KR20120040900A - Decision support method and ststem for abnormal sign of elderly patients - Google Patents

Abstract

PURPOSE: A decision making support method according to strange symptoms of old people and system thereof are provided to manage the condition change of old people by enabling a nurse to accurately select a mediation method. CONSTITUTION: Circumstances information is inputted according to condition strange symptoms of a patient(S10). The condition strange symptom of the patient is determined by extracting treatment standard matched with the inputted circumstances information(S20). The treatment information matched with the circumstances information and the determined condition strange symptom is outputted(S40). Nursing mediation information matched with the circumstances information or the determined condition strange symptom is outputted(S50). The condition of the patient is evaluated by using the nursing mediation information(S60).

Description

DECISION SUPPORT METHOD AND STSTEM FOR ABNORMAL SIGN OF ELDERLY PATIENTS}

The present invention relates to a decision support system and method according to the elderly vital signs abnormalities, more specifically, the vital signs abnormalities of the elderly who can easily select the appropriate intervention by contacting expert knowledge when the abnormal changes in vital signs of the elderly The present invention relates to a method and system for managing change, and to a method and system for supporting decision-making according to the vital vital symptoms of the elderly that can assist the nurses working at the elderly hospitals to correctly cope with the abnormal symptoms of the elderly. .

In addition to the recent increase in life expectancy, the rapid aging of the elderly has not only become a major social problem in the aging society, but it is expected that the necessity and importance of the elderly's health care will continue to grow in the future. It is expected that it will form a major demand group for the welfare service for the aged because it is not good and the dependency on living is very high. Therefore, the government has been operating the long-term care insurance system since 2008 to reduce the burden of increasing elderly care and prepare for entry into aging society.The institution provides various services to the elderly who need such care. In 2009, about 2016 facilities were opened.

According to the study, 74.2% of the elderly living in facilities are dementia elderly, 17.0% of strokes, 8.8% of hypertension, 4.4% of degenerative arthritis, and 1 most dependent on current long-term care insurance. Considering that class and level 2 subjects are limited to the elderly living in the institution, it is predicted that the primary patient group in the nursing home will be a patient with chronic disease or already deteriorated condition. At this point, the management of physical abnormalities informing the deterioration of the elderly is not only the management of chronic diseases of the elderly, but also the emergence of acute illnesses that are combined with the underlying diseases, aging, and reduced physical reserves. Nursing area. As a result, elderly nursing homes are expected to expand in the future, and nursing knowledge bodies on the management of quality of nursing care for the elderly are more necessary.

Nevertheless, according to Article 22, Paragraph 1 of the Elderly Welfare Act, the number of nurses is one for every 25 residents and one for a referral is based on the staffing criteria of 30 or more residents. The nurse, a medical practitioner responsible for symptomatic management and assessment and management, suffers from an absolute lack of practical personnel to respond and respond appropriately to changes in the elderly's condition, as well as a lack of relevant knowledge to manage the emergency of the elderly. It is expected to be.

First of all, the condition change of the vital signs of the elderly is a sign of a tragic event or changed by the consequences of the overlapping disease, treatment plan, history and weakness and other characteristics of the existing elderly's chronic diseases (Justin, Ethel & Sandi, 2008). Symptoms that indicate a change in the state of the elderly have distinctive clinical manifestations or atypical clinical manifestations that are found in younger patients. Thus, emergency and vital signs abnormalities mean physical or physical conditions that have not been diagnosed or recognized as needing further intervention, and that nursing care in these circumstances is based on the underlying disease characteristics of the elderly, underlying diseases and acute illnesses. Correlations, different ages require different body structures, disease processes, and multidimensional knowledge of different situations.

Therefore, the clinical experience and knowledge of prompt treatment and timely intervention and evaluation of dysfunction of vital signs that require emergency according to the management of dysfunction of vital signs of the elderly nurse will be an important resource for the quality of patient management. This will be a key indicator that will be used to continuously manage the patient's condition, including symptom management, cause management and emergency room evacuation, and hospice preparation. Therefore, the knowledge body on the decision-making of nurses who are practitioners in senior nursing homes is the main management category that can effectively link the medical facilities that manage severe patients with the aged nursing homes as housing and management facilities. It can be a basic and essential knowledge body, and in some cases, if the elderly living in the facility dies in the facility, it should manage the change in the vital signs of the elderly until the management of the dying signs.

With the recent development and specialization of medicine, medical knowledge has been further refined, and new and diverse diagnosis and treatment methods have been developed, requiring high medical expertise in disease management. As a result, research on decision support systems is underway as a way to share and utilize advanced expertise. Therefore, the characteristics of the manifestation of senile disease are multi-symptomatic and multiple, and the ambiguity of aging and underlying disease is complained, nonspecific and atypical manifestations, chronic complications and multi-drug use, senescence and homeostasis disorders, and righteousness. Considering the high incidence of complications and sequelae due to the disease, as a result, the need for first aid due to the extension of hospitalization rate and the change of consciousness according to the general recovery function of the elderly is the A knowledge body that manages symptoms. It is a knowledge area that requires the development of decision support systems.

Therefore, the management of vital signs and abnormal change of elderly living in the elderly nursing homes is an important part that cannot be overlooked by nurses. The results may vary depending on how the medical personnel make decisions and conduct the intervention. In particular, ambiguous and atypical symptom expression of elderly patients can complicate the elderly's health care decision-making, and improper assessment and intervention of the elderly's vital signs and abnormalities are related to improper evaluation and intervention. Misconducting and mediating the changes in the elderly vital signs of the elderly, the factors of the evaluation and the expression of ambiguous and vague state changes of the elderly have caused nurses to accurately assess the status changes due to the abnormal changes in the vital signs of the elderly. The difficulties and the various methods of health care mediation of the elderly according to the nurses, and the lack of knowledgeable materials for selecting the appropriate intervention method, have been raised.

Therefore, in order to improve the quality of nursing care for the elderly living in elderly care facilities, the practice of developing expert systems to support decision-making through the assessment and diagnosis, intervention, and reevaluation of vital signs management in elderly patients in the medical environment. It is very important to identify the effects of settlement and application.

Accordingly, an object of the present invention is to solve such a conventional problem, to improve the quality of nursing care of the elderly living in an elderly care facility, assessment, diagnosis, and intervention of vital signs abnormality management in elderly care in a medical environment. In addition, it provides a decision support system and method according to the vital vital signs of the elderly who can establish the working system and find the application effect by developing an expert system that can support decision making through re-evaluation.

In order to achieve the above object, the present invention provides a decision support method according to the elderly vital signs abnormalities (a) input the assessment information according to the vital signs of the patient, (b) the operation module is matched with the input assessment information Extracting a diagnosis standard from a database to determine whether the patient has an abnormality in vital signs, (c) transmitting the ejaculation information and vital signs abnormalities to an output unit at an input unit, and (d) the prescription module of the output unit is the assessment information. (B) outputting a nursing diagnosis matched with vital signs or abnormalities, (e) outputting the nursing intervention matching the at least one selected item from the list of the nursing diagnosis outputs, and (f) the patient. Re-evaluating vital signs of the patient, and (g) storing patient assessment information and nursing intervention information in a database.

The step (b) of the calculation module extracting the diagnosis criteria matched with the input assessment information from the database to determine whether the vital signs of the patient is abnormal, the initial evaluation process of abnormal symptoms, problems associated with the change of vital signs abnormality Characterized in that the process, process decision process and the initial symptoms of abnormal symptoms, including the evaluation of vital signs, evaluation of consciousness, evaluation of everyday life patterns, blood sugar check, physical examination.

Evaluation of the vital signs is made in the calculation module by extracting the diagnostic criteria from the database, specific diagnostic criteria are pulse 60 to 100 (times / minute), body temperature 36 ℃ to 37.2 ℃, breathing 12 to 20 If the vital sign evaluation item is within the diagnosis criteria, the vital sign evaluation is determined to be normal.

The evaluation of the consciousness is characterized by judging whether the patient is normal or abnormal by observing the eye opening reaction, speech response or motor response.

The open eye reaction is characterized in that whether the patient is normal or abnormal by judging whether the eyes open spontaneously open, call eyes open, pain stimulation eyes open, eyes not open at all. It is characterized by determining whether the patient is normal or abnormal by judging whether there is history of history, conversation is confusing, language use is wrong, whether there is no understanding, or there is no reaction at all. To determine whether the patient is normal or abnormal by evaluating whether it moves according to the instructions, indicates the pain area, actively avoids the pain stimulus, whether there is an abnormal flexion reaction, an abnormal kidney reaction, or no reaction at all. It features.

The evaluation of the daily life pattern is characterized by determining whether there is a change in meal volume, posture change, limited movement, gait change, sleep pattern based on the personal information stored in the database. The check is characterized in that fasting blood sugar is 80 to 110mg / ㎗, blood sugar within 2 hours after a meal is determined to be normal blood sugar when 80 to 140mg / ,, the physical examination, medical history, skin changes, joint abnormalities , Fractures, body pain, oral pain, general weakness, bowel movements, urine abnormalities, gastrointestinal traits.

The problem situation linkage caused by the abnormal change in vital signs is a problem situation of a patient currently occurring due to an abnormal symptom, and includes a process of assessing the current state of the patient such as asphyxiation, falls, fractures, hypoglycemia, and loss of consciousness. The information related to the treatment decision may include determining the cause of the symptom, whether it is unknown or whether there is a risk of recurrence, and determining whether it can be managed in the facility. It features.

Re-entering ejaculation information according to abnormal vital signs of the patient if the patient's condition is not improved or worsened as a result of the re-evaluation; Extracting diagnosis criteria matched with the ejaculation information re-entered from a database to determine whether vital signs are abnormal in a patient; Transmitting, by an operation unit, to the output unit whether the reentered ejaculation information and vital signs are abnormal; The output module prescribing module outputs a nursing diagnosis list matched with the reevaluation information and vital signs; The prescription module outputs a nursing intervention matched with at least one item re-selected from the output list of the nursing diagnosis; Reassessing vital signs of the patient; And storing the patient's re-evaluation information and nursing intervention information in a database.

In addition, in order to achieve the above object, the decision support system according to the present inventors vital signs abnormality to access the patient's information through the login information on the system and match the assessment information and diagnostic criteria to determine whether the vital signs abnormalities Judgment module, input interface, the input unit including the input device, the database including the personal information storage area, assessment information storage and diagnostic criteria storage area, nursing diagnosis and nursing intervention storage area, assessment information transmitted from the input unit, vitality And an output unit including a prescription module, an output interface, and an output device for extracting an abnormal response action history matched with a symptom abnormality from the database.

The assessment information, which is the basis for determining whether the vital signs are abnormal by matching the diagnostic criteria in the calculation module, includes information related to initial evaluation of abnormal symptoms, connection of problems due to abnormal changes in vital signs, and information related to treatment decision. The initial evaluation of abnormal symptoms may include evaluation of vital signs, evaluation of consciousness, evaluation of everyday life patterns, check of blood sugar, physical examination.

The evaluation of the vital signs is made in the calculation module by extracting a diagnostic criterion from the database, and if the diagnosis is within the diagnostic criteria, the vital sign evaluation is determined to be normal. It is characterized by determining whether the patient is normal or abnormal by observing the response or exercise response, and the evaluation of the daily life pattern is based on the personal information stored in the database, changes in meal volume, change in posture, limited It is characterized by determining whether there is a change in movement, gait change, or sleep pattern.

The blood sugar check is characterized in that the fasting blood sugar is 80 to 110mg / ㎗, 2 hours after meals when the blood sugar is 80 to 140mg / 정상, characterized in that the normal blood sugar, the physical examination is a history of changes in skin, skin , Joint abnormalities, fractures, body pains, oral pains, general weakness, bowel movements, urine abnormalities, gastrointestinal relationships, characterized in that the problems associated with the changes in vital signs abnormal symptoms As a result of the patient's current problem, it is characterized by the current state of the patient, such as choking, falls, fractures, hypoglycemia, loss of consciousness.

The information related to the treatment decision includes determining whether the cause of the symptom is obvious, whether it is unknown or whether there is a risk of recurrence, and determining whether it can be managed in the facility. The abnormal response action history in the output unit may include a nursing diagnosis connected to the diagnosis information based on the assessment information according to the vital symptom abnormality inputted from the input module, and a nursing intervention matched with the nursing diagnosis.

The prescription module extracts information on nursing diagnosis matched with the assessment information and vital sign abnormality transmitted from the input module from the database, and provides nursing intervention matching at least one selected from the list of the extracted nursing diagnosis. And extracting from the database and transmitting the extracted information to the output device, wherein the prescription module stores the processing history of the patient input after the treatment for the vital signs abnormal patient by providing nursing intervention in the database through the output interface. It is characterized by.

The prescription module reevaluates the vital signs of the patient by reflecting data related to improvement of consciousness, blood glucose stability, blood pressure stability, pulse stability, breathing stability, and temperature stability after nursing intervention. After reevaluating the vital signs, the data of the patient's treatment results are checked and stored in the database through the output interface.

According to the present invention, a research result having high applicability to the field by providing an infrastructure for managing the change of the vital signs of the elderly, in which the nurse can easily contact the expertise of the management of the abnormal symptoms of the vital signs in the elderly nursing facility, and select an appropriate intervention. Can be calculated, and the efficiency of nursing work can be improved.

In addition, the quality of the elderly nursing facility is improved and the synergy effect with the present invention can be expected as the information system is introduced in the nursing area of the elderly nursing facility.

In addition, the decision support method and system for management of abnormal change in vital signs of elderly patients can improve the supply of human resources by managing a small number of nurses efficiently in the evenings of nursing facilities where doctors do not reside. Knowledge can be used to manage the elderly.

Figure 1 is a flow chart of the decision support method according to the present inventors vital signs abnormality.
2 is a flowchart of input of ejaculation information according to abnormality of vital signs.
Figure 3 is a block diagram of a decision support system according to the present inventors vital signs abnormality.
Figure 4 is a block diagram showing the relationship between the components of the decision support system according to the present inventors vital signs abnormal.
5 is a view showing the main screen of the decision support system according to the elderly vital signs abnormal.

Hereinafter, specific embodiments of the present invention will be described in detail with reference to the drawings.

Figure 1 is a flow chart of the decision support method according to the present inventors vital signs abnormality. The present invention is a method and system for determining the abnormality of the patient's condition (with or without vital signs) to check and manage every day under specific diagnostic criteria, and a method and system that can be applied to a patient who has a problem caused by abnormal vital signs.

As shown in FIG. 1, in the decision support method according to the vital signs of the elderly, inputting the assessment information according to the abnormal symptoms of the vital signs of the patient (S10), and the calculation module matches the diagnosis criteria matched with the input information. Determining whether or not the vital signs of the patient is extracted from the step (S20), the step of transmitting the ejaculation information and vital signs abnormalities in the output unit (S30), the output module of the prescription module the assessment information, vital signs abnormalities Outputting the nursing diagnosis matched with whether (S40), the prescription module outputs the nursing intervention matched with at least one selected item from the list of the nursing diagnosis output (S50), and vital signs of the patient Re-evaluating (S60), and storing the patient's ejaculation information, nursing intervention information in a database (S70).

2 is a flowchart of input of ejaculation information according to abnormality of vital signs.

As shown in FIG. 2, the step of inputting the assessment information according to the vital signs abnormalities of the patient includes an initial evaluation of abnormal signs (S21), a connection of problems due to abnormal symptoms of vital signs (S22), and a treatment decision process (S23). Enter the patient's information to go through.

When the assessment information is input (S10), the calculation module extracts a diagnosis criterion matched with the input assessment information from a database and determines whether vital signs of the patient are abnormal (S20).

The initial symptom of abnormal symptoms includes vital signs evaluation, consciousness evaluation, daily life pattern evaluation, blood glucose check, physical examination, and when information on vital signs evaluation is input, diagnosis criteria matched with vital signs stored in the database. It is determined whether the abnormality of the vital signs of the patient by extracting the information, and if the information on the evaluation of consciousness, evaluation of everyday life, blood glucose check, physical examination is input, it is determined whether or not abnormality according to the diagnostic criteria.

The vital sign evaluation is made in the calculation module. Table 1 shows the items used as diagnostic criteria for vital sign evaluation stored in the database. As shown in Table 1, the systolic, diastolic blood pressure, pulse, body temperature, respiration, dyspnea, oxygen saturation, and arterial blood gas analysis are performed. If the diagnosis is not within the numerical range of normal judgment, vital signs are evaluated as abnormal.

Checklist Normal judgment numerical range Diagnosis Systolic blood pressure (times / minute) 150 < High blood pressure 90> Hypotension Diastolic blood pressure (times / minute) 100 < High blood pressure 60> Hypotension Pulse rate (times / minute) 100 < Tachycardia 60> Bradycardia Body temperature (℃) 38.3 < Solid temperature 37.8-38.2 Moderate heat 37.3-37.7 Low fever 36.0-37.2 normal 35.9> Hypothermia 35-32.2 Hardness <32.2-28 Moderate <28 Severe Breathing (times / minute) 20 < Empty breath 12> Shortness of breath 12 to 20 normal Dyspnea Yes No Oxygen Saturation (%) 93 < normal 92> Lack of oxygen Arterial blood gas analysis Normal / above pH 7.34-7.45 Normal / above PaO2 80-100 mmHg Normal / above PaCO2 34-45 mmHg Normal / above HCO3 22-26 mmEq / L Normal / above

The evaluation of the consciousness classifies the level of consciousness to discriminate clarity, lethargy, chaos, confusion, semicolon, and coma. In particular, the patient's eye, speech, and motor responses are specifically quantified to determine whether they reach a certain level or not, and determine whether they are normal or abnormal.

Table 2 is a table that specifically shows the evaluation items for the consciousness, whether they responded, and the values according to the responses.

domain reaction score Open eye reaction
spontaneous Open the eyes voluntarily 4 to voice Call out to open my eyes 3 to pain I open my eyes to pain stimulus 2 no response Do not open your eyes at all. One Speech oriented There is a long history. 5 confused The conversation is confusing. 4 inappropriate The language usage is wrong. 3 inconprehensive Say something I don't understand. 2 no response No response at all One Exercise response obey command Move according to instructions 6 localize Point out the pain area. 5 withdrawal Actively avoid pain stimulation. 4 abnormal flexion Abnormal flexion reaction 3 abnormal extension Aberrant extension 2 no response No response One

The patient's state of consciousness is examined to determine whether the state of consciousness is normal or abnormal by examining whether the patient's consciousness is above or below the standard score.

For example, if the diagnostic criteria for the patient's consciousness state are set to 3 eye opening reactions, 4 language reactions, and 5 exercise reactions, and one of the items is below the reference score, an abnormal indication is displayed for the patient's consciousness. Done. Eventually, abnormalities occur in the vital signs of the patient due to abnormal consciousness. This criterion is different for each patient. In other words, according to observation records from the time of hospitalization or in the past 3 to 5 days, it may be 2 points in the open eye reaction, 3 points in the verbal reaction, or 3 points in the motor reaction. The system will indicate that the signs have improved and store them in the database.

The pattern change for everyday life determines whether it is normal or abnormal by a change in meal amount, a change in posture, a limited movement, a change in a pedestrian path, and a change in a sleep pattern.

The database monitors the changing situation on a daily basis and compares the input and stored information with all behavioral patterns and life patterns in the patient's daily life. By comparing the patterns up to 3 days ago, based on the evaluation of vital signs, whether there was a change in the amount of meal, lying, sitting, standing, and movement slowed compared to the previous 3 days. In addition, it is determined whether the pattern changes in daily life based on the data that monitors changes in sleep time and sleep behavior as well as changes in pedestrian posture and changes in sleep patterns.

The blood glucose check determines whether or not hypoglycemia and hyperglycemia based on the criteria in Table 3 below.

division standard Fasting Blood Sugar 80-110mg / dl Blood sugar within 2 hours after eating 80-140mg / dl Hypoglycemia 60mg / dl or less Hyperglycemia 130mg / dl or more

The nurse checks the blood sugar every day and determines if the blood sugar is not within the standard range.

The physical examination includes changes in history, skin, redness, rash, eczema, abrasions, bedsores, fever, swelling, joint abnormalities, fractures, pain in the body, oral pain, general weakness, bowel movements, urine abnormalities. As a result of abnormal gastrointestinal tract, vomiting, loss of appetite, dietary change, complex increase, dehydration and binge eating are judged to be normal or abnormal.

After the initial evaluation process for abnormal symptoms, the process of linking the problems caused by abnormal changes in vital signs is carried out. Problems caused by abnormal symptoms of vital signs are classified as suffocation, falls, hypoglycemia, loss of consciousness, but it is desirable to be able to classify and input all possible problems. It is input for problem situations with high probability.

After the process of linking the problem situation due to the change of vital signs, the decision is made, which is the final step in determining whether the vital signs are abnormal, and the information related to the decision is determined whether the symptoms are obvious, whether they are unknown, or whether there is a risk of recurrence. It decides whether it can be managed in the facility, assesses whether emergency room evacuation is necessary and whether it is sufficient for management in the facility.

After initial evaluation of abnormal symptoms, linkage of problems due to abnormal symptoms of vital signs, and process of treatment results, if the abnormality of vital signs is judged according to the diagnostic criteria, the assessment information is input, and the input is judged from the input section to determine the vital signs. The information is passed through the step (S30) of transmitting vital signs or not.

The prescription module in the output unit outputs the nursing diagnosis matched with the assessment information and vital signs abnormality (S40).

The prescription module outputs the nursing intervention matched with at least one selected item from the list of the nursing diagnosis (S50). The information on the nursing intervention matched with the nursing diagnosis is stored in the database, and when one selected item from the list of nursing diagnosis is recognized by the prescription module, the matching nursing intervention information is extracted from the database and output.

After prescribing a patient with abnormalities in vital signs by nursing intervention information, the patient undergoes a step of re-evaluating vital signs of the patient (S60). The reevaluation of vital signs is judged on whether consciousness improves, blood sugar stabilization, blood pressure stabilization, pulse stabilization, respiratory stabilization, and temperature stabilization. Reentry information is entered again to enter information, and vital signs based on the redemption information, nursing diagnosis, and nursing intervention process.

If the patient's condition is improved or determined to be in a normal state as a result of nursing intervention, the assessment information and nursing intervention information are stored in a database (S70), and a report is output.

Hereinafter, the decision support system according to the vital signs of the elderly will be described.

Figure 3 is a block diagram of a decision support system according to the present inventors vital signs abnormality. As shown in FIG. 3, the present invention provides a calculation module 120 that allows access to patient information through login information on the system, and determines whether vital signs are abnormal by matching ejaculation information and diagnostic criteria, and an input interface. 130, an input unit 100 including an input device 110, a personal information storage area 210, an assessment information storage and diagnosis reference storage area 220, and a nursing diagnosis and nursing intervention storage area 230. Prescription module 320, output interface 330, output device for extracting the database 200, the ejaculation information transmitted from the input unit 100, the abnormal reaction action history matched with vital signs abnormality from the database 200 It includes an output unit 300 including a 310.

The input unit 100 inputs the login information on the vital signs abnormal patient to read the information on the patient, and receives the ejaculation information according to the vital signs abnormalities to transmit to the output unit 300. do. Here, the login information may be used as login information by selecting a specific item of basic information, such as inputting a name and identification number only from the basic information of the patient or inputting an identification number and social security number. The selection of specific items can be set at the beginning of the system implementation or can be changed after implementation.

The assessment information according to the vital signs abnormalities processed by the calculation module 120 of the input unit 100 includes initial evaluation of abnormal symptoms, connection of problem situations caused by abnormal symptoms of vital signs, and information related to processing decisions. Here, the initial evaluation of abnormal symptoms may be divided into evaluation of vital signs, evaluation of consciousness, evaluation of everyday life patterns, check of blood glucose, and physical examination.

Among the information on the vital signs, problems related to abnormal symptoms of vital signs, which are the next step in the initial evaluation of abnormal signs, are problems occurring in patients with abnormal symptoms such as asphyxiation, falls, fractures, hypoglycemia, pneumonia, chest pain, Patient status checks include cardiac arrest, shock, postural hypotension, bleeding, confusion, fever, and loss of consciousness.

The information related to the treatment decision of the patient, which is the next step in taking over the problem due to the abnormality of the vital signs, is sent to the emergency room by determining whether the cause of the symptom is obvious, whether it is unknown or whether there is a risk of recurrence. Include checks to see if they are required and if on-site management is sufficient.

The database 200 includes personal information of patients with abnormalities of vital signs, such as basic information such as name, identification number, date of birth, social security number, height and weight, age, disease name, medical history, diagnosis, and prescription data. . In addition to the patient's personal information, the database 200 stores data on ejaculation information according to abnormal vital signs. In addition, information on the diagnostic criteria serving as normal and abnormal judgment criteria for the ejaculation information input by the input unit 100 is stored. Nursing diagnosis and intervention are stored, and information on nursing intervention is classified and stored to match with the nursing diagnosis inputted by the input unit 100.

The output unit 300 outputs an abnormal reaction action history stored in the database 200 by matching with the assessment information according to the vital sign abnormality input by the input unit 100. The abnormal response action history in the output unit 300 includes a nursing diagnosis connected to the diagnosis information based on the assessment information according to the vital symptom abnormality input from the input unit 100, and the nursing intervention selected by the nursing diagnosis. The prescription module 320 in the 300 passes through the nursing diagnosis and outputs and provides nursing intervention data matched with the selected nursing diagnosis from the database 200. After treatment for abnormal symptoms of vital signs by nursing intervention, the treatment history of the patient is saved in the database, and the data related to improvement of consciousness, blood sugar stability, blood pressure stability, pulse stability, respiration stability, and temperature stability are reflected. To reevaluate the patient's vital signs.

Figure 4 is a block diagram showing the relationship between the components of the decision support system according to the present inventors vital signs abnormal. As shown in FIG. 4, when the user inputs login information related to the patient to the input unit 100, the patient information related to the login information is matched to the personal information storage area 210 stored in the database 200. You will be logged in to. ③ If the login is successful, the personal information of the patient will be read on the system. ④ Entering the various ejaculation information of the logged-in patient ⑤ The input unit 100 stores the ejaculation information in the ejaculation information storage and diagnosis criteria storage area of the database 200, and ⑥ abnormality of vital signs by matching with the pre-stored diagnosis criteria. Determine. (7) The input unit (100), which determines the abnormality of the patient's vital signs, transmits the patient's ejaculation information, the abnormality of the vital signs determined by the input module, and the judgment criteria to the output unit (300). Extracts the nursing diagnosis related to the various information about the patient received from the input unit 100 and provides a nursing intervention matched with the nursing diagnosis selected in the nursing diagnosis and nursing intervention storage area of the database ⑨ .

Hereinafter, a detailed system application example for the elderly vital signs patients with abnormal symptoms that occur due to a change in the vital signs caused a loss of consciousness as a problem situation.

5 is a view showing the main screen of the decision support system according to the elderly vital signs abnormal.

As shown in FIG. 5, by inputting the identification number "KMS1234", which is the login information, to the patient "Kim Mal-suk" who has an abnormality in the vital signs, gender, social security number, and age, which are personal information about the patient previously stored in the database. Data on weight, weight, height, and standard of living are provided. In addition, as an evaluation of vital signs, which is an item of initial evaluation of abnormal symptoms, information on systolic and diastolic blood pressure, pulse, and body temperature are input. If a check is made and one of the evaluation items mentioned in Table 1 deviates from the normal value, it is indicated as abnormal in vital signs evaluation, and the criteria determined by digitizing the data input from each item of consciousness evaluation mentioned in Table 2 Depending on the word, it is marked as alert, drowsy, confused, stupor, semi-coma or coma.

Similarly, the check for blood glucose mentioned in Table 3 evaluates the initial condition of the patient's abnormal symptoms according to the criteria stored in the database whether it is hypoglycemic, normal or hyperglycemic.

As the information on the vital signs, the information related to the abnormal symptoms of the vital signs is entered by clicking on the choking part, which is the problem state of the patient. Is it possible to manage the facility with a clear, persistent and recurrent risk ?, 3) Is the cause unclear and is a temporary symptom or is manageable at the facility? 4) The cause is unclear, persistent and recurrent It is determined that the facility can be managed in a dangerous state, and if yes to two or more items, it is managed in the facility, and if less than two items are YES, they are taken to the emergency room. You should see an indication that you should.

As the next step, the history of abnormal reaction measures, the nursing diagnosis provides on-screen initial diagnosis of abnormal symptoms, linkage of problems caused by abnormal symptoms of vital signs, and nursing diagnosis items that match the data entered in the treatment decision. In case of loss, the items of nursing diagnosis are ⅰ) trauma risk ii) inefficient tissue perfusion, ⅲ) airway aspiration risk, ⅳ) chronic chaos, and ⅴ acute chaos. If the nurse selects the appropriate item for the patient's condition, the intervention contents are specifically printed in the nursing intervention item. Table 4 shows the nursing interventions that are output when selecting inefficient tissue perfusion.

Nursing Diagnosis Nursing intervention Inefficient Tissue Perfusion Cardiopulmonary
1. Monitor and record hourly until the patient's vital signs (heart rate, blood pressure, central venous pressure) stabilize.
2. Monitor the subject's skin color and body temperature every two hours to assess whether the skin is impaired.
3. Monitor the subject's breathing rate and sound.
4. Monitor the subject's deep heart rate for changes in heart rate and rhythm.
5. Subject will maintain oxygen therapy by prescription.
6. Encourage them to change their positions and work.
7. Encourage the subject to take frequent breaks.
8. Monitor creatine kinase, lactate dehydrogenase and arterial blood hydrolysis.

<Brain>
1. The neurologic assessment should be done every 1 to 2 hours every day, and every 4 hours once the subject is stable.
2. The vital signs are initially taken every 1 to 2 hours every day, and once the subject is stabilized, it is assessed every 4 hours.
3. The subject's temperature is measured every 4 hours.
4. Raise the subject's head 30 degrees.
5. Center the head of the subject.
6. If the glasgow coma scale of the subject is less than 10, the subject is overvented with a ventilator.
7. Monitor the three signs of cushing.
8. Quiet the person's environment. Calm down if necessary. Nursing activities are also performed at intervals.
9. If the subject's airway is dangerous, use an anti-nausea or aspirate the nasogastric tube.
10. Begin physical and work rehabilitation.
11. Maintain proper nutrition.
12. Maintain the function of the subject's bowel and bladder.
13. Monitor the subject's hematocrit and hemoglobin levels and report any abnormalities.
14. Know test values to protect subjects from infection.
15. Accurately measure the subject's intake and excretion.
16. Educate subjects and their families on how to minimize risk factors for inefficient tissue perfusion.
17. Administer the prescribed antagonist histamine2 receptor.

The nursing intervention history description is stored in the database and the patient's condition is re-evaluated after treatment according to the nursing intervention. Whether consciousness improves, whether blood sugar is stable, blood pressure stabilization, pulse stabilization, respiratory stabilization, and temperature stabilization are entered and the treatment results are entered. If the results of the reevaluation did not improve compared to the initial assessment, the initial evaluation of abnormal symptoms on vital signs is performed again to treat the patients with nursing intervention.

The scope of the present invention is not limited to the above-described embodiment, but may be embodied in various forms of embodiments within the scope of the appended claims. It will be understood by those skilled in the art that various changes in form and details may be made therein without departing from the spirit and scope of the present invention as defined by the appended claims.

100 Input Unit 110 Input Unit
120 Operation Module 130 Input Interface
200 Database 210 Personal Information Storage Area
220 Assessment information storage and diagnostic criteria storage area
230 Nursing Diagnosis and Nursing Intervention Storage Area
300 Output 310 Output
320 Prescription Module 330 Output Interface

Claims (22)

In the decision support method according to the vital signs of the elderly,
(a) inputting ejaculation information according to abnormal vital signs of the patient;
(b) extracting a diagnosis criterion matched with the assessment information inputted to determine whether the patient has abnormality in vital signs;
(c) outputting a nursing diagnosis matched with the assessment information and the determined vital signs abnormality;
(d) outputting nursing intervention information that matches at least one item selected from the list of the nursing diagnosis output;
(e) re-evaluating vital signs of the patient using the nursing intervention information; And
and (f) if the patient's condition improves or is determined to be normal, as a result of the re-evaluation, storing the assessment information and the nursing intervention information of the patient. .
The method of claim 1,
Step (b) is;
Decision support method according to the abnormal vital signs of the elderly, characterized in that it goes through the initial evaluation process of abnormal symptoms, the process of linking the problem situation caused by the abnormality of vital signs, and the treatment decision process.
The method of claim 2,
The abnormal symptom initial evaluation process includes an evaluation of vital signs, an evaluation of consciousness, an assessment of everyday life patterns, a blood glucose check, and a physical examination.
The method of claim 3,
The evaluation of the vital signs is determined if the vital signs evaluation items are within the diagnostic criteria, the decision support method according to the elderly vital signs abnormality.
The method of claim 3,
The evaluation of the consciousness is determined by observing at least one of the eye response, speech response and motor response to determine whether the patient is normal.
The method of claim 3,
The evaluation of the daily life pattern is based on the patient's personal information to determine whether there is a change in meal volume, posture change, limited movement, gait change, sleep pattern change according to the elderly vital signs abnormalities Decision Support Methods.
The method of claim 2,
The problem-linked process caused by the abnormal change in vital signs is a problem situation of the patient currently occurring due to the abnormal symptom, and includes a process of assessing the current state of the patient such as asphyxiation, falls, fractures, hypoglycemia, and loss of consciousness. Decision Support Method for Vital Signs of the Elderly.
The method of claim 2,
The information related to the treatment decision process includes a process of determining whether the cause of the symptom is obvious, whether it is unknown or a risk of recurrence, and whether the management of the facility is possible and requiring evacuation of the emergency room. Decision Support Method for Elderly Vital Signs.
The method according to any one of claims 1 to 8,
The method comprising:
As a result of the reevaluation in step (e), if the patient's condition is not improved or worsens, the step (b) to (e) is repeated by receiving the ejaculation information according to the patient's vital signs. Decision support method according to the elderly vital signs abnormalities further comprising the step.
In the decision support system for the vital signs of the elderly,
A calculation module for accessing the patient's information through the login information on the system, and determining whether the vital sign is abnormal by matching the assessment information and the diagnosis criteria according to the vital sign of the patient;
A database for storing personal information of the patient, the assessment information, the diagnosis criteria, the nursing diagnosis matching the assessment information and the vital signs, and the nursing intervention information matching at least one item selected from the list of the nursing diagnosis. ; And
And a prescription module for extracting the assessment information transmitted from the calculation module and the abnormal reaction action history matched with the vital sign abnormality from the database.
The method of claim 10,
The operation module;
The assessment information is used to determine whether the vital sign abnormality is matched with the diagnostic criteria, wherein the assessment information includes information related to initial evaluation of abnormal symptoms, association of problems due to abnormal symptoms of vital signs, and information related to processing decisions. Decision Support System for the Vital Signs of the Elderly.
The method of claim 11,
The operation module;
Physician according to the elderly vital signs abnormalities characterized by at least the evaluation of vital signs of the patient, evaluation of consciousness, evaluation of everyday life patterns, check of blood sugar, and the initial evaluation of the abnormal signs using a physical examination Decision Support System.
The method of claim 12,
The operation module;
The diagnosis criteria are extracted from the database, and the evaluation of the vital signs is processed. If the evaluation of the vital signs is within the diagnosis criteria, the patient's condition is determined to be normal. Decision support system.
The method of claim 12,
The operation module;
The decision support system according to the vital vital symptoms of the elderly, characterized in that for processing the evaluation of the consciousness by determining whether the patient is normal by observing at least one of the patient's eye response, speech and motor response.
The method of claim 12,
The operation module;
Based on the patient's personal information stored in the database, it is determined whether there is a change in meal volume, posture change, limited movement, pedestrian change, and sleep pattern change to process the evaluation of the daily life pattern. Decision Support System for the Vital Signs of the Elderly.
The method of claim 11,
The operation module;
The vitality of the elderly, characterized by the treatment of the problems associated with the change in vital signs, including the current status of patients such as asphyxiation, falls, fractures, hypoglycemia, loss of consciousness as a problem situation of the patient currently occurring due to abnormal symptoms Decision support system for symptom abnormalities.
The method of claim 11,
The operation module;
It is determined whether the cause of the patient's symptoms is clear, whether it is unknown or there is a risk of recurrence, and if it is possible to manage in the facility, input information on whether emergency room evacuation is required and process the information related to the treatment decision. Decision Support System for the Vital Signs of the Elderly.
The method of claim 10,
The prescription module is;
The elderly vital signs of the elderly characterized in that by using the nursing diagnosis connected to the basis of the assessment information according to the vital symptoms abnormality input from the calculation module, using the nursing intervention information matched with the nursing diagnosis Decision support system based on the above.
The method of claim 18,
The decision support system further includes an output device connected to the prescription module;
The prescription module extracts information on the nursing diagnosis matched with the assessment information and the vital sign abnormality transmitted from the calculation module from the database, and matches the at least one selected from the list of the extracted nursing diagnosis. Decision support system according to the elderly vital signs, characterized in that the nursing intervention information is extracted from the database and transmitted to the output device.
20. The method of claim 19,
The decision support system further comprises an output interface between the prescription module and the database;
The prescription module according to the elderly vital signs abnormalities, characterized in that for storing the abnormal response measures for the patient input after the treatment for the vital signs abnormal patients by providing the nursing intervention information through the output interface Decision Support System.
20. The method of claim 19,
The prescription module reevaluates vital signs of the elderly by reflecting data related to improvement of consciousness, blood sugar stability, blood pressure stability, pulse stability, respiratory stability, and temperature stability after providing the nursing intervention information. Decision support system based on the above.
The method of claim 21,
The decision support system;
And the prescription module stores the data of the patient's treatment result in the database through the output interface after re-evaluating the vital signs of the patient.

Images