JPH0994273A - Home visiting care supporting system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To support home visiting care by determining required nursing works quickly and adequately so that a visiting nurse can care for a patient adequately for a sufficient time. SOLUTION: A centralized control unit 1 of this home visiting care supporting system stores, in a concentrated manner, informations related to home visiting cares for a number of patients in a hard disk 6, where informations related to degree of self-support and associated nursing items are referred to and extracted from various types of stored informations related to home visiting cares, to have home visiting care informations for individual patients.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a home-visit nursing support device for assisting home-visit nursing care for elderly home patients, and in particular, it enables prompt and accurate identification of nursing content items performed by a nursing staff for home-visit nursing care. Technology for making decisions.

[0002]

2. Description of the Related Art As one of the measures to improve the medical welfare for home patients against the increase in the number of home patients who need home-visit nursing as the population ages, medical corporations, medical associations, and municipalities are the main business operators. There is a home-visit nursing station established by At the home-visit nursing station, while coordinating with hospitals and doctors, nursing staff (nurses, etc.) regularly visit home patients for a certain period of time (for example, about 2 hours) to provide necessary nursing care. Nationwide expansion has already started.

[0003] The staff in charge of nursing at the station makes a home-visit nursing application, a home-visit nursing instruction from the attending doctor, a chart, and a home-visit nursing plan (documents created by the regular nurse (person) at the station based on the home-visit nursing instruction). I receive a copy of the above, visit the home-patient according to the visit schedule decided at the home-visit nursing station, and select and implement appropriate nursing content items based on the received documents.

[0004]

However, it is normal that the same nursing staff constantly cares for one home patient, and that the nursing staff changes from beginning to end. Since it is difficult to select the optimal nursing content item due to the fact that the previous nursing content etc. are unknown and the nursing staff have to look through many documents each time, Since we are once again considering appropriate nursing content items, the time taken to select the nursing content items will result in a reduction in the time to actually carry out nursing.

In view of the above circumstances, the present invention supports home-visit nursing services so that the contents of nursing can be promptly and appropriately determined and the home-patient can be sufficiently cared for the contents of appropriate nursing. It is an object to provide a home-visit nursing care support device that does.

[0006]

In order to achieve the above-mentioned object, the present invention has the following configuration. That is, the present invention is an apparatus configured to support home-visit nursing services by providing a central management apparatus that centrally manages home-visit nursing-related information of a large number of home patients. , Memory means for storing at least the independence degree information indicating the degree of independence of each home-patient in daily life and the nursing content item group in the home-visit nursing performed for the home-patient as the home-visit nursing-related information; When extracting an appropriate nursing content item to give to each home-based patient, refer to the independence level information for the nursing content item related to the independence level information from the nursing content item group, And a nursing content defining means for defining optimal home care information.

[0007]

In the home-visit nursing care support apparatus of the present invention, the nursing content defining means of the centralized management device extracts in advance suitable nursing content items to be applied to each home patient from the nursing content item group stored in the memory means. It is provided to the nursing staff in the organized form of optimal home care information. When extracting a nursing content item by the nursing content definition means, this independence information is referenced for the nursing content item related to each home patient's independence information, which is useful for helping the home patient in their daily lives. Nursing content items (that is, low independence and needing help from a third party) are preferentially extracted, and optimal home care information includes nursing that has a high need for home patients in the nursing content item group. Content items are definitely included as information.

[0008]

Next, an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is a home-visit nursing support device according to an embodiment (hereinafter, abbreviated as “support device” as appropriate).
3 is a block diagram showing the overall configuration of FIG. FIG. 2 is a block diagram showing the configuration of the portable terminal device of the support devices. The home-visit nursing support device of the embodiment is a combination of a centralized management device 1 installed at a home-visit nursing station and a portable terminal device 2 that a nursing staff (nurse (person) etc.) possesses. Has become. Since one home-visit nursing station has a plurality of nursing staff, when the support device actually operates, one centralized management device 1 and a plurality of portable terminal devices 2 are combined.

The centralized management apparatus 1 is a personal computer (personal computer) 5 having a keyboard 3 as an input means and a TV monitor 4 (displaying a menu etc.) as an output means, a hard disk 6 as a storage means, and another. The printer 7 is provided as the output means of the printer and the communication interface is provided as the communication means. As a communication interface, an RS232C IF (not shown) capable of serial remote communication using a telephone line, a contactless communication IF box 8 such as optical communication or electromagnetic induction communication capable of high-speed communication although remote communication is not possible , IC card R / W capable of batch communication with IC card 10
There is 9. Of course, it is not necessary to have all these three communication interfaces, and only one of the above three communication interfaces may be provided.

The storage information file managed by the centralized management device 1 is as shown in FIG. That is, the hard disk 6 stores the information shown in (1) to (12) below. The hard disk 6 also stores an OS and a control program necessary for the operation of the centralized management device 1. (1) Patient-related file: Basic patient information for each individual [ID number, name, date of birth, address, area code, health insurance item, public expense item, municipality number, family item, medical history / medical history Matters, independence matters (sleepiness, movement,
Meals, dementia, etc.), visit frequency items, etc.] are included. FIG. 5 schematically shows an example of basic patient information.

(2) Personnel-related file: Basic personnel information for each individual [personnel number, name, address, occupation category (regular nurse, associate nurse, public health nurse, physical therapist, etc.), work form Items (full-time, part-time, work days, working hours, etc.)] are included.

(3) Facility-related file: This is the facility information of the visiting nursing station itself [business name, representative, name, location, business date and time, manager's name, founder, adjunct status, after hours, [Addition of holidays] is paid.

(4) Related organization related files: This section contains information about the information providing organization (public organization, etc.), nursing cost requesting organization (insurance organization, etc.), medical facility, etc. [I
D number, name, location, etc.] are stored.

(5) Patient diagnosis related file: Here, patient diagnosis information [patient name, injury / illness name, medical condition, treatment state, drug being administered, based on visiting nursing instruction of medical facilities, etc.,
Dementia status, worn medical device items, rehabilitation items, etc.] are stored.

(6) Home-visit nursing care plan related file: Here, home-visit nursing care plan information [nursing target,
Problems, nursing items, rehabilitation plans and goals, etc.] are stored.

(7) Schedule database related file: This is the basic information necessary for determining the visit schedule for home patients [station holidays and daily maximum number of visitors (monthly) and staff vacation days (monthly). ), The optimal visit interval mode based on the number of visits, etc.) are stored in the form of tables.

(8) Visit schedule related files:
This mainly stores a daily list of home-visit patients visited by each nursing staff, which is created from the necessary file information. FIG. 6 is a schematic diagram showing an example of a home-visited patient list.

(9) Care content candidate related file: This is a group in which a group of nursing content items, which are candidates for nursing content items to be implemented, are divided based on their content relationships [contents concerning physical condition, nursing Care contents, contents of rehabilitation assistance, contents of medical treatment, contents of instruction for caregivers, etc.] are separately arranged in the form of a table.

(10) Optimal home-care related files: Here, the optimal home-care information [contents relating to physical condition, nursing care content, rehabilitation assistance content] appropriate for each patient from the above-mentioned group of nursing content items , Contents of medical treatment, contents of guidance to carers] are paid for each patient.
FIG. 7 schematically shows an example of optimum home care information.

(11) Home-visit nursing record related file: This mainly stores the home-visit nursing record information that has been implemented. FIG. 8 schematically shows an example of home-visit nursing record information.

(12) Nursing fee-related files: Here,
The information (rate list, etc.) necessary to calculate the cost required for home-visit nursing care is stored.

Further, the centralized management device 1 has functions (means) necessary for centrally managing the home-visit nursing-related information of a large number of home patients. These functions mainly include the CPU of the personal computer 5 and the control program. That is, a data input function for fetching the information stored in the above various files from the keyboard 3 and the like, and referring to the necessary file information, a daily list of home patients to be visited by each nursing staff is defined (monthly). Nursing content defining function (which is a characteristic configuration of the present invention) for defining optimal home care information for each patient by extracting a nursing content item suitable for giving to each home patient from the function and nursing content item group Equipped with necessary functions (information provision for home-visit nursing, business report for designated elderly home-visit nursing, etc.), function for making invoices / statements for completed home-visit nursing, print function for printing necessary documents, etc. In addition to the information transmission function of transmitting necessary information in the file to the portable terminal device via the communication means, the portable terminal device is added to the home-visit nursing record related file. It is provided with a receiving storage function for receiving and storing visiting nursing record information that is al transmitted.

The portable terminal device 2 includes a touch-type input pen 1
1, a touch-type input pen 1 is provided for the control CPU 15.
1 and a liquid crystal display panel 12 are connected via a liquid crystal driving / input IF 14 and a signal bus BUS, and an on-board memory 13 is connected via a signal bus BUS.
Further, the control CPU 15 has three communication interfaces for two-way communication means for performing transmission / reception with the centralized management device 1, that is, an IC card IF1.
6, IF17 for non-contact communication, IF18 for RS232C for remote communication using a telephone line, and IF1 for a printer as an interface for transmitting signals to an appropriate external printer 20 or the printer 7 of a visiting nursing station.
9 is also connected to the CPU 15 via the signal bus BUS. Of course, it is not necessary to have all three communication interfaces, and only one may be provided. The above-mentioned input means and output means are mainly composed of a control program for controlling the operation of the CPU 15 and the apparatus.

As shown in FIG. 1, the modem (modulator / demodulator) 21 of the visiting nursing station and the modem 2 on the nursing staff side.
Information can be exchanged with each other by connecting the central control device 1 and the portable terminal device 2 to each other via a public line. By the information transmission function of the centralized management device 1, the mobile terminal device 2 side is scheduled to be visited in addition to a predetermined number of days (for example, January) of the latest home visit patient list of each nursing staff The latest basic patient information, the latest patient diagnosis information, the latest home-visit nursing care plan information, the latest optimal home care information, and the necessary portion of the home-visit nursing record information (previous visit nursing record information and five-day vital signs) (Body temperature, weight, blood pressure,
Respiration, pulse, etc.) are transmitted and stored in the onboard memory 13 of the portable terminal device 2. The files stored in the onboard memory 13 are as shown in FIG. In the case of exchanging information by contactless communication, bidirectional communication is executed via the contactless communication IF box 8 and the contactless communication IF 17. Although it is necessary to bring the portable terminal device 2 to the visiting nursing station, communication can be performed at high speed.
When exchanging information with the IC card 10, bidirectional communication is executed via the IC card R / W 9 and the IC card IF 16. The IC card 10 itself is relatively expensive,
Communication can be performed without bringing the portable terminal device 2 to the visiting nursing station.

In the portable terminal device 2, the liquid crystal display panel 1
By operating the touch screen input pen 11 on the 2nd screen, daily home visit patient list, basic patient information, patient diagnosis information, visiting nursing plan information, previous visiting nursing record and vital signs for about 5 days (graph display) It may be displayed) and may be displayed on the screen of the liquid crystal display panel 12 at any time. Nursing staff, in particular,
By displaying and checking the optimal home care information and the previous home-visit nursing record on the screen of the liquid crystal display panel 12, the content of actual nursing care (content of care) can be accurately and promptly determined,
Adequate care can be given to patients.

When the home care is completed, the visiting nursing record of this time is input to the portable terminal device 2 by operating the touch input pen 11. The input visiting care record of this time is transmitted to the centralized management device 1 and is stored and stored in the visiting care record related file by the reception and storage function of the centralized management device 1. This completes the home-visit nursing service for one home patient.

Next, the configuration related to the optimal home care information, which is a feature of the present invention, will be specifically described. As a configuration related to the optimal home care information, first, a care content candidate related file, an optimal home care related file, and a nursing content defining means are first mentioned. In general, the nursing content definition means extracts appropriate nursing content items from the group of nursing content items in the care content candidate related file to give to each home patient, based on the patient's personal information. The optimal home care information is defined for each patient and stored in the optimal home care related file, which will be described in more detail below.

Nursing content item groups in the care content candidate related file, which can be said to be a database, are physical condition item groups shown in FIG. 9, nursing care item groups shown in FIG. 10, rehabilitation assistance item groups shown in FIG. 11, and FIG. It is composed of a total of 5 subgroups of the medical treatment item group shown and the caregiver guidance item group shown in FIG. 13, and is set in the form of a table in the care content candidate related file when the operation of the device is started. (It can be changed if necessary) and stored. And
Another database can be said to be the degree of independence information shown in FIG. 14, that is, the information indicating the degree of independence of each home patient in daily life. It is also stored as a part of the basic patient information in the patient-related file.

On the other hand, as shown in FIG. 15, the nursing content defining means assigns each home patient from the nursing content item group based on the patient basic information, the patient diagnosis information, and the visiting nursing care plan information which are the personal information of each patient. Extract appropriate nursing content items for each patient. The item codes assigned to each nursing content item are used as an index to check and extract correspondences (such as the presence or absence of a doctor's instruction) with related items in each item of basic patient information, patient diagnosis information, and visiting nursing care plan information. The suitability of is judged. However, how to extract from each item group is
As described below, it depends on the nature of each item group.

For the physical condition item group, all items are virtually unconditionally extracted. The nursing care item group is extracted based on patient basic information, visiting nursing plan information, and independence level information. The rehabilitation assistance item group is extracted based on patient basic information, patient diagnosis information, visiting nursing plan information, and independence level information. The medical treatment item group is extracted based on the basic patient information and the patient diagnosis information. For the caregiver guidance item group, basic patient information,
It is extracted based on the patient diagnosis information and the visiting nursing care plan information. In addition, the independence level information may be extracted from the patient basic information and may be extracted and attached as reference information as it is.

Further, in the case of extracting the nursing care item group and the rehabilitation assistance item group, the rank of the independence degree information of 3 or less (low independence) is extracted, and the extraction is also appropriate from other information. Therefore, items for which a plurality of pieces of information are suitable for extraction are extracted as first priority items with special distinction, and items that are not so extracted are assigned as priorities as second priority items. Correspondence relationships between each item of the nursing care item group, the rehabilitation assistance item group, and the item of independence information are shown in FIGS. 10, 11, and 14, respectively. Items that are low in patient independence cannot be performed by the patient himself,
It becomes an important nursing item, and the significance of being referred to is very great. In particular, since the items that require nursing care from other information are the most important nursing items, distinguishing them from other items as the first priority item is very meaningful in implementing appropriate home-visit nursing care.

The optimal home care information thus defined is stored in the appropriate home care related file. Figure 7
Is a schematic representation of an example of optimal home care information. It is also possible to print and output the optimal home care information on the paper with the printer 7, the content relating to the physical condition, the content of nursing care, the content of rehabilitation assistance, the content of medical treatment, the content of guidance for the caregiver, and the independence information. Is. The optimum home care information stored in the suitable home care related file is used as described above. Further, the optimal home care information may be used to create a visiting nursing record. From the optimum home care information, the items that have not been implemented are deleted, and the added items are input and added as the visiting nursing record.

Next, FIG. 16 showing the flow of the defining operation and FIG. 17 showing the flow of the visiting nursing will be described for the defining operation of the optimum home care information by the apparatus of the embodiment and the visiting nursing work using the visiting nursing support apparatus. It will be explained with reference to FIG.

First, the operation of defining the optimum home care information will be described. [Step SA] At the visiting nursing station, when starting the operation of the visiting nursing support device, each nursing content item group is set and stored. That is, a physical condition item group that can be called a database, a nursing care item group, a rehabilitation assistance item group, a medical treatment item group, and a caregiver guidance item group,
It is entered in the table of care content candidate related files.

[Step SB] When an application for home-visit nursing is made by a home-based patient, patient basic information (independence level information is stored as personal information of the patient based on the home-visit nursing application form, the doctor's medical certificate, and the home-visit nursing instruction form). (Including), patient diagnosis information and home-visit nursing care plan information are input / stored in respective files.

[Step SC] At the stage where the necessary data has been input and stored, the home-visiting nursing support apparatus uses the item codes attached to the respective nursing content items as an index to generate basic patient information (including independence information). ), Examine the correspondence with the related items in each information of the patient diagnosis information and the visiting nursing care plan information, and extract the appropriate items to define the optimal home care information,
Store in appropriate home care related files.

Next, a series of flow of visiting nursing work will be described. [Step S1] The person in charge of nursing goes to the visiting nursing station and connects the portable terminal device 2 he / she has to the centralized management device 1.

[Step S2] By performing an operation of inputting a nursing staff code and a password and a transmission instruction operation on the centralized management apparatus 1, the nursing staff will be able to obtain a predetermined number of days on the home-patient list for each day visited by the nursing staff. , Basic information of each patient, diagnosis information, visiting nursing care plan information, optimal home care information,
Necessary information such as home-visit nursing record information is stored in the mobile end device 2.

[Step S3] The nursing staff goes to the first patient's home in the visit list.

[Step S4] The nursing staff who arrives at the patient's home displays and examines the optimal home care information and visiting nursing record information transmitted to the portable terminal device 2, and
Nursing content (care content) to be carried out by looking at the actual condition of the patient
To determine.

[Step S5] The person in charge of nursing conducts nursing care for the patient at home with the determined care content.

[Step S6] After carrying out nursing,
After inputting the visiting care record information of this time to the portable terminal device 2, the visiting care record information of this time is transmitted to the central control device 1 using the telephone line (this transmission is done at the end of the day. You may go together).

[Step S7] If there is another person who is scheduled to perform nursing care on that day, the process returns to step S3. If there are no more people scheduled to care for that day, the home visit service for that day is complete.

[Step S8] If the portable terminal device 2 still has a home-visit nursing list for the next day, the steps from step 3 onward are repeated on the next day. If the portable terminal device 2 does not have a home-visit nursing list for the next day, one cycle of home-visit nursing work will be completed (again, the central management device 1
Will receive more information).

The present invention is not limited to the above embodiment, but can be modified as follows, for example. (1) In the above embodiment, the mobile terminal device is provided. However, another embodiment is one in which the mobile terminal device is not provided. In this case, the minimum home care information is provided to the nursing staff in the form of, for example, being printed out on paper.

(2) Needless to say, information other than those exemplified in the embodiment may be used as the types of nursing content item groups, independence level information, and patient personal information.

[0047]

According to the home-visit nursing support system of the present invention,
Since the nursing content information of home patients is provided to the nursing staff in the form of optimal home care information defined based on the patient's personal information that takes into account the degree of independence of the patient, the nursing staff does not need to spend time and accurately As a result of being able to determine the contents of care to be given to the patient, it is possible to perform appropriate nursing for the home patient for a sufficient time.

[Brief description of drawings]

FIG. 1 is a block diagram showing an overall configuration of a home-visit nursing support system according to an embodiment.

FIG. 2 is a block diagram showing a configuration of a portable terminal device of the support devices of the embodiment.

FIG. 3 is a schematic diagram showing a file structure in a hard disk of the centralized management device.

FIG. 4 is a schematic diagram showing an example of information stored in a memory mounted on a mobile terminal device.

FIG. 5 is a schematic diagram showing an example of patient basic information.

FIG. 6 is a schematic diagram showing an example of a home-visited patient list.

FIG. 7 is a schematic diagram showing an example of optimum home care information.

FIG. 8 is a schematic diagram showing an example of visiting nursing record information.

FIG. 9 is a schematic diagram showing an example of a physical condition item group.

FIG. 10 is a schematic diagram showing an example of a nursing care item group.

FIG. 11 is a schematic diagram showing an example of a rehabilitation assistance item group.

FIG. 12 is a schematic diagram showing an example of a medical treatment item group.

FIG. 13 is a schematic diagram showing an example of a caregiver guidance item group.

FIG. 14 is a schematic diagram showing an example of independence level information.

FIG. 15 is an explanatory diagram showing a relationship between files when defining a nursing content item.

FIG. 16 is a flowchart showing a flow of defining optimal home-care information.

FIG. 17 is a flow chart showing a flow at the time of performing home-visit nursing.

[Explanation of symbols]

 1 ... Centralized management device 5 ... PC 6 ... Hard disk

Claims (1)

[Claims] 1. A device configured to support home-visit nursing services by providing a central management device for centrally managing home-visit nursing-related information of a large number of home patients,
The centralized management device stores at least the independence degree information indicating the degree of independence of each home-patient in daily life and the nursing content item group in home-visit nursing performed on the home-patient as home-visit nursing-related information; When extracting appropriate nursing content items to give to each home patient from the content item group, refer to the independence level information for the nursing content items related to the independence level information in the nursing content item group. According to the above, the home-nursing support device is provided with nursing content defining means for defining optimal home-care information for each patient.