TWI482115B - Nursing shift system - Google Patents

Description

Nursing shift system

The present invention relates to a care system, and more particularly to a care delivery system that provides a caregiver to standardize the shifting operation.

Handoff is an important workload item in the nursing workflow and the most common and important procedure in the medical communication process. According to the definition of Joint Commission International (JCI), shifting refers to an interactive process in which patient data is consistently transmitted from one health care provider to another health care provider. These materials contain basic information about the patient, the content of care, the results of care and the results. The process of data transmission must be highly correct and complete in order to achieve good quality of care.

Riesenberg, Leitzsch, and Cunningham collated the literature on care shifts from 1987 to 2008 and found that the main reasons for impeding effective delivery include: communication barriers, lack of standardized processes, lack of delivery tools, shifting environmental issues, lack of time or abuse time, case complexity, or There are eight projects such as over-care for patients, lack of education and training, and human factors. The strategies to improve effective delivery include: increasing communication skills, establishing standardized procedures, improving delivery tools, reducing environmental impact, establishing shift education, employee participation, and leadership. Seven projects, such as competence, in which communication barriers are one of the most frequently asked obstacles in the literature, and the establishment of standardized processes and computer shifting systems as a means of handover are the two most frequently mentioned documents in the literature. Effective shift strategy. (Riesenberg, LA, Leisch, J., Cunningham, JM (2010) Nursing Handoffs: A Systematic Review of the Literature. American Journal of Nursing, 110 (4), 24-34.)

As far as the methods used in the shifts are concerned, there have been studies on three types of shifts, such as verbal, note and written. It is found that after five shifts, the integrity and correctness of the oral assignments is almost zero, and the notes are left over. %, written assignments are almost error-free. (Pothier, D., Monteiro, P., Mooktiar, M., Shaw, A. (2005). Pilot study to show the loss of important data in nursing handover. British Journal of Nursing , 14 (20), 1090-1093 .)

In addition, the literature organizes the contents of the shifts that must be covered when the patients in severe units are delivered, including admission data, patient clinical problems, vital signs, drugs, tubing, results, events during hospitalization, examination of the patient's condition, and implementation of Chinese medicine. and many more. According to this structure, it is designed to be a severe patient's delivery schedule, and the results of the design of the severely ill patient's delivery form and the traditional medical record leaflet are compared. It is found that the designed delivery schedule can achieve a more complete delivery, and There are significant differences compared to traditional shift methods. (Berkenstadt, H., Haviv, Y., Tuval, A., Shemesh, Y., Megrill, A., Perry, A., Rubin, O., Ziv, A. (2008). Improving handoff communications in critical care Chest , 134 (1), 158-162.)

At present, the practice of nursing shifts is to use the verbal, written and note papers at the bedside, and the average shift time for one patient is about 10 to 15 minutes. bell. The tools for the shift are the admission assessment form, the handwritten blank assignment form, and the medical record. In special care units, such as the intensive care unit, an additional intensive care unit assessment form and an intensive care unit monitoring record form will be added. However, handwritten delivery orders are often not fully documented because of the busyness of the caregiver or too much information, and the integrity of the data is easily affected by the memory of the caregiver. On the other hand, the quality of the shift will be different because of the work experience and the seniority. When the patient stays too long or the condition changes greatly, when the shift record is incomplete, the successor cannot see The main treatment and examination process of the patient, and is susceptible to the completeness of the oral care of the nursing staff.

In summary, the current nursing shift tools and methods have problems in which the shifting materials are easily missed, especially in the process of shifting, which is easily affected by many external factors, which makes the shifting materials missing or missing, which causes the workflow to be interfered. The patient's life safety is under threat. In serious cases, medical disputes may occur and affect the same thing.

The main object of the present invention is to provide a care delivery system comprising at least one physiological monitor, a database, a server and a plurality of terminal devices. The physiological monitor is configured with a monitoring parameter and is used to monitor the physiological state of the patient to generate a monitoring information. The database stores a plurality of nursing staff data, at least one patient data, a monitoring parameter form, a medication form, an input and output form, an event form, a consultation form, and a delivery confirmation form. The monitoring parameter form shows that the physiological monitor is set Monitor parameters. The medication form records the medication status of the patient data. The output form records the status of the input and output of the patient data. The event form records the actual status of the patient data. The consultation form is a record of the patient's data being consulted. The shift confirmation form records the status of each caregiver's information. The server is connected to the physiological monitor and the database, and stores the monitoring parameter, the nursing staff data corresponding to the monitoring parameter, and the set monitoring information generated by the physiological monitor to the database, the servo The device stores a care management program. The server executes the care management program to generate a care management interface. The nursing management mask has an inpatient status area and a nursing handover area. The hospital status area shows the inpatient data. The care shift zone has a warning option, a monitoring option, a medication option, an input and output option, an event option, a consultation option, and a shifting unit option. The terminal devices are respectively connected to the server, and are used to display the care management interface and are used to operate the care management interface. The server provides the monitoring parameter form when the alert option is operated. When the monitoring option is operated, the server generates a chart based on the monitoring message in the database, the chart showing the status of the patient. The server provides the medication form when the medication option is operated. The server provides the output form when the input and output options are operated. When the event option is operated, the server provides the event form, wherein the event form has a log field for recording an event, and storing the event and the caregiver data recording the event to the database The event form. The server provides the consultation form when the consultation option is operated. When the shifting unit option The server provides the delivery confirmation form when it is operated. The delivery confirmation form has an input confirmation, a monitoring confirmation, and a medication confirmation for selection confirmation, and the confirmed delivery confirmation form and the confirmed caregiver data are stored in the database.

Thus, the care shifting system of the present invention can complete the shift by a standardized work process to improve the correctness and integrity of the shift information and reduce the time required for the shift. In addition, the present invention further provides the care management interface for the caregiver to obtain complete patient data in an instant and complete manner.

Detailed construction, features, assembly or use of the present invention will be described in the detailed description that follows. However, it should be understood by those of ordinary skill in the art that the present invention is not limited by the scope of the invention.

The technical content and features of the present invention will be described in detail below with reference to the accompanying drawings, in which: FIG. Block diagram of the nursing shift system 1. The nursing shift system 1 is applied to a medical institution and is used to provide a caregiver to view and record the physiological state of the patient being cared for. The care delivery system 1 includes at least one physiological monitor 10, a database 12, a server 14, and a plurality of terminal devices 16. The server 14 is connected to the physiological monitor 10, the database 12, and the terminal devices 16.

The physiological monitor 10 is placed at the bedside of the hospital bed to monitor the disease. The physiological state of the person produces a monitoring information including the patient's breathing, pulse and body temperature. The nursing staff can set a monitoring parameter for the physiological monitor 10, and the purpose and use of the monitoring parameter are described later.

The database 12 stores a plurality of nursing staff materials, at least one patient data, a monitoring parameter form, a medication form, an input and output form, an event form, a consultation form, and a delivery confirmation form. The nurses' data are respectively corresponding to the nursing staff who are actually serving in the medical institution, such as nurses and nursing directors. The patient data is a record of the inpatient data and medical records. It should be noted that in this embodiment, in order to allow any reader to clearly understand the present invention, only one patient is taken as an example, but in fact, this The invention's nursing shift system can be used to manage multiple patients, that is, the database actually stores multiple patient data. The medication form records the status of administration of the patient's data, including the medication order prescribed by the physician to the patient, and the response of the patient after taking the order. The input and output form records the input and output status corresponding to the patient data, and the input and output status includes the input and output time, the injection, the flow rate of the injection, the patient's food intake, the additive, the total amount of the infusion, the actual dose, the blood volume, and the diet. , medicine / water volume, discharge time, urine, drainage volume, and stool. The event form records the actual status of the patient's data, including visitor status, ward status, patient response, and other practical matters. The consultation form is a record of the patient's data being consulted. The consultation status refers to the advice and explanations given by the physicians after consultation and discussion. The shift confirmation form records each caregiver The status of the staff information delivery indicates that each nursing staff will hand over the actual condition to the next nursing staff during the care period.

The server 14 stores the monitoring parameter corresponding to each nursing staff data and the set monitoring information generated by the physiological monitor to the database, indicating that the database can continuously store the monitoring information and the monitoring parameter. The server 14 stores a care management program 141 and executes the care management program 141 to generate a care management interface. In this embodiment, the care management interface is presented in a webpage manner.

The terminal devices 16 are used to display the care management interface and are used to execute the care management interface. The terminal devices 16 generally refer to a desktop computer or a notebook computer, etc., and the browsing management is browsed by a browser. interface.

The second figure shows a schematic diagram of the care management interface. As shown in the second figure, the care management interface 30 has an inpatient status area 32 and a care shift area 34. The inpatient status area 32 displays the inpatient information for review by the attending caregiver. The care shift area 34 has an alert option 341, a current option 342, a medication option 343, an event option 344, an output option 345, a consultation option 346, and a handover option 347.

As shown in the third figure, the third figure shows a schematic diagram of the monitoring parameter form. When the alert option 341 is executed, the server provides the monitoring parameter form 51, and the monitoring parameter form 51 displays the monitoring parameter set by the physiological monitor for the nursing staff to understand that the physiological monitor is currently Set monitoring parameters. In practice, the caregiver can directly set the monitoring parameters on the physiological monitor, and then input the monitoring parameters into the monitoring parameter form 51, or directly in the monitoring by the terminal device. The monitoring parameters are input in the measurement parameter form 51, and the physiological monitor is indirectly set. The monitoring parameter has a maximum value and a minimum value indicating the range boundary of the physiological monitor currently being monitored.

As shown in the fourth figure, the fourth figure is a schematic diagram of the diagram. When the current option 342 is executed, the server generates a chart 52 based on the monitoring messages in the database, the chart 52 showing the status of the patient, indicating that the caregiver can understand the patient by using the chart 52. Physiological changes during hospitalization.

As shown in the fifth figure, the fifth figure shows a schematic diagram of the medication form. When the medication option 343 is executed, the server provides the medication form 53 for the caregiver to know the type of medication taken by the patient and the condition after administration of the medication.

As shown in the sixth figure, the sixth figure shows a schematic diagram of the input and output form. When the output option 345 is executed, the server provides the output form 54 to enable the caregiver to know if the condition of the fluid flowing into and out of the patient is reasonable.

As shown in the seventh figure, the seventh figure shows a schematic diagram of the event form. When the event option 344 is executed, the server provides the event form 55, wherein the event form 55 has a log field 551 for recording an event corresponding to the patient profile, and recording the event and recording the event. The caregiver profile is stored in the event form 55 of the database, indicating that the caregiver can learn from the event form 55 what happened to the patient or the ward, and record the event to the event form 55 for the care of the successor. People understand.

As shown in the eighth figure, the eighth figure is a schematic diagram showing the consultation form. When the consultation option 346 is executed, the server provides the consultation form 56 for the caregiver to know the medical treatment and medical advice made by the physician.

As shown in the ninth figure, the ninth figure is a schematic diagram showing the handover confirmation form. When the shifting unit option 347 is executed, the server provides the shift confirmation form 57, wherein the shift confirmation form 57 has an input confirmation 571, a monitoring confirmation 572, and a medication confirmation 573 for confirmation, and The confirmed delivery confirmation form 57 and the confirmed nursing staff information are stored in the database, so that when the nursing staff has to hand over to the next nursing staff, the confirmation item in the delivery confirmation form 57 can be performed. Confirmation, and the confirmed results will be stored back in the database for review, so that the shift confirmation form 57 can be used to know the changes made by each nursing staff, and the nursing staff can follow the care delivery system. The standard work of the shift is carried out to ensure that the changes and records made during the shift are stored in the database at any time to improve the efficiency of the shift.

Referring again to the first figure, the care delivery system further includes at least one respirator 18 coupled to the server 14 and having a code number and a plurality of output modes. The database 12 also stores a respirator form that records the code and the output modes.

Referring again to the second figure, the care transfer area 34 also has a respirator option 348. As shown in the tenth figure, the tenth figure shows a schematic view of the respirator form. Wherein, when the respirator option 348 is executed, the server provides the respirator form 58 for selecting the code and its one of the output modes, and storing the selected respirator form 58 to the database. Please refer again In the ninth figure, the delivery confirmation form 57 further has a respirator confirmation 574 for confirmation, and stores the confirmed delivery confirmation form 57 and the confirmed caregiver data to the database. It is indicated that the nursing staff can select the appropriate respirator and its output mode by the nursing delivery system, or the nursing staff can directly input the respirator on the respirator, and then input the selected respirator code and its output mode into the respirator form. And save to the database. In addition, when the caregiver is handed over, it is also known from the shift confirmation form 57 whether the caregiver has changed the respirator. However, if the respirator is not required, the respirator option 348 and the respirator confirmation 574 may be omitted.

The eleventh, twelfth, fourteenth and fifteenth drawings respectively show the schematic diagram of the hospitalization status area, and the thirteenth figure shows the flow chart of the steps of the abnormal treatment procedure. As shown in FIG. 11, the hospitalization status area 32 includes a patient option 321 including a basic information form that records the patient's inpatient medical record and at least one contact person, and is useful for selection. Multiple first aid options 322. Wherein, when the patient option is executed, the server provides the basic data form. The inpatient medical record usually includes the patient's current hospitalization history and past medical history, etc. The contact person's information is for the nursing staff to inform the family members. The first aid option 322 is selected by the patient's family, and is checked by the nursing staff and stored. In the server. In this way, the caregiver can select the patient option 321 to obtain the patient's basic hospitalization information.

As shown in Fig. 12, the hospitalization status area 32 includes an assessment option 323 that includes a health check form that records the examinations performed during the patient's hospital stay. Among them, when executed The server provides the health check form when the option 323 is evaluated. The health check form includes a physical examination, an examination report, a computed tomography, an MRI, an ultrasound, an X-ray, a biochemical test, a serum test, a microbiological test, an electrolyte test, a blood cell count, a liver and kidney function test, and a microbiological test. Wait. The medical examination item is filled in the health check form by the caregiver after observing the patient's condition. The other items mentioned above are established by the specialized personnel of the medical institution to the server for the nursing staff to obtain relevant inspection information through the nursing management interface.

In fact, if the health check form has a reminder message 327, the reminder message 327 indicates that there is an abnormality index 328 in the test form. In this embodiment, the "one month check report" item in the twelfth figure. The middle glycemic index is too high, so that the background color of the glycemic index (ie, the above-mentioned abnormality index 328) will be different from the surrounding color (ie, the above reminder message 327) for the nursing staff to identify the abnormality index in the health check form. 328 location.

As shown in the thirteenth figure, when the abnormality index is selected, the server executes an abnormality handling program, and the abnormality handling program includes: S71: providing a disposal form having a time column, a disposal record column, and A storage option. The nursing staff can fill in the time column and record the manner of disposal in the disposal record column. When the storage option is selected, the server system S72: the disposal form is stored in the database; When the disposal form is stored in the database, the server is S73: the color of the abnormal index is changed.

In this way, after the caregiver delivers the shift, the abnormality index 328 can be used. Color understands if this anomaly has been disposed of. Furthermore, the reminder message 327 is displayed in the vicinity of the abnormality index 328 for the caregiver to quickly find the abnormality for effective treatment. In addition, the reminder message 327 can also alert the caregiver by using color flicker, sound, or screen beating. Furthermore, each caregiver who cares for the patient can also access the previous disposal method record through the disposal form stored in the database.

As shown in FIG. 14, the hospitalization status area 32 includes a form option 324, and the inpatient information includes a signature document form having a form name, a date of delivery, a date of completion, and a name of a person. And an edit option 325 for editing the form name, the date of the offer, the date of completion, and the name of the person. The name of the person is the name of the caregiver. Wherein, when the form option is executed, the server provides the signed file form for clicking the edit option 325 for editing, and storing the edited signed file form to the database. The form name includes a blood transfusion consent form, a rejection of cardiopulmonary resuscitation consent, a rejection of cardiopulmonary resuscitation, a consent consent form, an examination consent form, a self-paying consent form, a surgical consent form, an anesthesia consent form, A computerized tomography consent form, a magnetic resonance photography consent form, all conclusions and a major injury application. In practice, the nursing staff can use the editing option to establish the name of the form, the date of the offer, and the name of the person when providing any of the above-mentioned consent forms. After the family member signs the consent form, the nursing staff fills in the form. The completion date, in this way, will be able to manage whether the above-mentioned various forms of consent have been provided to the family and whether the family has signed it back.

As shown in the fifteenth diagram, the hospital status area 32 includes an option 326. The inpatient data includes a status form that records a physician shift event, a care diagnosis, and a catheter record. When the current option 326 is executed, the server provides the status form. In this way, the caregiver can learn the doctor's shift, care diagnosis and catheter record through the current situation form to avoid the omission of handover during the shift.

It should be noted that the patient option 321, the evaluation option 323, the form option 324, and the current option 326 of the hospital status area 32 may also display only the patient option 321 or display a combination of the patient option 321 and the evaluation option 323, or The combination of the patient option 321, the evaluation option 323, and the form option 324 is displayed. Therefore, the four options in the hospital status area 32 of the present invention can be arbitrarily selected and combined according to actual needs.

As shown in FIG. 15, the care management interface 30 also has a patient list area 36 and a patient summary area 38 for displaying a plurality of patient names and corresponding beds. The patient summary area 38 is used to display one of the patient names in the patient list area 36. In this embodiment, the patient summary area 38 displays the patient name of the bed number 02. The hospitalization status area 32 and the care delivery area 34 are corresponding to patient data showing and managing the patient's name. It is indicated that the caregiver can achieve the purpose of switching different patients by clicking on the patient's name or hospital bed in the patient list area.

It is to be understood that the foregoing detailed description of the drawings is merely illustrative of the technical aspects and features of the present invention, and those who have ordinary knowledge in the field of the invention After the technical content and features of the invention, various simple modifications, replacements, or reductions in components are included in the spirit of the invention. It is within the scope of the patent application disclosed below.

1‧‧‧Nursing shift system

10‧‧‧ Physiological monitor

12‧‧‧Database

14‧‧‧Server

141‧‧‧Nursing Management Program

16‧‧‧ Terminal devices

18‧‧‧Respirator

30‧‧‧Nursing management interface

32‧‧‧Inpatient status area

321‧‧‧ patient options

322‧‧‧First aid options

323‧‧‧Evaluation options

324‧‧‧Form options

325‧‧‧Editing options

326‧‧‧Status options

327‧‧‧ reminder message

328‧‧ Anomaly Index

34‧‧‧Nursing shift area

341‧‧‧ Warning options

342‧‧‧ Current options

343‧‧‧ drug options

344‧‧‧Event options

345‧‧‧Output options

346‧‧‧ consultation options

347‧‧‧Handover options

348‧‧‧Respirator options

36‧‧‧ Patient list area

38‧‧‧ Patient Summary Area

51‧‧‧Monitoring parameter form

52‧‧‧ Chart

53‧‧‧ medication form

54‧‧‧Output form

55‧‧‧Event Form

551‧‧‧record column

56‧‧‧Consultation Form

57‧‧‧Transfer confirmation form

571‧‧‧Import and export confirmation

572‧‧‧Monitoring confirmation

573‧‧‧Confirmation of medication

574‧‧‧Respirator confirmation

58‧‧‧Vistor form

S71~S73‧‧‧Steps

The first figure is a block diagram showing a care shifting system in accordance with a preferred embodiment of the present invention.

The second figure shows a schematic diagram of the care management interface.

The third figure shows a schematic diagram of the monitoring parameter form.

The fourth figure is a schematic diagram showing the chart.

The fifth figure shows a schematic diagram of the drug form.

The sixth figure is a schematic diagram showing the input and output forms.

The seventh diagram shows a schematic diagram of the event form.

The eighth figure is a schematic diagram showing the consultation form.

The ninth figure is a schematic diagram showing the handover confirmation form.

The tenth figure shows a schematic diagram of the respirator form.

The eleventh and twelfth drawings respectively show schematic diagrams of the hospitalization status area.

The thirteenth figure is a flow chart showing the steps of the abnormal treatment procedure.

The fourteenth and fifteenth drawings respectively show schematic diagrams of the hospitalization status area.

30‧‧‧Nursing management interface

32‧‧‧Inpatient status area

34‧‧‧Nursing shift area

341‧‧‧ Warning options

342‧‧‧ Current options

343‧‧‧ drug options

344‧‧‧Event options

345‧‧‧ Liquid input and output options

346‧‧‧ consultation options

347‧‧‧Handover options

348‧‧‧Respirator options

Claims (9)

A nursing shifting system comprising: at least one physiological monitor, configured with a monitoring parameter, and configured to monitor a physiological state of the patient to generate a monitoring information; a database storing a plurality of nursing personnel data, at least one patient data, a monitoring parameter form, a medication form, an input and output form, an event form, a consultation form, and a delivery confirmation form, wherein the monitoring parameter form displays monitoring parameters set by the physiological monitor, and the medication form is recorded correspondingly The medication status of the patient data, the input and output form records the input and output status of the patient data, and the event form records the actual status of the patient data, and the consultation form records the patient information to be consulted, and the delivery confirmation The form records the status of each nursing staff data delivery; a server connects the physiological monitor and the database, and generates the monitoring parameter, the nursing staff data corresponding to the monitoring parameter, and the physiological monitor that is set The monitoring information is stored in the database, and the server stores a care a server that executes the care management program to generate a care management interface, the care management mask has an inpatient status area and a care transfer area, the hospital status area displays the inpatient information, and the care transfer area has a warning option, a monitoring option, a medication option, an input and output option, an event option, a consultation option, and a handover unit option; and a plurality of terminal devices connected to the server and configured to display the care management interface And for operating the care management interface, wherein, when the alert When the option is operated, the server provides the monitoring parameter form. When the monitoring option is operated, the server generates a chart according to the monitoring message in the database, and the chart displays the status of the patient when the When the medication option is operated, the server provides the medication form, and when the input and output option is operated, the server provides the input and output form, and when the event option is operated, the server provides the event form The event form has a log field for recording an event, and storing the event and the caregiver data recording the event to the event form of the database, when the consultation option is operated, the server system Providing the consultation form, when the delivery unit option is operated, the server provides the delivery confirmation form, wherein the delivery confirmation form has an input confirmation, a monitoring confirmation, and a medication confirmation for selection confirmation, and The confirmed delivery confirmation form and the confirmed caregiver data are stored in the database. The nursing delivery system of claim 1, further comprising at least one respirator connected to the server, the respirator having a code number and a plurality of output modes, the database further storing a respirator form, the respirator The form records the code and the output mode, and the care shift zone further has a respirator option, wherein when the respirator option is operated, the server provides the respirator form for selecting the code and the middle thereof An output mode stores the selected respirator form to the database, the shift confirmation form also having a respirator confirmation for confirmation. The nursing shift system of claim 1, wherein the monitoring parameter has a maximum value and a minimum value. Such as the nursing shift system described in claim 1 of the patent scope, The hospitalization status area includes a patient option, and the inpatient information includes a basic information form that records a patient's inpatient medical record and at least one contact person, and is useful for selecting a plurality of first aid options, wherein The server provides the basic data form when the patient option is executed. The nursing delivery system of claim 1, wherein the hospitalization status area includes an evaluation option, the inpatient information includes a health check form for recording an examination performed during a patient's hospitalization, wherein The server provides the health check form when the evaluation option is executed. The nursing delivery system of claim 5, wherein the health check form has at least one reminder message indicating that the health check form has an abnormal index position when the abnormal index is selected The server executes an exception handling program, the exception handling program includes: providing an exception handling form, having a time column, a disposal record column, and a storage option, the time column is used to fill in the time, the disposal record column The internal recording processing mode, when the storage option is selected, the server stores the disposal form to the database, and changes the color of the abnormal index. The nursing delivery system of claim 1, wherein the hospitalization status area includes a form option, the inpatient information includes a signature document form, the signature document form has a form name, a date of providing, and a a completion date and a name of a person, and an editing option for editing the form name, the date of the offer, the date of completion, and the name of the person, wherein the server provides the form when the form option is executed Sign the document form for editing by clicking on the editing option and saving the edited signed document form to the database. The nursing delivery system of claim 1, wherein the hospitalization status area includes a current status option, and the inpatient information includes a current status form, which records a physician shift event, a nursing diagnosis, and a catheter record. The server provides the status form when the option is executed. The care delivery system of claim 1, wherein the care management interface further has a patient list area and a patient summary area, wherein the patient list area is used to display a plurality of patient names and corresponding beds, the patient The summary area is used to display one of the patient names in the patient list area, wherein the hospital status area and the care handover area correspond to patient data showing and managing the patient name.