a path line 44 to the I,/'O interface 45 .

A ROM (read only memory) 47 connected to the pass line 44 stores the operation program of the handset 7 and the handset number attached to each handset 7. Also RAM
(Random access memory) 48 stores data received by the transmitting/receiving circuit 46 for a necessary period of time.

In the handset 7 having this configuration, when the transmitting/receiving circuit 46 receives a transmission signal from the central monitoring device 1, the CPU 39 checks whether the data is related to itself or not, and if the data is related to itself, an alarm is raised. The buzzer 35 is activated depending on the type of signal, and the content of the alarm is displayed in text on the liquid crystal display section 34.

FIG. 8 shows an example of a character display and a ring tone depending on the type of alarm signal received by the handset 7.

In this figure, when the time signal alarm signal that is emitted every hour on the hour is received, the letter "b" is displayed to distinguish it from the second signal, which is a time signal, and the bed number is also displayed. The ringing tone at this time is "beep beep beep." This time signal alarm signal allows the nurse to confirm that the handset 7 is operating normally.

If a plot confirmation alarm signal issued when online data is plotted is received, no characters will be displayed. The ringtone at this time was "B".

It is.

When a paging medication alarm signal is received to communicate the time of a routine medication;
The character "rC" is displayed to identify that the content of the treatment is medication, and the patient's node number is also displayed. The ring tone at this time is r-bee-bee-bee...''. This medication alarm reduces the burden on nurses because they do not need to be aware of the time of regularly administered medication.

When an alarm signal corresponding to the paging treatment instruction sheet is received, rAJ is displayed as characters to identify this treatment other than medication, and a be/nod number is also displayed. The ring tone at this time is ``Beep beep beep beep beep...''.

When a paging device alarm signal that is issued when a device is abnormal is received, the letter “E” is displayed as a response to the abnormal device, and
The ring tone at this time is "Beep beep beep beep beep beep beep beep beep...".

When a disease state alarm signal issued when a patient's disease condition suddenly changes is received, rAc is used to identify that the treatment is for a patient whose disease state has worsened.

is displayed in text, and the patient's bed number is also displayed. The ring tone at this time is particularly necessary to draw attention, so it is a continuous alarm of 7 beep beep beep beep beep beep...''.

After confirming that each alarm signal for paging has been received by the ring tone or text display, when the nurse presses the confirmation switch 36 on the handset 7, the ring tone stops and a confirmation signal indicating that paging has been confirmed is signaled. is transmitted from the handset 7 to the central monitoring device 1.

After completing the treatment based on the contents of the paging alarm, when the treatment completion transmission switch 37 is pressed, the central monitoring device 1 is notified that the treatment corresponding to the alarm has been carried out.

Next, the operation flow of the patient monitoring system configured as described above will be explained based on the operation flowchart of FIG. 9.

First, when necessary items are entered into the central monitoring device 1 to create a treatment instruction sheet (step Sl),
At the treatment corresponding time, a paging medication alarm signal or a treatment instruction sheet corresponding alarm signal is transmitted to the handset 7 (steps 82 to S4).

Also, a time signal alarm signal is transmitted every hour on the hour (steps 85 to S6).

When the online data plotting time comes, a plot confirmation alarm signal is transmitted and the online data is captured (steps 87 to S9). Also, in step S10, offline data is captured. When a disease state alarm or a device alarm is confirmed through the acquisition of online data and offline data, a paging disease alarm signal or a paging device alarm signal is transmitted (steps 811 to 514).

When one of the alarm signals is received by the handset 7 carried by the nurse, the handset 7 displays characters to indicate the type of alarm and sounds a ringing tone (step/prompt). S15-816).

In the case of a paging alarm, when the nurse presses the confirmation switch 36 on the handset 7 after confirming the alarm, the indicator light 38 starts blinking, the ringing tone stops, and the confirmation signal is sent to the central By receiving this confirmation signal, which is transmitted to the monitoring device 1 (steps S17 to S519), the central monitoring device 1 can know that the baging has been confirmed by the nurse (step S520).
If the confirmation signal is not received even after a certain waiting time of 1°, the central monitoring device 1 determines that the nurse did not perform the treatment. This “untreated” determination is (steps 321 to 321)
522).

After the treatment corresponding to the alarm is completed, when the nurse presses the treatment completion transmission switch 37 of the handset 7, the indicator light 38 stops blinking, the character display on the display unit 34 disappears, and the treatment completion signal is turned off. It is transmitted to the central monitoring device 1 (steps S23 to 525). By receiving this treated signal, the central monitoring device 1 can confirm that the treatment corresponding to the alarm has been completed (step 826).
). If the treated signal is not received even after a certain waiting time, the central monitoring device 1 sends a 7 untreated signal. (Step S27.522).

Furthermore, when the treatment instruction (step 532) input to the handheld bus terminal 17 reaches the treatment time (step 533), an alarm is activated and the nurse performs the treatment. (Step S3.i, 35). After the treatment, input that the treatment has been completed to Hantei Bus Terminal 17 (Step 5)
36). The handy terminal 17 is connected to the central monitoring device 1 and a treated signal is sent out (step 537).

The central monitoring device 1 creates a progress chart corresponding to a nursing record based on the confirmation of the processed signal and the determination of ``no treatment'' (step 528). The progress table is displayed on screen 2 as appropriate.
It can be monitored by a and printed by the printer 4 (steps 329 to 532).

In this way, with this patient monitoring system, there is no need for nurses to fill out progress sheets each time, so the burden on nurses can be significantly reduced.

In addition, when displaying the alarm content for paging in text on the liquid crystal display section 34 of the handset 7, the drug name, other treatment name, pathological condition name, device abnormality name, etc. may also be displayed together. .

[Effects of the Invention] As explained above, according to the present invention, treatment items such as medication indicated in the treatment order can be transmitted to the nurse at the relevant time of the treatment by wireless signal, so the nurse can perform the treatment one by one. There is no need to be aware of the time, which reduces mental burden. This also has the advantage of ensuring that the instructions given in the treatment order form are carried out without error.Also, by sending back a treatment completion signal from the handset and handy terminal carried by the nurse, Since a progress chart is dynamically created on the central monitoring device side, nurses do not need to fill in the progress chart every time the treatment is completed, which greatly reduces the processing burden.

Furthermore, even if a clinical condition alarm or equipment alarm occurs, the alarm does not go off on the bedside monitor, but the alarm goes off on the central monitoring device and the handset carried by the nurse. Patients are freed from alarm pollution without any psychological adverse effects.

[Brief explanation of the drawing]

Fig. 1 is a block diagram showing an embodiment of the patient monitoring system according to the present invention, Fig. 2 is a block diagram of a central monitoring device constituting this patient monitoring system, and Fig. 3 shows how the central monitoring device communicates with slave units. Figure 4 shows the format of the alarm signal that is issued, Figure 4 shows the alarm screen displayed when there is an abnormality in the device or slave unit, Figure 5 shows the format of the slave unit operation confirmation signal, Figure 6 shows the format of the slave unit operation confirmation signal, and Figure 6 shows the format of the slave unit operation confirmation signal. Fig. 7 is a block diagram of the slave unit, Fig. 8 is a diagram showing the types of alarms, Fig. 9 is an operation flowchart of the patient monitoring system, Fig. 10
The figure is a diagram showing the flow of work related to drug administration. 1... Central monitoring device 2... Display device 3... Keyboard 4... Printer 5... Treatment instruction form editor 7... Slave device 8... Bedside monitor 17... Handy terminal 18...Test data terminal 19...Transmitting/receiving device 20...Control unit 24...
・Time-related alarm generation unit 24a...Time signal alarm generation unit 24b...Medication alarm generation unit 25...State recognition-related alarm generation unit 25a...Treatment instruction corresponding alarm generation unit 25b...
- Pathology alarm generation section 29...Device information system alarm generation section 31...Buzzer 32...Progress chart creation section 3
3... Handset operation confirmation section 34... Liquid crystal display section 35.
・・Buzzer 36・・Confirmation・Sochi 37・
... Treated transmission switch 38 ... Indicator light 39 ... CPU46 ...
・Receiving and sending agent Patent attorney Book 1) Takashi Figure 4 Figure 5 3A Figure 6

Claims (1)

[Scope of Claims] A central monitoring device into which data necessary for the treatment instructions indicated in the treatment instruction form is input; and a central monitoring device that monitors information on the patient's biological functions and the operating status of treatment equipment, and generates an alarm for the patient's medical condition when an abnormality occurs. a bedside monitor that sends a signal and an equipment alarm signal to the central monitoring device; an alarm generating means that generates an alarm in the central monitoring device upon receiving a disease state alarm signal or an equipment alarm signal from the bedside monitor; A call signal that is provided in the device and that corresponds to the treatment item based on the input data necessary for the treatment instruction is transmitted by radio signal at the relevant time of treatment, and a call signal that corresponds to the alarm when a disease state alarm or equipment alarm occurs. a transmitting means for transmitting a radio signal by a wireless signal; and a transmitting means carried by a nurse, which emits an alarm corresponding to the type of the paging signal when receiving a paging signal from the transmitting means, and after completing the treatment corresponding to the request of the paging signal. A handset that transmits a treatment completion signal to the receiving means of the central monitoring device, and a handy terminal that can input treatment instructions shown in the treatment instruction sheet stored in the central monitoring device and input that the treatment has been performed based on the instructions. and a progress chart creation means, provided in the central monitoring device, for creating a progress chart corresponding to a nursing record based on the treatment completed signal transmitted from the slave device and the treatment clear symbol transmitted from the handheld terminal. A patient monitoring system comprising: