WO2009139149A1 - Medication monitoring apparatus - Google Patents

Medication monitoring apparatus Download PDF

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Publication number
WO2009139149A1
WO2009139149A1 PCT/JP2009/002063 JP2009002063W WO2009139149A1 WO 2009139149 A1 WO2009139149 A1 WO 2009139149A1 JP 2009002063 W JP2009002063 W JP 2009002063W WO 2009139149 A1 WO2009139149 A1 WO 2009139149A1
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WO
WIPO (PCT)
Prior art keywords
medication
medicine
patient
electronic medical
instruction information
Prior art date
Application number
PCT/JP2009/002063
Other languages
French (fr)
Japanese (ja)
Inventor
横手祐二
林秀朗
Original Assignee
株式会社ジェイ・エム・エス
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 株式会社ジェイ・エム・エス filed Critical 株式会社ジェイ・エム・エス
Publication of WO2009139149A1 publication Critical patent/WO2009139149A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/16831—Monitoring, detecting, signalling or eliminating infusion flow anomalies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00—Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/14—Infusion devices, e.g. infusing by gravity; Blood infusion; Accessories therefor
    • A61M5/168—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body
    • A61M5/172—Means for controlling media flow to the body or for metering media to the body, e.g. drip meters, counters ; Monitoring media flow to the body electrical or electronic
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
    • G16H20/17—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients delivered via infusion or injection
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502—User interfaces, e.g. screens or keyboards

Definitions

  • the present invention relates to a medication monitoring apparatus that monitors medication administered to a patient.
  • Patent Documents 1 and 2 a medical institution such as a hospital has an electronic medical record that digitizes a medical record that records a medical practice of a doctor.
  • a system has been introduced.
  • patient information such as the patient's name, doctor's medical practice information, interpretation report information that summarizes the image findings by the image diagnostician, medication instruction information determined by the doctor, etc. are input and stored. Yes.
  • digitizing such various medical information it becomes possible to share medical information among healthcare professionals and to quickly search and use it.
  • the syringe pump is designed to set a syringe filled with a medicine. By setting the injection amount and the injection speed of the medicine, the medicine in the syringe is automatically injected into the patient according to the set value. Can be done.
  • the infusion pump is set with an infusion bag filled with a medicine, and in the same way as a syringe pump, the medicine in the infusion bag can be automatically infused to a patient according to a set value. It is like that.
  • a nurse obtains instruction information (medicine type, injection amount, injection rate, etc.) relating to the medication of a patient to be treated using an electronic medical record system. Then, after preparing the medicine in the dispensing room and transporting it to the patient's hospital room, the medicine is set in the dosing device, and the dosing device is operated to set the injection amount, the injection speed, etc., and start the dosing. The nurse who confirms that the medication has started is away from the patient and is engaged in other tasks.
  • instruction information medicine type, injection amount, injection rate, etc.
  • the mistake in the injection rate and dose of this drug can be easily recognized by a doctor in charge who knows in detail about the patient's medical condition and the drug to be administered, but nurses take care of many patients.
  • the medical conditions of individual patients are not as detailed as doctors, and there is a risk of starting medication without noticing a mistake, which causes a medical accident.
  • the present invention has been made in view of such a point, and an object of the present invention is to more effectively utilize an electronic medical record system at the time of medication when performing medication to a patient using a medication device. It is to prevent the occurrence of medical accidents.
  • the present invention makes it possible to determine that the execution information of the medication started by the medication device does not correspond to the instruction information regarding the medication of the patient stored in the electronic medical record system, An alarm signal was issued when it was not compatible.
  • a medication monitoring apparatus for monitoring medication administered to a patient
  • instruction information regarding medication to a patient connected to an electronic medical record system and stored in the electronic medical record system is input.
  • An instruction information input unit an execution information input unit that is connected to a dosing device in which a medicine to be administered to a patient is set, and in which dosing information started by the dosing device is input, and the instruction information input unit
  • a control unit that is connected to the execution information input unit and determines whether or not the execution information corresponds to the instruction information based on information input to the input unit. If it is determined that the execution information input to the execution information input unit does not correspond to the instruction information input to the instruction information input unit, an alarm signal is generated.
  • the execution information is input to the execution information input unit of the medication monitoring device.
  • the instruction information related to medication to the patient stored in the electronic medical chart system is input to the instruction information input unit.
  • the control unit determines that the execution information does not correspond to the instruction information if any one of the pieces of execution information is different from the instruction information. To emit. Also, when one piece of execution information is input, an alarm signal is similarly issued. As a result, it is possible to prevent the drug from being administered to the patient at an injection rate or an injection volume different from the instruction information, or to prevent the wrong drug from being administered to the patient.
  • the execution information is at least one of the kind of medicine, the infusion speed when administering the medicine to the patient, and the amount of the infusion.
  • a notification unit that is connected to the control unit and notifies the surroundings of an alarm signal issued by the control unit.
  • control unit transmits an alarm signal to the electronic medical chart system.
  • the alarm signal is transmitted to the electronic medical chart system.
  • the execution information of the medication started by the medication device does not correspond to the medication instruction information of the patient stored in the electronic medical record system, this is indicated to the operator of the electronic medical record system and the surroundings. It becomes possible to notify the person.
  • a storage unit for storing a change in the injection rate of the medicine is provided.
  • control unit determines whether or not the operation state of the medication device is normal, and issues an alarm signal when the operation state is not normal. It is assumed that
  • the control unit issues an alarm signal.
  • a position information acquisition unit for acquiring current position information is provided, and the control unit stores the current position information acquired by the position information acquisition unit in an electronic medical record. Assume that it is configured to send to the system.
  • This configuration makes it possible to grasp the location of the medication monitoring device on the electronic medical record system.
  • the warning signal is generated.
  • the patient does not start medication while setting the injection rate and injection amount of the drug, the type of the drug, etc., so that a medical accident at the time of medication can be prevented.
  • the notification unit for notifying the surroundings of the alarm signal issued by the control unit since the notification unit for notifying the surroundings of the alarm signal issued by the control unit is provided, if the injection rate, the injection amount, the type of the drug, or the like is wrong, A person around can be notified and a medical accident can be surely prevented.
  • the alarm signal issued by the control unit can be transmitted to the electronic medical chart system, it is confirmed that the injection rate and the injection amount of the medicine, the kind of medicine, etc. are incorrect. It is possible to notify the operator and those around him and prevent medical accidents with certainty.
  • an alarm signal can be issued when the injection rate greatly deviates from the value of the instruction information during the medication. Can also prevent medical accidents.
  • the control unit since the control unit issues an alarm signal when the operating state of the medication device is abnormal, it is possible to prevent the occurrence of a medical accident due to the abnormal operation of the medication device.
  • the current position information of the medication monitoring device is acquired and transmitted to the electronic medical record system, so that the location of the medication monitoring device can be grasped on the electronic medical record system and the location management is facilitated. be able to.
  • FIG. 1 is a front view showing a state in which a medication monitoring apparatus according to an embodiment of the present invention is attached to an infusion pump.
  • FIG. 2 is a schematic view showing a state in which the medication monitoring apparatus and the electronic medical chart system are connected to a LAN in a hospital.
  • FIG. 3 is a block diagram of the medication monitoring apparatus and the electronic medical record system.
  • FIG. 4 is a block diagram of the electronic medical record server.
  • FIG. 5 is a block diagram of the infusion pump.
  • FIG. 6 is a block diagram of the syringe pump.
  • FIG. 7 is a block diagram of the medication monitoring apparatus.
  • FIG. 8 is a diagram illustrating an operation terminal on which a mark is displayed when a medicine is wrong.
  • FIG. 8 is a diagram illustrating an operation terminal on which a mark is displayed when a medicine is wrong.
  • FIG. 9 is a diagram showing a display screen of the operation terminal when the injection rate of the medicine is wrong.
  • FIG. 10 is a diagram showing a display screen of the operation terminal when the injection amount of the medicine is wrong.
  • FIG. 11 is a diagram illustrating a display screen of the operation terminal when the medicine flow rate is decreased.
  • FIG. 12 is a diagram illustrating a display screen of the operation terminal when bubbles are mixed in the medicine.
  • FIG. 13 is a diagram illustrating a display screen of the operation terminal when there is no medicine.
  • FIG. 14 is a diagram showing a display screen of the operation terminal when the power supply voltage of the medication monitoring apparatus decreases.
  • FIG. 1 shows a medication monitoring apparatus 1 according to an embodiment of the present invention mounted on an infusion pump 10 for use.
  • the medication monitoring apparatus 1 is installed in hospital rooms A to C together with an infusion pump 10 (medication device) and a syringe pump 20 (medication device).
  • the infusion pump 10 and the syringe pump It is configured so that an alarm can be issued if there is an abnormality by monitoring the medication according to 20.
  • the electronic medical record system 30 includes an electronic medical record server 31, an examination room operation terminal 32 connected to the electronic medical record server 31, and a nurse station operation terminal 33.
  • the electronic medical record server 31 and the operation terminals 32 and 33 are connected to a LAN (Local Area Network) A installed in the hospital.
  • LAN Local Area Network
  • Each of the examination room operation terminal 32 and the nurse station operation terminal 33 is not limited to one, but may be a plurality.
  • symbol B in FIG. 2 is HUB.
  • the electronic medical record server 31 includes a patient information database 34, a diagnosis information database 35, a medication instruction information database 36, and an infusion pump / syringe pump management database 37.
  • the patient information database 34 the patient's name, date of birth, address, blood type, health insurance card number, hospital ward, hospital room number, bed number, etc. are stored in association with the patient ID assigned to each patient. ing.
  • the information stored in the patient information database 37 is input at the time of hospital outpatient reception.
  • the diagnosis information database 38 stores a disease name, medical treatment information of a doctor, interpretation report information obtained by collecting image findings by an image diagnostician, a medical history, hospitalization history, a doctor name in charge, and the like in association with a patient ID.
  • the medication instruction information database 36 stores, as instruction information related to medication, the type of medication prescribed, the timing of medication, the number of medications, the amount of injection to the patient per injection, and the injection speed in association with the patient ID. Yes.
  • the medication instruction information database 36 when a tablet or the like is prescribed for the patient, the type, administration time, and dosage are similarly stored.
  • the infusion pump / syringe pump management database 37 the current position, use period, number of times of use, maintenance status, etc. of the infusion pump 10 and syringe pump 20 in the hospital are assigned to each infusion pump 10 and each syringe pump 20. It is stored in association with the ID.
  • the current positions of the infusion pump 10 and the syringe pump 20 are transmitted from the infusion pump 10 and the syringe pump 20 to the electronic medical record server 31 as will be described in detail later.
  • the instruction information stored in the medication instruction information database 36 of the electronic medical record server 31 is transmitted to the medication monitoring apparatus 1 via the LAN.
  • the electronic medical record server 31 is configured to receive an alarm signal (described later) issued by the medication monitoring apparatus 1 via the LAN.
  • the electronic medical record server 31 is configured to display a predetermined alarm mark on the operation terminals 32 and 33 when receiving an alarm signal issued from the medication monitoring apparatus 1. This alarm mark is different for each alarm signal, and these alarm marks are stored in the electronic medical record server 31.
  • the examination room operation terminal 32 is a computer terminal having a display screen 32a and is installed in the examination room and is mainly operated by a doctor.
  • the result of the doctor's examination and the prescription are input at the examination room operation terminal 32 and stored in the examination information database 35 and the medication instruction information database 36 of the electronic medical record server 31.
  • the nurse station operation terminal 33 is a computer terminal having a display screen 33a.
  • the nurse station operation terminal 33 is installed in the nurse station and is mainly operated by a nurse.
  • the retrieved information is output from the electronic medical record server 31 to the operation terminals 32 and 33 and displayed on the display screens 32a and 33a.
  • the infusion pump 10 and the syringe pump 20 are portable pumps arranged in hospital rooms A to C, outpatient drip chambers, and the like, and are operated by a built-in rechargeable battery or an AC power source. .
  • a large number of such infusion pumps 10 and syringe pumps 20 are generally arranged in a hospital.
  • the infusion pump 10 is configured to inject a predetermined amount of medicine in the infusion bag C (shown in FIG. 1) into the patient at a predetermined infusion rate.
  • a tube D extending from the infusion bag C is connected to the infusion pump 10, and a tube E having a puncture needle (not shown) for puncturing the patient is connected.
  • the medicine in the infusion bag C is introduced into the infusion pump 10 through the tube D, and the medicine introduced into the infusion pump 10 is discharged into the tube E by a built-in pump (not shown) and administered to the patient. It has become.
  • the infusion pump 10 is provided with an infusion bag capacity input unit 11, an injection rate input unit 12, and an injection amount input unit 13.
  • the case 14 of the infusion pump 10 has an operation panel 16 having an operation switch 15 for inputting an infusion bag capacity, an infusion rate, and an infusion amount, and an infusion rate input by the operation switch 15.
  • a display panel 17 having a display screen for displaying the injection amount.
  • the operation panel 16 is provided with a power switch, an administration start switch, a stop switch, and the like.
  • the amount of medicine in the infusion bag C is input to the infusion bag capacity input unit 11, the injection rate is input to the injection rate input unit 12, and the injection amount is input to the injection amount input unit 13. .
  • the amount and flow rate of the medicine discharged from the infusion pump 10 are determined based on the values input to these input units 11 to 13. After the input to each of the input units 11 to 13 is finished, the medicine injection is started by operating the start button on the operation panel 16. In the infusion pump 10, the injection speed of the chemical solution during operation can be obtained.
  • the infusion pump 10 is provided with an output terminal 18 for outputting the infusion bag capacity, the infusion rate, the infusion amount and the current infusion rate set on the operation panel 16.
  • the syringe pump 20 is configured to inject a medicine in a syringe (not shown) into a patient, and the basic configuration is the same as that of the infusion pump 10.
  • a syringe filled with a medicine is set in the syringe pump 20 and a tube (not shown) having a puncture needle is connected thereto, and the medicine in the syringe is discharged to the tube by a built-in pump (not shown).
  • the syringe pump 20 is provided with a syringe size input unit 21, a syringe manufacturer input unit 22, an injection rate input unit 23, and an injection amount input unit 24.
  • the case of the syringe pump 20 has an operation panel having operation switches for inputting a syringe size, a syringe manufacturer, an injection speed, and an injection amount, and a display for displaying an injection speed and an injection amount input by the operation switch. And a display panel having a screen.
  • the syringe size is input to the syringe size input unit 21, and the syringe manufacturer is input to the syringe manufacturer input unit 22. Further, the injection rate of the medicine is input to the injection rate input unit 23, and the injection amount is input to the injection amount input unit 24. Based on the values input to these input units 21 to 24, the amount and flow rate of the medicine discharged from the syringe pump 20 are determined.
  • the syringe pump 20 is provided with an output terminal (not shown) for outputting the syringe size, syringe manufacturer, injection speed, injection amount, and current injection speed.
  • the medication monitoring apparatus 1 includes a case 39 and is attached to and integrated with the side portions of the infusion pump 10 and the syringe pump 20. As shown in FIG. 7, the medication monitoring apparatus 1 includes a barcode reader 40, a flow rate sensor 41, a bubble sensor 42, a pump connection unit 43, a position information acquisition unit 44, an alarm lamp 45 (informing unit), a speaker 46 (informing unit). A transmission unit 47, a reception unit 48, a camera 51, and a control unit 49.
  • the medication monitoring apparatus 1 is wirelessly connected to a LAN in a hospital.
  • a standard for wireless connection for example, ZigBee can be mentioned, but it is not limited to this.
  • 2 is a connection terminal for ZigBee, and is connected to the LAN.
  • the medication monitoring device 1 may be connected to the LAN by wire.
  • the barcode reader 40 is for reading the medicine barcode F attached to the infusion bag C and the patient barcode attached to the patient's bed (not shown).
  • the medicine barcode F is determined in advance for each kind of medicine. For example, in the case of a medicine having a plurality of concentrations such as physiological saline, different medicine barcodes F are attached as different medicines. ing.
  • the type of drug in the infusion bag C can be identified by reading the bar code F for drug with the bar code reader 40.
  • the patient barcode is predetermined for each patient bed. By reading this bar code for a patient, it is possible to identify the patient.
  • the flow rate sensor 41 is attached in the middle of the tube D extending from the infusion bag C, and detects the flow rate of the drug flowing through the tube D.
  • the flow sensor 41 has a known structure that measures the flow rate of the liquid using ultrasonic waves.
  • the bubble sensor 42 is attached in the middle of the tube E extending from the puncture needle, and detects whether or not bubbles are mixed in the medicine flowing through the tube E.
  • the bubble sensor 42 has a known structure that detects bubbles in the liquid using, for example, ultrasonic waves.
  • the pump connection part 43 has a terminal connected to the output terminal 18 of the infusion pump 10 via the signal line 50.
  • the infusion bag capacity, the infusion rate and the infusion amount of each input unit 11 to 13 of the infusion pump 10 and the current infusion rate are input to the medication monitoring apparatus 1. It has become so.
  • the syringe pump 20 is connected to the pump connection unit 43, the syringe size, syringe manufacturer, injection rate and injection amount, and the current injection rate of each input unit 21 to 24 of the syringe pump 20 are monitored for medication. The data is input to the device 1.
  • the position information acquisition unit 44 is configured by a well-known GPS (global positioning system).
  • the position information acquisition unit 44 has a known structure for receiving the radio wave transmitted from a predetermined artificial satellite and measuring the current position, and outputs the current position measurement result to the control unit 49 as position information as needed. Is configured to do.
  • the alarm lamp 45 is, for example, lit or blinks in red, and is lit or blinks in response to an alarm signal (details will be described later) issued from the control unit 49.
  • the light emission color and flashing pattern of the alarm lamp 45 can be arbitrarily set.
  • This alarm lamp 45 may be provided at a plurality of locations of the case 39.
  • the speaker 46 emits a predetermined alarm sound, and is activated in response to an alarm signal generated from the control unit 49.
  • the alarm sound can be set to an arbitrary tone color.
  • an antenna 53 is connected to the transmission unit 47 and the reception unit 48.
  • the transmission unit 47 is configured to provide information on the current position of the infusion pump 10, an injection start signal issued at the start of drug injection, and an injection end signal issued at the end of drug injection. Is transmitted to the electronic medical record server 31, and when the syringe pump 20 is connected to the pump connection unit 43, current position information of the syringe pump 20, an injection start signal, and an injection end signal are transmitted to the electronic medical record server 31. It is configured as follows.
  • the receiving unit 48 is configured to receive the information in the medication instruction information database 36 transmitted from the electronic medical record server 31 of the electronic medical record system 30.
  • a unique ID is assigned to the medication monitoring apparatus 1, and the ID is assigned when various information is transmitted from the medication monitoring apparatus 1. For this reason, it is possible to determine on the electronic medical record server 31 side which information is transmitted from the medication monitoring apparatus 1 in which of the hospital rooms A to C. In addition, a signal related to the power supply voltage of the medication monitoring apparatus 1 is also transmitted to the electronic medical record server 31.
  • the camera 51 is a well-known CCD camera.
  • the camera 51 is fixed to the tip of a flexible arm 52 extending from the case 39, and the position can be changed. With this camera 51, the display panel 17 can be photographed.
  • an image captured by the camera 51 is input to the control unit 49, and the control unit 49 recognizes the numerical value displayed on the display panel 17.
  • the camera 51 can also be configured by a camera other than a CCD camera.
  • the control unit 49 is connected to the alarm lamp 45, the speaker. 46, configured to control the transmission unit 47.
  • the control unit 49 is configured to transmit information on the patient barcode read by the barcode reader 40 to the electronic medical record server 31 by the transmission unit 47.
  • the patient ID of the patient specified by the bed number obtained from the information of the patient barcode is obtained.
  • the electronic medical record server 31 obtains instruction information related to the patient's medication from the medication instruction information database 36 and transmits it to the medication monitoring apparatus 1.
  • the instruction information transmitted to the medication monitoring apparatus 1 is input to and stored in an instruction information input unit 57 provided in the control unit 49 of the medication monitoring apparatus 1.
  • control unit 49 obtains the type of medicine filled in the infusion bag C from the information of the infusion barcode F read by the barcode reader 40.
  • the type of the medicine is input to and stored in an execution information input unit 58 provided in the control unit 49.
  • the infusion bag capacity, the infusion rate and the infusion amount set by the operation switch 15 of the infusion pump 10 and inputted to the input units 11 to 13 are also inputted to the execution information input unit 58 and stored.
  • the kind of medicine, the infusion bag capacity, the infusion rate, and the infusion volume are the execution information of the medication that is started from the infusion pump 10.
  • the control unit 49 includes a determination unit 55 that determines whether or not the execution information corresponds to the instruction information.
  • the determination unit 55 determines that the execution information corresponds to the instruction information if all of the drug type, the infusion bag capacity, the injection speed, and the injection amount are the same as the instruction information, and the drug type, the infusion bag capacity If at least one of the injection speed and the injection amount is different (incorrect) from the instruction information, the execution information is determined not to correspond to the instruction information.
  • the control unit 49 generates an alarm signal when the determination unit 55 determines that the execution information does not correspond to the instruction information.
  • This alarm signal is input to the alarm lamp 45 and the speaker 46.
  • the alarm signal is transmitted to the electronic medical record server 31 together with the ID of the medication monitoring apparatus 1 by the transmission unit 47.
  • the alarm signal that is issued when the injection amount does not correspond to the instruction information is different from the alarm signal that is issued.
  • control unit 49 When the flow rate of the medicine in the tube D output from the flow rate sensor 41 is smaller than the injection amount set in the infusion pump 10, the control unit 49 has bubbles in the tube E by the bubble sensor 42. When is detected, a different alarm signal is generated.
  • the control unit 49 is configured to output the current position information output from the position information acquisition unit 44 to the electronic medical record server 31 by the transmission unit 47.
  • the current position information of the infusion pump 10 and the syringe pump 20 is stored in the infusion pump / syringe pump management database 37 of the electronic medical record server 31.
  • control unit 49 includes a storage unit 56 that stores change data of the injection rate of the medicine output from the infusion pump 10.
  • the storage unit 56 continuously stores the injection rate of the drug from the start to the end of the drug administration.
  • the change data of the injection rate of the medicine stored in the storage unit 56 is transmitted to the electronic medical record server 31 and stored in the examination information database 35.
  • the control unit 49 may have an abnormality in the infusion pump 10. Therefore, an alarm signal is issued. That is, the control unit 49 is configured to determine whether or not the operation state of the infusion pump 10 is normal, and to issue an alarm signal when the operation state is not normal.
  • the control unit 49 issues an alarm signal. It is like that. That is, the fact that the medicine does not flow into the tube D even though the administration of the medicine is not completed is when the tube D is broken or the inside of the tube D is clogged, and such an abnormality has occurred. An alarm signal is issued.
  • the flow rate of the medicine detected by the flow sensor 41 may change abruptly. In this case, an alarm signal is generated. It has become.
  • control unit 49 when air bubbles are detected by the air bubble sensor 42 after administration of the medicine to the patient is started, and when the power supply voltage of the infusion pump 10 is lowered, the control unit 49 also generates different alarm signals. It is like that. Furthermore, an alarm signal is also issued when the medicine in the infusion bag C runs out. The control unit 49 also issues an alarm signal even when the medicine in the infusion bag C runs out.
  • One medication monitoring apparatus 1 is attached to one infusion pump 10 or one syringe pump 20 for use.
  • the nurse operates the nurse station operation terminal 33 of the electronic medical record system 30 to obtain the prescription of the patient. Based on this prescription, the nurse prepares, for example, an infusion bag C in the dispensing room, carries it to the B room, and sets it in the infusion pump 10 of the patient.
  • the nurse When the infusion bag C is set, the nurse first reads the patient barcode attached to the patient's bed by the barcode reader 40 of the medication monitoring apparatus 1. Information on the patient bar code read by the bar code reader 40 is transmitted to the electronic medical chart system 30, and instruction information related to medication to the patient is transmitted from the electronic medical chart system 30 to the medication monitoring apparatus 1. The instruction information is input and stored in the instruction information input unit 57 of the control unit 49.
  • the nurse reads infusion barcode F of infusion bag C.
  • the infusion bar code F indicates the type of medicine in the infusion bag C to be set, and this is input to the execution information input unit 58 of the control unit 49 and stored.
  • the determination unit 55 of the control unit 49 determines that the type of medicine corresponds to the instruction information when the kind of medicine obtained by the infusion barcode 40 is different from the kind of medicine based on the instruction information. Judge that it is not. Then, the control unit 49 issues an alarm signal. As a result, the alarm lamp 45 is turned on or blinks, an alarm sound is emitted from the speaker 46, and the nurse and other persons around the medication monitoring apparatus 1 are notified that the type of medicine is wrong.
  • the warning signal is transmitted to the electronic medical record server 31.
  • the warning signal is displayed on the display screens 32a and 33a of the examination room operation terminal 32 and the nurse station operation terminal 33.
  • the person around the operation terminals 32 and 33 is notified that the type of medicine is different.
  • the electronic medical record server 31 receives an alarm signal when the type of medicine is wrong, for example, the electronic medical record server 31 displays an alarm mark as shown in FIG. 8 over the entire display screens 32a and 33a. To display information identifying the patient. An alarm sound may be emitted from a speaker (not shown) of the operation terminals 32 and 33 together with the display of the alarm mark.
  • the control unit 49 does not issue an alarm signal.
  • the amount is input to the infusion pump 10. That is, the nurse operates the operation switch 15 while looking at the display panel 17 of the infusion pump 10 to set the infusion rate and the infusion amount to values as prescribed.
  • the determination unit 55 of the control unit 49 determines that the injection rate does not correspond to the instruction information when the value of the injection rate input at this time is different from the injection rate based on the instruction information. Further, the injection amount is similarly determined. When the determination unit 55 determines that it does not correspond to the instruction information, the control unit 49 issues an alarm signal as described above.
  • a mark as shown in FIG. 9 is displayed large over the entire display screens 32a and 33a.
  • a mark as shown in FIG. 10 is displayed so as to cover the entire display screens 32a and 33a. Is done. An alarm sound may be emitted from the speakers of the operation terminals 32 and 33 together with the display of these marks.
  • the control unit 49 since the camera 51 for photographing the display panel 17 is provided, and the numerical value of the display panel 17 photographed by the camera 51 is recognized by the control unit 49, the nurse performs an input operation and is displayed on the display panel 17. Even when the numerical value is different from the instruction information, the control unit 49 can issue an alarm signal.
  • the determination unit 55 After reading each barcode F as described above and setting the injection rate and the injection amount, the determination unit 55 has the same drug injection rate and injection amount as the instruction information and corresponds to the instruction information. When it determines with having carried out, the control part 49 does not emit an alarm signal. Therefore, the nurse next operates the start switch of the infusion pump 10. Then, the infusion pump 10 operates and administration of the medicine to the patient is started. Changes in the injection rate during the administration of the drug are stored in the storage unit 56. The control unit 49 issues an alarm signal when the injection rate of the drug is deviated by, for example, 5% or more from the value of the instruction information.
  • the control unit 49 gives a warning signal of the flow rate decrease. Is emitted.
  • an alarm mark as shown in FIG. 11 is displayed so as to extend over the entire display screens 32a and 33a.
  • the control unit 49 issues an air bubble detection alarm signal.
  • the electronic medical record server 31 receives an alarm signal for detecting a bubble, for example, a mark as shown in FIG. 12 is displayed large over the entire display screen 32a, 33a.
  • the position information acquired by the position information acquisition unit 44 is stored in the above-described infusion pump / syringe pump management database 37 of the electronic medical record server 31 together with the ID of the infusion pump 10. This position information is updated after a predetermined time has elapsed. Thereby, it is possible to grasp the location of the infusion pump 10 with the operation terminals 32 and 33. Further, by using the infusion pump 10, an injection start signal and an injection end signal are transmitted to the electronic medical record server 31. The electronic medical record server 31 obtains the use period and the number of uses of the infusion pump 10 based on these signals. The use period and the number of uses obtained in this way are stored in the infusion pump / syringe pump management database 37. Furthermore, when the infusion pump 10 is inspected and repaired, the operation terminals 32 and 33 are operated and stored as maintenance information in the infusion pump / syringe pump management database 37.
  • the electronic medical record server 31 when the electronic medical record server 31 receives an alarm signal indicating that the medicine in the infusion bag C has run out, the electronic medical record server 31 displays a large mark as shown in FIG. 13 over the entire display screens 32a and 33a.
  • the electronic medical record server 31 When the electronic medical record server 31 receives a signal related to the power supply voltage of the infusion pump 10 and determines that the power supply voltage of the infusion pump 10 has decreased, a mark as shown in FIG. 14 is displayed on the display screen 32a. , 33a is displayed large.
  • control part 49 can emit various alarm signals similarly to the case of the infusion pump 10 mentioned above.
  • the alarm signal can be issued. It can. Thereby, medication is not started to the patient while setting the injection speed and the injection amount of the medicine, the kind of the medicine, etc., and therefore a medical accident at the time of medication can be prevented.
  • the medication monitoring device 1 is provided with an alarm lamp 45 and a speaker 46, it is possible to notify the surrounding people that the injection rate, the injection amount, the type of the drug, etc. of the drug are wrong, and a medical accident can be reported. It can be surely prevented. Only one of the alarm lamp 45 and the speaker 46 may be provided.
  • the operator of the electronic medical record system 30 can confirm that the injection rate, the injection amount, the type of the drug, etc. are incorrect. The person around it can be informed, and this can also reliably prevent medical accidents.
  • the change in the injection rate of the medicine is stored in the medication monitoring apparatus 1, an alarm signal can be issued when the injection rate greatly deviates from the value of the instruction information during the medication. Further, it is possible to confirm whether or not the medicine has been administered according to the instruction information even after the medication.
  • control unit 49 issues an alarm signal when the operation state of the infusion pump 10 is not normal, it is possible to prevent the occurrence of a medical accident due to the abnormal operation of the infusion pump 10.
  • the location of the medication monitoring apparatus 1 can be grasped on the electronic medical record system 30 and the location management can be facilitated. it can.
  • the drug barcode F is attached to the infusion bag C and the patient barcode is attached to the patient's bed.
  • the present invention is not limited thereto, and an IC tag is attached to the infusion bag C to An IC tag may be attached to the bed.
  • the barcode reader 40 of the medication monitoring apparatus 1 may be changed to an IC tag reader.
  • the medication monitoring device 1 is separated from the infusion pump 10 and the syringe pump 20 and can be retrofitted.
  • the present invention is not limited to this, and the medication monitoring device 1 is attached to the infusion pump 10 and the syringe pump 11. It may be built in.
  • the medication monitoring apparatus can be used, for example, when medication is given to a patient using an infusion pump or a syringe pump in a hospital.
  • medication monitoring device 10 infusion pump (medication device) 20 Syringe pump (medication device) 30 Electronic Medical Record System 31 Electronic Medical Record Server 32 Examination Room Operation Terminal 33 Nurse Station Operation Terminal 44 Position Information Acquisition Unit 45 Alarm Lamp (Notification Unit) 46 Speaker (notification part) 49 control unit 55 determination unit 56 storage unit 57 instruction information input unit 58 execution information input unit

Abstract

A medication monitoring device (1) is provided with an instruction information input section (57) to which instruction information relating to medication to a patient which is stored in an electronic medical chart system (30) is inputted and an execution information input section (58) to which execution information relating to medication to be started by an infusion pump is inputted.  The medication monitoring device (1) is provided with a control part (49) which judges whether or not the execution information corresponds to the instruction information.  The control part (49) outputs an alarm signal when judging that the execution information does not correspond to the instruction information.

Description

投薬監視装置Medication monitoring device
　本発明は、患者に行われる投薬を監視する投薬監視装置に関する。 The present invention relates to a medication monitoring apparatus that monitors medication administered to a patient.
　近年、医療情報の電子化が推進されており、例えば、特許文献１、２に開示されているように、病院等の医療機関には、医師の医療行為を記録するカルテを電子化する電子カルテシステムが導入されるようになっている。電子カルテシステムには、患者の氏名等の患者情報、医師の診療行為情報、画像診断医が画像所見をまとめた読影レポート情報、医師が決定した投薬の指示情報等が入力されて記憶保存されている。このような様々な医療情報の電子化によって、医療情報を医療従事者の間で共有化することや、素早く検索して利用することができるようになる。 In recent years, the digitization of medical information has been promoted. For example, as disclosed in Patent Documents 1 and 2, a medical institution such as a hospital has an electronic medical record that digitizes a medical record that records a medical practice of a doctor. A system has been introduced. In the electronic medical record system, patient information such as the patient's name, doctor's medical practice information, interpretation report information that summarizes the image findings by the image diagnostician, medication instruction information determined by the doctor, etc. are input and stored. Yes. By digitizing such various medical information, it becomes possible to share medical information among healthcare professionals and to quickly search and use it.
　また、一般に、医療機関では、患者への投薬が行われる。投薬を行う際には、シリンジポンプや、輸液ポンプ等の投薬機器が用いられることが多い。シリンジポンプは、薬剤が充填されたシリンジがセットされるようになっており、薬剤の注入量や、注入速度等を設定することにより、シリンジ内の薬剤を設定値通りに患者へ自動的に注入することができるようになっている。また、輸液ポンプは、薬剤が充填された輸液バッグがセットされるようになっており、シリンジポンプと同様にして、輸液バッグ内の薬剤を設定値通りに患者へ自動的に注入することができるようになっている。 Also, in general, medical institutions administer medication to patients. When performing medication, medication devices such as syringe pumps and infusion pumps are often used. The syringe pump is designed to set a syringe filled with a medicine. By setting the injection amount and the injection speed of the medicine, the medicine in the syringe is automatically injected into the patient according to the set value. Can be done. In addition, the infusion pump is set with an infusion bag filled with a medicine, and in the same way as a syringe pump, the medicine in the infusion bag can be automatically infused to a patient according to a set value. It is like that.
　上述した電子カルテシステムを導入した医療機関において投薬機器を用いて患者に投薬を行う際には、次のようにして行われるのが一般的である。まず、看護師が、これから投薬を行う患者の投薬に関する指示情報（薬剤の種類、注入量、注入速度等）を電子カルテシステムを用いて得る。その後、調剤室で薬剤を準備して患者の病室へ運んでから、投薬機器にセットし、投薬機器を操作して注入量や注入速度等を設定して投薬を開始する。投薬が開始されたことを確認した看護師は、患者から離れて他の業務に当たっている。 When a patient is dispensed using a dispensing device in a medical institution where the electronic medical record system described above is introduced, it is generally performed as follows. First, a nurse obtains instruction information (medicine type, injection amount, injection rate, etc.) relating to the medication of a patient to be treated using an electronic medical record system. Then, after preparing the medicine in the dispensing room and transporting it to the patient's hospital room, the medicine is set in the dosing device, and the dosing device is operated to set the injection amount, the injection speed, etc., and start the dosing. The nurse who confirms that the medication has started is away from the patient and is engaged in other tasks.
特開２００６－９２２４７号公報JP 2006-92247 A 特開２００６－２５１９０１号公報JP 2006-251901 A
　ところが、電子カルテシステムによって患者の投薬に関する指示情報を簡単に得ることができるようになったものの、患者に投薬を行う際、看護師の人為的なミスを完全に無くすのは困難である。例えば、投薬機器を操作して薬剤の注入量や注入速度等を設定する際に、電子カルテシステムから得た投薬に関する指示情報とは異なった値に設定してしまうことが考えられる。具体的には、電子カルテシステムから得た投薬に関する指示情報では薬剤の注入速度が１０．０ｍｌ／ｈと指示されていたのに対し、看護師が、小数点を何らかの原因で見逃してしまったり、紙面上に記録した注入速度の数値から小数点が消えてしまっていたりして、投薬機器において注入速度１００ｍｌ／ｈと設定してしまう場合が考えられる。注入量についても同様のことが考えられる。この薬剤の注入速度や注入量の間違いは、その患者の病状及び投与する薬剤について詳しく知っている担当医師ならば容易に気づくのであるが、看護師は、多くの患者の看護を引き受けているため、個々の患者の病状を医師ほど詳しくは把握しておらず、ミスに気づかずに投薬を開始してしまう虞れがあり、これが医療事故の原因となってしまう。 However, although it has become possible to easily obtain instruction information on patient medication by using an electronic medical record system, it is difficult to completely eliminate a human error of a nurse when medication is given to a patient. For example, when setting the injection amount, injection speed, etc. of the medicine by operating the medication device, it may be set to a value different from the instruction information related to medication obtained from the electronic medical record system. Specifically, the instruction information on medication obtained from the electronic medical chart system indicated that the injection rate of the drug was 10.0 ml / h, whereas the nurse missed the decimal point for some reason, It is conceivable that the decimal point disappears from the numerical value of the injection speed recorded above and the injection speed is set to 100 ml / h in the dosing device. The same can be considered for the injection amount. The mistake in the injection rate and dose of this drug can be easily recognized by a doctor in charge who knows in detail about the patient's medical condition and the drug to be administered, but nurses take care of many patients. The medical conditions of individual patients are not as detailed as doctors, and there is a risk of starting medication without noticing a mistake, which causes a medical accident.
　また、投薬機器を操作する際、投薬機器の表示画面上に、たまたま異物が付着していて、それが小数点や数字の一部に見えてしまう虞れもあり、この場合にも、注入速度や注入量の入力間違いが起こる可能性がある。 In addition, when operating the prescription device, there is a possibility that a foreign object may accidentally adhere to the display screen of the prescription device, and it may appear as a part of the decimal point or number. There is a possibility that an incorrect injection amount may be entered.
　また、看護師の人為的なミスとしては、薬剤間違いもある。すなわち、複数の患者に投薬を行う際には、調剤室からそれぞれの患者用の薬剤を一度に持ち出して、各患者の元へ運んで患者毎の投薬機器にセットすることになる。このとき、投薬機器に他の患者用の薬剤を誤ってセットしてしまうと、電子カルテシステムから得た投薬に関する指示情報とは異なった薬剤が患者に投薬されることになり、このことによっても医療事故が起こる可能性がある。 Also, there are drug mistakes as artificial mistakes of nurses. That is, when a plurality of patients are dispensed, each patient's medicine is taken out from the dispensing room at once, and is carried to each patient and set in a dosing device for each patient. At this time, if a medication for other patients is set in the medication device by mistake, a medication different from the medication instruction information obtained from the electronic medical record system will be dispensed to the patient. Medical accidents can occur.
　本発明は斯かる点に鑑みてなされたものであり、その目的とするところは、投薬機器を用いて患者に投薬を行う際に、電子カルテシステムをより一層有効に活用することによって、投薬時における医療事故の発生を防止することにある。 The present invention has been made in view of such a point, and an object of the present invention is to more effectively utilize an electronic medical record system at the time of medication when performing medication to a patient using a medication device. It is to prevent the occurrence of medical accidents.
　上記目的を達成するために、本発明では、投薬機器により開始される投薬の実行情報が、電子カルテシステムに記憶されている患者の投薬に関する指示情報と対応してないことを判定できるようにし、対応していない場合には警報信号を発するようにした。 In order to achieve the above object, the present invention makes it possible to determine that the execution information of the medication started by the medication device does not correspond to the instruction information regarding the medication of the patient stored in the electronic medical record system, An alarm signal was issued when it was not compatible.
　具体的には、第１の発明では、患者に行われる投薬を監視する投薬監視装置において、電子カルテシステムに接続され、該電子カルテシステムに記憶されている患者への投薬に関する指示情報が入力される指示情報入力部と、患者に投与するための薬剤がセットされる投薬機器に接続され、該投薬機器により開始される投薬の実行情報が入力される実行情報入力部と、上記指示情報入力部及び上記実行情報入力部に接続され、これら入力部に入力された情報に基づいて上記実行情報が上記指示情報に対応しているか否かを判定する制御部とを備え、上記制御部は、上記実行情報入力部に入力された実行情報が上記指示情報入力部に入力された指示情報に対応していないと判定すると、警報信号を発するように構成されているものとする。 Specifically, in the first invention, in a medication monitoring apparatus for monitoring medication administered to a patient, instruction information regarding medication to a patient connected to an electronic medical record system and stored in the electronic medical record system is input. An instruction information input unit, an execution information input unit that is connected to a dosing device in which a medicine to be administered to a patient is set, and in which dosing information started by the dosing device is input, and the instruction information input unit And a control unit that is connected to the execution information input unit and determines whether or not the execution information corresponds to the instruction information based on information input to the input unit. If it is determined that the execution information input to the execution information input unit does not correspond to the instruction information input to the instruction information input unit, an alarm signal is generated.
　この構成によれば、例えば、看護師が薬剤の注入速度や注入量、種類等の実行情報を投薬機器に入力すると、その実行情報が投薬監視装置の実行情報入力部に入力される。一方、電子カルテシステムに記憶されている患者への投薬に関する指示情報は、指示情報入力部に入力される。制御部は、複数の実行情報が入力された場合には、それら実行情報のうち、１つでも指示情報と異なっていると、実行情報が指示情報と対応していないと判定して、警報信号を発する。また、１つの実行情報が入力された場合も、同様に警報信号を発する。これにより、薬剤が、指示情報とは異なる注入速度や注入量で患者に投与されることや、患者に間違った薬剤が投与されることをなくすことが可能になる。 According to this configuration, for example, when the nurse inputs execution information such as the injection rate, injection amount, and type of the drug to the medication device, the execution information is input to the execution information input unit of the medication monitoring device. On the other hand, the instruction information related to medication to the patient stored in the electronic medical chart system is input to the instruction information input unit. When a plurality of pieces of execution information are input, the control unit determines that the execution information does not correspond to the instruction information if any one of the pieces of execution information is different from the instruction information. To emit. Also, when one piece of execution information is input, an alarm signal is similarly issued. As a result, it is possible to prevent the drug from being administered to the patient at an injection rate or an injection volume different from the instruction information, or to prevent the wrong drug from being administered to the patient.
　第２の発明では、第１の発明において、実行情報は、薬剤の種類、薬剤を患者に投与する際の注入速度及びその注入量のうち、少なくとも１つであるものとする。 In the second invention, in the first invention, the execution information is at least one of the kind of medicine, the infusion speed when administering the medicine to the patient, and the amount of the infusion.
　第３の発明では、第１または２の発明において、制御部に接続され、該制御部が発した警報信号を周囲に報知する報知部を備えているものとする。 In the third invention, in the first or second invention, there is provided a notification unit that is connected to the control unit and notifies the surroundings of an alarm signal issued by the control unit.
　この構成によれば、投薬機器により開始される投薬の実行情報が、電子カルテシステムに記憶されている患者の投薬に関する指示情報に対応していないことが判定されると、そのことを周囲の者に報知することが可能になる。 According to this configuration, when it is determined that the medication execution information started by the medication device does not correspond to the patient medication instruction information stored in the electronic medical record system, this is indicated to the surrounding people. Can be notified.
　第４の発明では、第１から３のいずれか１つの発明において、制御部は、警報信号を電子カルテシステムに送信する構成とする。 In the fourth invention, in any one of the first to third inventions, the control unit transmits an alarm signal to the electronic medical chart system.
　この構成によれば、制御部が警報信号を発した場合に、その警報信号が電子カルテシステムに送信されることになる。これにより、投薬機器により開始される投薬の実行情報が、電子カルテシステムに記憶されている患者の投薬指示情報に対応していない場合に、そのことを電子カルテシステムの操作者や、その周囲の者に報知することが可能になる。 According to this configuration, when the control unit issues an alarm signal, the alarm signal is transmitted to the electronic medical chart system. Thereby, when the execution information of the medication started by the medication device does not correspond to the medication instruction information of the patient stored in the electronic medical record system, this is indicated to the operator of the electronic medical record system and the surroundings. It becomes possible to notify the person.
　第５の発明では、第１から４のいずれか１つの発明において、薬剤の注入速度の変化を記憶する記憶部を備えている構成とする。 In the fifth invention, in any one of the first to fourth inventions, a storage unit for storing a change in the injection rate of the medicine is provided.
　この構成によれば、投薬機器による薬剤の注入速度の変化を記憶しておくことが可能になる。 According to this configuration, it is possible to store a change in the injection rate of the medicine by the administration device.
　第６の発明では、第１から５のいずれか１つの発明において、制御部は、投薬機器の動作状態が正常であるか否かを判定し、動作状態が正常でない場合に警報信号を発するように構成されているものとする。 In a sixth invention, in any one of the first to fifth inventions, the control unit determines whether or not the operation state of the medication device is normal, and issues an alarm signal when the operation state is not normal. It is assumed that
　この構成によれば、投薬機器の動作状態が異常である場合には、制御部が警報信号を発することになる。 According to this configuration, when the operating state of the medication device is abnormal, the control unit issues an alarm signal.
　第７の発明では、第１から６のいずれか１つの発明において、現在位置情報を取得する位置情報取得部を備え、制御部は、上記位置情報取得部で取得された現在位置情報を電子カルテシステムに送信するように構成されているものとする。 According to a seventh invention, in any one of the first to sixth inventions, a position information acquisition unit for acquiring current position information is provided, and the control unit stores the current position information acquired by the position information acquisition unit in an electronic medical record. Assume that it is configured to send to the system.
　この構成によれば、投薬監視装置の所在を電子カルテシステム上で把握することが可能になる。 This configuration makes it possible to grasp the location of the medication monitoring device on the electronic medical record system.
　第１の発明によれば、投薬機器により開始される投薬の実行情報が、電子カルテシステムに記憶されている患者の投薬に関する指示情報に対応していない場合に、警報信号を発するようにしたので、薬剤の注入速度や注入量の設定、薬剤の種類等を間違えたままで患者に投薬が開始されることはなく、よって、投薬時における医療事故を防止することができる。 According to the first invention, when the execution information of the medication started by the medication device does not correspond to the instruction information regarding the medication of the patient stored in the electronic medical record system, the warning signal is generated. The patient does not start medication while setting the injection rate and injection amount of the drug, the type of the drug, etc., so that a medical accident at the time of medication can be prevented.
　第３の発明によれば、制御部が発した警報信号を周囲に報知する報知部を備えているので、薬剤の注入速度や注入量、薬剤の種類等が間違っている場合に、そのことを周囲の者に報知することができ、医療事故を確実に防止することができる。 According to the third aspect of the present invention, since the notification unit for notifying the surroundings of the alarm signal issued by the control unit is provided, if the injection rate, the injection amount, the type of the drug, or the like is wrong, A person around can be notified and a medical accident can be surely prevented.
　第４の発明によれば、制御部が発した警報信号を電子カルテシステムに送信することができるので、薬剤の注入速度や注入量、薬剤の種類等が間違っていることを、電子カルテシステムの操作者やその周りの者に報知することができ、医療事故を確実に防止することができる。 According to the fourth aspect of the invention, since the alarm signal issued by the control unit can be transmitted to the electronic medical chart system, it is confirmed that the injection rate and the injection amount of the medicine, the kind of medicine, etc. are incorrect. It is possible to notify the operator and those around him and prevent medical accidents with certainty.
　第５の発明によれば、薬剤の注入速度の変化を記憶するようにしたので、投薬中に注入速度が指示情報の値から大きく外れた場合に、警報信号を発することができ、投薬中においても医療事故を防止できる。 According to the fifth invention, since the change in the injection rate of the medicine is stored, an alarm signal can be issued when the injection rate greatly deviates from the value of the instruction information during the medication. Can also prevent medical accidents.
　第６の発明によれば、投薬機器の動作状態が異常である場合に制御部が警報信号を発するので、投薬機器の異常動作による医療事故の発生も防止することができる。 According to the sixth invention, since the control unit issues an alarm signal when the operating state of the medication device is abnormal, it is possible to prevent the occurrence of a medical accident due to the abnormal operation of the medication device.
　第７の発明によれば、投薬監視装置の現在位置情報を取得して電子カルテシステムに送信するようにしたので、投薬監視装置の所在を電子カルテシステム上で把握でき、所在管理を容易にすることができる。 According to the seventh invention, the current position information of the medication monitoring device is acquired and transmitted to the electronic medical record system, so that the location of the medication monitoring device can be grasped on the electronic medical record system and the location management is facilitated. be able to.
図１は、本発明の実施形態に係る投薬監視装置を輸液ポンプに取り付けた状態を示す正面図である。FIG. 1 is a front view showing a state in which a medication monitoring apparatus according to an embodiment of the present invention is attached to an infusion pump. 図２は、投薬監視装置及び電子カルテシステムを病院内のＬＡＮに接続した状態を示す概略図である。FIG. 2 is a schematic view showing a state in which the medication monitoring apparatus and the electronic medical chart system are connected to a LAN in a hospital. 図３は、投薬監視装置及び電子カルテシステムのブロック図である。FIG. 3 is a block diagram of the medication monitoring apparatus and the electronic medical record system. 図４は、電子カルテサーバのブロック図である。FIG. 4 is a block diagram of the electronic medical record server. 図５は、輸液ポンプのブロック図である。FIG. 5 is a block diagram of the infusion pump. 図６は、シリンジポンプのブロック図である。FIG. 6 is a block diagram of the syringe pump. 図７は、投薬監視装置のブロック図である。FIG. 7 is a block diagram of the medication monitoring apparatus. 図８は、薬剤が間違っている場合のマークが表示された操作端末を示す図である。FIG. 8 is a diagram illustrating an operation terminal on which a mark is displayed when a medicine is wrong. 図９は、薬剤の注入速度が間違っている場合の操作端末の表示画面を示す図である。FIG. 9 is a diagram showing a display screen of the operation terminal when the injection rate of the medicine is wrong. 図１０は、薬剤の注入量が間違っている場合の操作端末の表示画面を示す図である。FIG. 10 is a diagram showing a display screen of the operation terminal when the injection amount of the medicine is wrong. 図１１は、薬剤の流量が減少した場合の操作端末の表示画面を示す図である。FIG. 11 is a diagram illustrating a display screen of the operation terminal when the medicine flow rate is decreased. 図１２は、薬剤に気泡が混入した場合の操作端末の表示画面を示す図である。FIG. 12 is a diagram illustrating a display screen of the operation terminal when bubbles are mixed in the medicine. 図１３は、薬剤が無くなった場合の操作端末の表示画面を示す図である。FIG. 13 is a diagram illustrating a display screen of the operation terminal when there is no medicine. 図１４は、投薬監視装置の電源電圧が低下した場合の操作端末の表示画面を示す図である。FIG. 14 is a diagram showing a display screen of the operation terminal when the power supply voltage of the medication monitoring apparatus decreases.
　以下、本発明の実施形態を図面に基づいて詳細に説明する。尚、以下の好ましい実施形態の説明は、本質的に例示に過ぎず、本発明、その適用物或いはその用途を制限することを意図するものではない。 Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. It should be noted that the following description of the preferred embodiment is merely illustrative in nature, and is not intended to limit the present invention, its application, or its use.
　図１は、本発明の実施形態に係る投薬監視装置１を輸液ポンプ１０に装着して使用するものである。この投薬監視装置１は、図３に示すように、病院の各病室Ａ～Ｃに輸液ポンプ１０（投薬機器）やシリンジポンプ２０（投薬機器）と一緒に設置され、これら輸液ポンプ１０やシリンジポンプ２０による投薬を監視して異常があれば警報を発することができるように構成されている。 FIG. 1 shows a medication monitoring apparatus 1 according to an embodiment of the present invention mounted on an infusion pump 10 for use. As shown in FIG. 3, the medication monitoring apparatus 1 is installed in hospital rooms A to C together with an infusion pump 10 (medication device) and a syringe pump 20 (medication device). The infusion pump 10 and the syringe pump It is configured so that an alarm can be issued if there is an abnormality by monitoring the medication according to 20.
　この実施形態の説明では、投薬監視装置１の構造を説明する前に、本投薬監視装置１が配置される病院に導入されている電子カルテシステム３０について説明する。電子カルテシステム３０は、図２にも示すように、電子カルテサーバ３１と、電子カルテサーバ３１に接続される診察室用操作端末３２と、ナースステーション用操作端末３３とを備えている。電子カルテサーバ３１と、両操作端末３２、３３とは、病院内に設置されているＬＡＮ（Local Area Network）Ａに接続されている。診察室用操作端末３２及びナースステーション用操作端末３３は、各々、１つに限られるものではなく、複数あってもよい。尚、図２における符号Ｂは、ＨＵＢである。 In the description of this embodiment, before describing the structure of the medication monitoring apparatus 1, an electronic medical record system 30 installed in a hospital where the medication monitoring apparatus 1 is disposed will be described. As shown in FIG. 2, the electronic medical record system 30 includes an electronic medical record server 31, an examination room operation terminal 32 connected to the electronic medical record server 31, and a nurse station operation terminal 33. The electronic medical record server 31 and the operation terminals 32 and 33 are connected to a LAN (Local Area Network) A installed in the hospital. Each of the examination room operation terminal 32 and the nurse station operation terminal 33 is not limited to one, but may be a plurality. In addition, the code | symbol B in FIG. 2 is HUB.
　図４に示すように、電子カルテサーバ３１は、患者情報データベース３４、診察情報データベース３５、投薬指示情報データベース３６及び輸液ポンプ・シリンジポンプ管理データベース３７を備えている。患者情報データベース３４には、患者の氏名、生年月日、住所、血液型、健康保険証番号、入院病棟、病室番号、ベッド番号等が、患者毎に割り当てられた患者ＩＤに対応付けて記憶されている。この患者情報データベース３７に記憶されている情報は、病院の外来受付の際に入力される。診察情報データベース３８には、病名、医師の診療行為情報、画像診断医が画像所見をまとめた読影レポート情報、病歴、入院歴、担当医師名等が、患者ＩＤに対応付けて記憶されている。投薬指示情報データベース３６には、投薬に関する指示情報として、処方された薬剤の種類、投薬時期、投薬回数、１回あたりの患者への注入量及び注入速度が、患者ＩＤに対応付けて記憶されている。この投薬指示情報データベース３６には、患者に錠剤等が処方されている場合には、その種類、投与時期、投薬量も同様に記憶されている。輸液ポンプ・シリンジポンプ管理データベース３７には、病院内の輸液ポンプ１０及びシリンジポンプ２０の現在位置、使用期間、使用回数、保守状況等が、輸液ポンプ１０毎及びシリンジポンプ２０毎に割り当てられたポンプＩＤに対応付けて記憶されている。 As shown in FIG. 4, the electronic medical record server 31 includes a patient information database 34, a diagnosis information database 35, a medication instruction information database 36, and an infusion pump / syringe pump management database 37. In the patient information database 34, the patient's name, date of birth, address, blood type, health insurance card number, hospital ward, hospital room number, bed number, etc. are stored in association with the patient ID assigned to each patient. ing. The information stored in the patient information database 37 is input at the time of hospital outpatient reception. The diagnosis information database 38 stores a disease name, medical treatment information of a doctor, interpretation report information obtained by collecting image findings by an image diagnostician, a medical history, hospitalization history, a doctor name in charge, and the like in association with a patient ID. The medication instruction information database 36 stores, as instruction information related to medication, the type of medication prescribed, the timing of medication, the number of medications, the amount of injection to the patient per injection, and the injection speed in association with the patient ID. Yes. In the medication instruction information database 36, when a tablet or the like is prescribed for the patient, the type, administration time, and dosage are similarly stored. In the infusion pump / syringe pump management database 37, the current position, use period, number of times of use, maintenance status, etc. of the infusion pump 10 and syringe pump 20 in the hospital are assigned to each infusion pump 10 and each syringe pump 20. It is stored in association with the ID.
　輸液ポンプ１０及びシリンジポンプ２０の現在位置は、詳細は後述するが、輸液ポンプ１０及びシリンジポンプ２０から電子カルテサーバ３１へ送信されるようになっている。また、電子カルテサーバ３１の投薬指示情報データベース３６に記憶されている指示情報は、ＬＡＮを介して投薬監視装置１に送信されるようになっている。さらに、電子カルテサーバ３１は、投薬監視装置１が発する警報信号（後述する）をＬＡＮを介して受信するように構成されている。また、電子カルテサーバ３１は、投薬監視装置１から発せられた警報信号を受信したときに、操作端末３２、３３に所定の警報マークを表示させるように構成されている。この警報マークは、警報信号毎に異なっており、これら警報マークは、電子カルテサーバ３１に記憶されている。 The current positions of the infusion pump 10 and the syringe pump 20 are transmitted from the infusion pump 10 and the syringe pump 20 to the electronic medical record server 31 as will be described in detail later. In addition, the instruction information stored in the medication instruction information database 36 of the electronic medical record server 31 is transmitted to the medication monitoring apparatus 1 via the LAN. Furthermore, the electronic medical record server 31 is configured to receive an alarm signal (described later) issued by the medication monitoring apparatus 1 via the LAN. The electronic medical record server 31 is configured to display a predetermined alarm mark on the operation terminals 32 and 33 when receiving an alarm signal issued from the medication monitoring apparatus 1. This alarm mark is different for each alarm signal, and these alarm marks are stored in the electronic medical record server 31.
　図２に示すように、診察室用操作端末３２は、表示画面３２ａを有するコンピュータ端末であり、診察室に設置され、主に医師が操作するものである。医師による診察の結果及び処方箋は、診察室用操作端末３２で入力されて、電子カルテサーバ３１の診察情報データベース３５及び投薬指示情報データベース３６に記憶保存されるようになっている。また、ナースステーション用操作端末３３は、表示画面３３ａを有するコンピュータ端末であり、ナースステーションに設置され、主に看護師が操作するものである。 As shown in FIG. 2, the examination room operation terminal 32 is a computer terminal having a display screen 32a and is installed in the examination room and is mainly operated by a doctor. The result of the doctor's examination and the prescription are input at the examination room operation terminal 32 and stored in the examination information database 35 and the medication instruction information database 36 of the electronic medical record server 31. The nurse station operation terminal 33 is a computer terminal having a display screen 33a. The nurse station operation terminal 33 is installed in the nurse station and is mainly operated by a nurse.
　診察室用操作端末３２及びナースステーション用操作端末３３を操作して、電子カルテサーバ３１の患者情報データベース３４、診察情報データベース３５、投薬指示情報データベース３６及び輸液ポンプ・シリンジポンプ管理データベース３７に記憶されている情報を検索することができるようになっている。検索された情報は、電子カルテサーバ３１から各操作端末３２、３３へ出力されて、表示画面３２ａ、３３ａに表示されるようになっている。 It is stored in the patient information database 34, the examination information database 35, the medication instruction information database 36, and the infusion pump / syringe pump management database 37 of the electronic medical record server 31 by operating the examination room operation terminal 32 and the nurse station operation terminal 33. You are able to search for information. The retrieved information is output from the electronic medical record server 31 to the operation terminals 32 and 33 and displayed on the display screens 32a and 33a.
　次に、輸液ポンプ１０及びシリンジポンプ２０について説明する。輸液ポンプ１０及びシリンジポンプ２０は、病院の各病室Ａ～Ｃや、外来の点滴室等に配置されている可搬型のポンプであり、内蔵する充電池またはＡＣ電源で作動するようになっている。このような輸液ポンプ１０及びシリンジポンプ２０は、一般に、病院内に多数配置してある。 Next, the infusion pump 10 and the syringe pump 20 will be described. The infusion pump 10 and the syringe pump 20 are portable pumps arranged in hospital rooms A to C, outpatient drip chambers, and the like, and are operated by a built-in rechargeable battery or an AC power source. . A large number of such infusion pumps 10 and syringe pumps 20 are generally arranged in a hospital.
　輸液ポンプ１０は、輸液バッグＣ（図１に示す）内の薬剤を患者に所定の注入速度で所定量注入するように構成されている。輸液ポンプ１０には、輸液バッグＣから延びるチューブＤが接続されるとともに、患者へ穿刺される穿刺針（図示せず）を有するチューブＥが接続されている。輸液バッグＣ内の薬剤がチューブＤにより輸液ポンプ１０に導入され、この輸液ポンプ１０に導入された薬剤は、内蔵するポンプ（図示せず）によってチューブＥに吐出されて患者に投与されるようになっている。 The infusion pump 10 is configured to inject a predetermined amount of medicine in the infusion bag C (shown in FIG. 1) into the patient at a predetermined infusion rate. A tube D extending from the infusion bag C is connected to the infusion pump 10, and a tube E having a puncture needle (not shown) for puncturing the patient is connected. The medicine in the infusion bag C is introduced into the infusion pump 10 through the tube D, and the medicine introduced into the infusion pump 10 is discharged into the tube E by a built-in pump (not shown) and administered to the patient. It has become.
　図５に示すように、輸液ポンプ１０には、輸液バッグ容量入力部１１、注入速度入力部１２、注入量入力部１３が設けられている。また、図１に示すように、輸液ポンプ１０のケース１４には、輸液バッグ容量、注入速度、注入量を入力するための操作スイッチ１５を有する操作パネル１６と、操作スイッチ１５により入力した注入速度及び注入量を表示する表示画面を有する表示パネル１７とが設けられている。操作パネル１６には、他にも、電源スイッチ、投与開始スイッチや、停止スイッチ等が設けられている。 As shown in FIG. 5, the infusion pump 10 is provided with an infusion bag capacity input unit 11, an injection rate input unit 12, and an injection amount input unit 13. As shown in FIG. 1, the case 14 of the infusion pump 10 has an operation panel 16 having an operation switch 15 for inputting an infusion bag capacity, an infusion rate, and an infusion amount, and an infusion rate input by the operation switch 15. And a display panel 17 having a display screen for displaying the injection amount. In addition, the operation panel 16 is provided with a power switch, an administration start switch, a stop switch, and the like.
　輸液バッグＣ内の薬剤量は、輸液バック容量入力部１１に入力され、注入速度は、注入速度入力部１２に入力され、注入量は、注入量入力部１３に入力されるようになっている。これら入力部１１～１３に入力された値に基づいて、輸液ポンプ１０から吐出される薬剤の量及び流量が決定されるようになっている。各入力部１１～１３への入力が終わった後に、操作パネル１６にある開始ボタンを操作することで、薬剤の注入が開始されるようになっている。輸液ポンプ１０では、動作中における薬液の注入速度が得られるようになっている。 The amount of medicine in the infusion bag C is input to the infusion bag capacity input unit 11, the injection rate is input to the injection rate input unit 12, and the injection amount is input to the injection amount input unit 13. . The amount and flow rate of the medicine discharged from the infusion pump 10 are determined based on the values input to these input units 11 to 13. After the input to each of the input units 11 to 13 is finished, the medicine injection is started by operating the start button on the operation panel 16. In the infusion pump 10, the injection speed of the chemical solution during operation can be obtained.
　また、輸液ポンプ１０には、操作パネル１６で設定された輸液バッグ容量、注入速度、注入量及び現在の注入速度を出力する出力端子１８が設けられている。 Further, the infusion pump 10 is provided with an output terminal 18 for outputting the infusion bag capacity, the infusion rate, the infusion amount and the current infusion rate set on the operation panel 16.
　シリンジポンプ２０は、シリンジ（図示せず）内の薬剤を患者に注入するように構成されており、基本構成は、輸液ポンプ１０と同じである。シリンジポンプ２０には、薬剤が充填されたシリンジがセットされるとともに、穿刺針を有するチューブ（図示せず）が接続され、シリンジ内の薬剤が、内蔵するポンプ（図示せず）によってチューブに吐出されて患者に投与されるようになっている。図６に示すように、シリンジポンプ２０には、シリンジサイズ入力部２１、シリンジメーカー入力部２２、注入速度入力部２３、注入量入力部２４が設けられている。図示しないが、シリンジポンプ２０のケースには、シリンジサイズ、シリンジメーカー、注入速度、注入量を入力するための操作スイッチを有する操作パネルと、操作スイッチにより入力した注入速度及び注入量を表示する表示画面を有する表示パネルとが設けられている。 The syringe pump 20 is configured to inject a medicine in a syringe (not shown) into a patient, and the basic configuration is the same as that of the infusion pump 10. A syringe filled with a medicine is set in the syringe pump 20 and a tube (not shown) having a puncture needle is connected thereto, and the medicine in the syringe is discharged to the tube by a built-in pump (not shown). To be administered to patients. As shown in FIG. 6, the syringe pump 20 is provided with a syringe size input unit 21, a syringe manufacturer input unit 22, an injection rate input unit 23, and an injection amount input unit 24. Although not shown, the case of the syringe pump 20 has an operation panel having operation switches for inputting a syringe size, a syringe manufacturer, an injection speed, and an injection amount, and a display for displaying an injection speed and an injection amount input by the operation switch. And a display panel having a screen.
　シリンジサイズは、シリンジサイズ入力部２１に入力され、シリンジメーカーは、シリンジメーカー入力部２２に入力されるようになっている。また、薬剤の注入速度は、注入速度入力部２３に入力され、注入量は、注入量入力部２４に入力されるようになっている。これら入力部２１～２４に入力された値に基づいて、シリンジポンプ２０から吐出される薬剤の量及び流量が決定されるようになっている。 The syringe size is input to the syringe size input unit 21, and the syringe manufacturer is input to the syringe manufacturer input unit 22. Further, the injection rate of the medicine is input to the injection rate input unit 23, and the injection amount is input to the injection amount input unit 24. Based on the values input to these input units 21 to 24, the amount and flow rate of the medicine discharged from the syringe pump 20 are determined.
　また、シリンジポンプ２０には、シリンジサイズ、シリンジメーカー、注入速度、注入量及び現在の注入速度を出力する出力端子（図示せず）が設けられている。 Also, the syringe pump 20 is provided with an output terminal (not shown) for outputting the syringe size, syringe manufacturer, injection speed, injection amount, and current injection speed.
　次に、投薬監視装置１の構造について説明する。この投薬監視装置１は、図１に示すように、ケース３９を備えており、輸液ポンプ１０やシリンジポンプ２０の側部に取り付けられて一体化するようになっている。投薬監視装置１は、図７にも示すように、バーコードリーダ４０、流量センサ４１、気泡センサ４２、ポンプ接続部４３、位置情報取得部４４、警報ランプ４５（報知部）、スピーカー４６（報知部）、送信部４７、受信部４８、カメラ５１及び制御部４９を備えている。バーコードリーダ４０、流量センサ４１、気泡センサ４２、ポンプ接続部４３、位置情報取得部４４、警報ランプ４５、スピーカー４６、送信部４７、受信部４８及びカメラ５１は、制御部４９に接続されている。また、図２に示すように、この投薬監視装置１は、病院内のＬＡＮに無線接続されている。無線接続の規格としては、例えば、ＺｉｇＢｅｅが挙げられるが、これに限られるものではない。図２における符号Ｇは、ＺｉｇＢｅｅ用の接続端末であり、ＬＡＮに接続されている。尚、投薬監視装置１をＬＡＮに有線接続するようにしてもよい。 Next, the structure of the medication monitoring apparatus 1 will be described. As shown in FIG. 1, the medication monitoring apparatus 1 includes a case 39 and is attached to and integrated with the side portions of the infusion pump 10 and the syringe pump 20. As shown in FIG. 7, the medication monitoring apparatus 1 includes a barcode reader 40, a flow rate sensor 41, a bubble sensor 42, a pump connection unit 43, a position information acquisition unit 44, an alarm lamp 45 (informing unit), a speaker 46 (informing unit). A transmission unit 47, a reception unit 48, a camera 51, and a control unit 49. The barcode reader 40, flow sensor 41, bubble sensor 42, pump connection unit 43, position information acquisition unit 44, alarm lamp 45, speaker 46, transmission unit 47, reception unit 48, and camera 51 are connected to the control unit 49. Yes. As shown in FIG. 2, the medication monitoring apparatus 1 is wirelessly connected to a LAN in a hospital. As a standard for wireless connection, for example, ZigBee can be mentioned, but it is not limited to this. 2 is a connection terminal for ZigBee, and is connected to the LAN. The medication monitoring device 1 may be connected to the LAN by wire.
　バーコードリーダ４０は、輸液バッグＣに付けられている薬剤用バーコードＦ及び患者のベッド（図示せず）に付けられている患者用バーコードを読み取るためのものである。薬剤用バーコードＦは、薬剤の種類毎に予め決められており、例えば、生理的食塩水のように濃度が複数通りある薬剤の場合も、異なる薬剤として互いに異なる薬剤用バーコードＦが付けられている。この薬剤用バーコードＦをバーコードリーダ４０で読み取ることで、輸液バッグＣ内の薬剤の種類が分かるようになっている。患者用バーコードは、患者のベッド毎に予め決められている。この患者用バーコードを読み取ることで、患者を特定することが可能になっている。 The barcode reader 40 is for reading the medicine barcode F attached to the infusion bag C and the patient barcode attached to the patient's bed (not shown). The medicine barcode F is determined in advance for each kind of medicine. For example, in the case of a medicine having a plurality of concentrations such as physiological saline, different medicine barcodes F are attached as different medicines. ing. The type of drug in the infusion bag C can be identified by reading the bar code F for drug with the bar code reader 40. The patient barcode is predetermined for each patient bed. By reading this bar code for a patient, it is possible to identify the patient.
　流量センサ４１は、輸液バッグＣから延びるチューブＤの途中に取り付けられ、該チューブＤ内を流れる薬剤の流量を検出するためのものである。この流量センサ４１は、超音波を利用して液体の流量を計測する周知の構造を有している。また、気泡センサ４２は、穿刺針から延びるチューブＥの途中に取り付けられ、該チューブＥ内を流れる薬剤に気泡が混入しているか否かを検出するためのものである。この気泡センサ４２は、例えば、超音波を利用して液体中の気泡を検出する周知の構造を有している。 The flow rate sensor 41 is attached in the middle of the tube D extending from the infusion bag C, and detects the flow rate of the drug flowing through the tube D. The flow sensor 41 has a known structure that measures the flow rate of the liquid using ultrasonic waves. The bubble sensor 42 is attached in the middle of the tube E extending from the puncture needle, and detects whether or not bubbles are mixed in the medicine flowing through the tube E. The bubble sensor 42 has a known structure that detects bubbles in the liquid using, for example, ultrasonic waves.
　ポンプ接続部４３は、信号線５０を介して輸液ポンプ１０の出力端子１８に接続される端子を有している。このポンプ接続部４３に輸液ポンプ１０を接続することで、輸液ポンプ１０の各入力部１１～１３の輸液バッグ容量、注入速度及び注入量と、現在の注入速度とが投薬監視装置１に入力されるようになっている。また、ポンプ接続部４３にシリンジポンプ２０を接続した場合には、シリンジポンプ２０の各入力部２１～２４のシリンジサイズ、シリンジメーカー、注入速度及び注入量と、現在の注入速度とが、投薬監視装置１に入力されるようになっている。 The pump connection part 43 has a terminal connected to the output terminal 18 of the infusion pump 10 via the signal line 50. By connecting the infusion pump 10 to the pump connection unit 43, the infusion bag capacity, the infusion rate and the infusion amount of each input unit 11 to 13 of the infusion pump 10 and the current infusion rate are input to the medication monitoring apparatus 1. It has become so. In addition, when the syringe pump 20 is connected to the pump connection unit 43, the syringe size, syringe manufacturer, injection rate and injection amount, and the current injection rate of each input unit 21 to 24 of the syringe pump 20 are monitored for medication. The data is input to the device 1.
　位置情報取得部４４は、周知のＧＰＳ（global positioning system）で構成されている。即ち、位置情報取得部４４は、所定の人工衛星から発信される電波を受信して現在位置を測定する周知の構造のものであり、現在位置の測定結果を位置情報として制御部４９へ随時出力するように構成されている。 The position information acquisition unit 44 is configured by a well-known GPS (global positioning system). In other words, the position information acquisition unit 44 has a known structure for receiving the radio wave transmitted from a predetermined artificial satellite and measuring the current position, and outputs the current position measurement result to the control unit 49 as position information as needed. Is configured to do.
　警報ランプ４５は、例えば、赤色に点灯又は点滅するものであり、制御部４９から発せられた警報信号（詳細は後述する）を受けて点灯又は点滅するようになっている。警報ランプ４５の発光色や点滅パターンは任意に設定することが可能である。この警報ランプ４５は、ケース３９の複数箇所に設けてもよい。また、スピーカー４６は、所定の警報音を発するものであり、制御部４９から発せられた警報信号を受けて作動するようになっている。警報音は、任意の音色に設定することが可能である。 The alarm lamp 45 is, for example, lit or blinks in red, and is lit or blinks in response to an alarm signal (details will be described later) issued from the control unit 49. The light emission color and flashing pattern of the alarm lamp 45 can be arbitrarily set. This alarm lamp 45 may be provided at a plurality of locations of the case 39. The speaker 46 emits a predetermined alarm sound, and is activated in response to an alarm signal generated from the control unit 49. The alarm sound can be set to an arbitrary tone color.
　送信部４７及び受信部４８には、図１に示すように、アンテナ５３が接続されている。送信部４７は、輸液ポンプ１０がポンプ接続部４３に接続されている場合には、当該輸液ポンプ１０の現在位置情報、薬剤の注入開始時に発する注入開始信号、薬剤の注入終了時に発する注入終了信号を電子カルテサーバ３１に送信し、シリンジポンプ２０がポンプ接続部４３に接続されている場合には、当該シリンジポンプ２０の現在位置情報、注入開始信号及び注入終了信号を電子カルテサーバ３１に送信するように構成されている。 As shown in FIG. 1, an antenna 53 is connected to the transmission unit 47 and the reception unit 48. When the infusion pump 10 is connected to the pump connection unit 43, the transmission unit 47 is configured to provide information on the current position of the infusion pump 10, an injection start signal issued at the start of drug injection, and an injection end signal issued at the end of drug injection. Is transmitted to the electronic medical record server 31, and when the syringe pump 20 is connected to the pump connection unit 43, current position information of the syringe pump 20, an injection start signal, and an injection end signal are transmitted to the electronic medical record server 31. It is configured as follows.
　また、受信部４８は、電子カルテシステム３０の電子カルテサーバ３１から送信される投薬指示情報データベース３６の情報を受信するように構成されている。 Further, the receiving unit 48 is configured to receive the information in the medication instruction information database 36 transmitted from the electronic medical record server 31 of the electronic medical record system 30.
　また、投薬監視装置１には、固有のＩＤが割り振られており、投薬監視装置１から各種情報を送信する際には、そのＩＤが付されている。このため、どの病室Ａ～Ｃの投薬監視装置１から送信されてきた情報であるか、電子カルテサーバ３１側で判別できるようになっている。また、投薬監視装置１の電源電圧に関する信号も、電子カルテサーバ３１に送信されるようになっている。 In addition, a unique ID is assigned to the medication monitoring apparatus 1, and the ID is assigned when various information is transmitted from the medication monitoring apparatus 1. For this reason, it is possible to determine on the electronic medical record server 31 side which information is transmitted from the medication monitoring apparatus 1 in which of the hospital rooms A to C. In addition, a signal related to the power supply voltage of the medication monitoring apparatus 1 is also transmitted to the electronic medical record server 31.
　カメラ５１は、周知のＣＣＤカメラである。このカメラ５１は、ケース３９から延びるフレキシブルアーム５２の先端に固定されており、位置の変更が可能となっている。このカメラ５１で、表示パネル１７を撮影することができるようになっている。また、カメラ５１で撮影された画像は、制御部４９に入力されて、制御部４９では、表示パネル１７に表示されている数値が認識されるようになっている。カメラ５１は、ＣＣＤカメラ以外のカメラで構成することもできる。 The camera 51 is a well-known CCD camera. The camera 51 is fixed to the tip of a flexible arm 52 extending from the case 39, and the position can be changed. With this camera 51, the display panel 17 can be photographed. In addition, an image captured by the camera 51 is input to the control unit 49, and the control unit 49 recognizes the numerical value displayed on the display panel 17. The camera 51 can also be configured by a camera other than a CCD camera.
　制御部４９は、バーコードリーダ４０、流量センサ４１、気泡センサ４２、ポンプ接続部４３、位置情報取得部４４、受信部４８及びカメラ５１から得られた各種情報に基づいて、警報ランプ４５、スピーカー４６、送信部４７を制御するように構成されている。制御部４９は、バーコードリーダ４０で読み取られた患者用バーコードの情報を送信部４７により電子カルテサーバ３１に送信するようになっている。電子カルテサーバ３１では、患者用バーコードの情報から得たベッド番号により特定した患者の患者ＩＤが得られるようになっている。電子カルテサーバ３１は、投薬指示情報データベース３６からその患者の投薬に関する指示情報を得て、投薬監視装置１に送信する。投薬監視装置１に送信された指示情報は、投薬監視装置１の制御部４９に設けられた指示情報入力部５７に入力されて記憶されるようになっている。 Based on various information obtained from the bar code reader 40, the flow rate sensor 41, the bubble sensor 42, the pump connection unit 43, the position information acquisition unit 44, the reception unit 48, and the camera 51, the control unit 49 is connected to the alarm lamp 45, the speaker. 46, configured to control the transmission unit 47. The control unit 49 is configured to transmit information on the patient barcode read by the barcode reader 40 to the electronic medical record server 31 by the transmission unit 47. In the electronic medical record server 31, the patient ID of the patient specified by the bed number obtained from the information of the patient barcode is obtained. The electronic medical record server 31 obtains instruction information related to the patient's medication from the medication instruction information database 36 and transmits it to the medication monitoring apparatus 1. The instruction information transmitted to the medication monitoring apparatus 1 is input to and stored in an instruction information input unit 57 provided in the control unit 49 of the medication monitoring apparatus 1.
　また、制御部４９は、バーコードリーダ４０で読み取られた輸液用バーコードＦの情報により、輸液バッグＣに充填されている薬剤の種類を得る。この薬剤の種類は、制御部４９に設けられた実行情報入力部５８に入力されて記憶されるようになっている。さらに、輸液ポンプ１０の操作スイッチ１５で設定されて入力部１１～１３に入力された輸液バッグ容量、注入速度及び注入量も、実行情報入力部５８に入力されて記憶される。薬剤の種類、輸液バッグ容量、注入速度及び注入量は、輸液ポンプ１０によってこれから開始される投薬の実行情報である。制御部４９は、この実行情報が、指示情報に対応しているか否かを判定する判定部５５を備えている。判定部５５は、薬剤の種類、輸液バッグ容量、注入速度及び注入量の全てが指示情報と同じであれば、実行情報が指示情報に対応していると判定し、薬剤の種類、輸液バッグ容量、注入速度及び注入量のうち、１つでも指示情報と異なって（間違って）いれば、実行情報が指示情報に対応していないと判定するように構成されている。 Further, the control unit 49 obtains the type of medicine filled in the infusion bag C from the information of the infusion barcode F read by the barcode reader 40. The type of the medicine is input to and stored in an execution information input unit 58 provided in the control unit 49. Further, the infusion bag capacity, the infusion rate and the infusion amount set by the operation switch 15 of the infusion pump 10 and inputted to the input units 11 to 13 are also inputted to the execution information input unit 58 and stored. The kind of medicine, the infusion bag capacity, the infusion rate, and the infusion volume are the execution information of the medication that is started from the infusion pump 10. The control unit 49 includes a determination unit 55 that determines whether or not the execution information corresponds to the instruction information. The determination unit 55 determines that the execution information corresponds to the instruction information if all of the drug type, the infusion bag capacity, the injection speed, and the injection amount are the same as the instruction information, and the drug type, the infusion bag capacity If at least one of the injection speed and the injection amount is different (incorrect) from the instruction information, the execution information is determined not to correspond to the instruction information.
　制御部４９は、判定部５５によって実行情報が指示情報に対応していないと判定されると、警報信号を発するようになっている。この警報信号は、警報ランプ４５及びスピーカー４６に入力されるようになっている。また、警報信号は、送信部４７によって投薬監視装置１のＩＤと共に、電子カルテサーバ３１に送信されるようになっている。薬剤の種類が指示情報に対応していない場合に発せられる警報信号と、輸液バッグＣの容量が指示情報に対応していない場合に発せられる警報信号と、注入速度が指示情報に対応していない場合に発せられる警報信号と、注入量が指示情報に対応していない場合に発せられる警報信号とは、互いに異なっている。 The control unit 49 generates an alarm signal when the determination unit 55 determines that the execution information does not correspond to the instruction information. This alarm signal is input to the alarm lamp 45 and the speaker 46. The alarm signal is transmitted to the electronic medical record server 31 together with the ID of the medication monitoring apparatus 1 by the transmission unit 47. An alarm signal that is issued when the type of medicine does not correspond to the instruction information, an alarm signal that is issued when the capacity of the infusion bag C does not correspond to the instruction information, and the injection rate does not correspond to the instruction information. The alarm signal that is issued when the injection amount does not correspond to the instruction information is different from the alarm signal that is issued.
　制御部４９は、流量センサ４１から出力されたチューブＤ内の薬剤の流量が、輸液ポンプ１０に設定されている注入量に比べて少ない場合、及び気泡センサ４２によりチューブＥ内に気泡があることが検出された場合には、それぞれ、異なる警報信号を発するようになっている。また、制御部４９は、位置情報取得部４４から出力された現在位置情報を送信部４７によって、電子カルテサーバ３１へ出力するように構成されている。輸液ポンプ１０及びシリンジポンプ２０の現在位置情報は、電子カルテサーバ３１の輸液ポンプ・シリンジポンプ管理データベース３７に記憶されるようになっている。 When the flow rate of the medicine in the tube D output from the flow rate sensor 41 is smaller than the injection amount set in the infusion pump 10, the control unit 49 has bubbles in the tube E by the bubble sensor 42. When is detected, a different alarm signal is generated. The control unit 49 is configured to output the current position information output from the position information acquisition unit 44 to the electronic medical record server 31 by the transmission unit 47. The current position information of the infusion pump 10 and the syringe pump 20 is stored in the infusion pump / syringe pump management database 37 of the electronic medical record server 31.
　また、制御部４９は、輸液ポンプ１０から出力された薬剤の注入速度の変化データを記憶する記憶部５６を備えている。この記憶部５６には、薬剤の投与が開始されてから終了するまでの間、薬剤の注入速度が連続して記憶されるようになっている。この記憶部５６に記憶された薬剤の注入速度の変化データは、電子カルテサーバ３１へ送信されて診察情報データベース３５に記憶されるようになっている。 Further, the control unit 49 includes a storage unit 56 that stores change data of the injection rate of the medicine output from the infusion pump 10. The storage unit 56 continuously stores the injection rate of the drug from the start to the end of the drug administration. The change data of the injection rate of the medicine stored in the storage unit 56 is transmitted to the electronic medical record server 31 and stored in the examination information database 35.
　制御部４９は、記憶部５６に記憶された薬剤の注入速度が、指示情報の値に対し、例えば、５％以上ずれた場合には、輸液ポンプ１０に異常が発生していることが考えられるので、警報信号を発するようになっている。つまり、制御部４９は、輸液ポンプ１０の動作状態が正常であるか否かを判定して、動作状態が正常でない場合に警報信号を発するように構成されている。 When the injection rate of the medicine stored in the storage unit 56 is deviated by, for example, 5% or more with respect to the value of the instruction information, the control unit 49 may have an abnormality in the infusion pump 10. Therefore, an alarm signal is issued. That is, the control unit 49 is configured to determine whether or not the operation state of the infusion pump 10 is normal, and to issue an alarm signal when the operation state is not normal.
　また、患者への薬剤の投与が開始されてから終了予定時間よりも前に、流量センサ４１により検出される薬剤の流量が急激に減少した場合には、制御部４９により、警報信号が発せられるようになっている。すなわち、薬剤の投与が終了していないのにチューブＤに薬剤が流れなくなるということは、チューブＤが折れていたり、チューブＤの内部が詰まっている場合であり、このような異常が起こった場合に警報信号が発せられるようになっている。また、輸液ポンプ１０が故障して動作状態が異常になった場合にも、流量センサ４１により検出される薬剤の流量が急激に変化することがあり、この場合にも警報信号が発せられるようになっている。 In addition, when the flow rate of the drug detected by the flow sensor 41 suddenly decreases before the scheduled end time from the start of the administration of the drug to the patient, the control unit 49 issues an alarm signal. It is like that. That is, the fact that the medicine does not flow into the tube D even though the administration of the medicine is not completed is when the tube D is broken or the inside of the tube D is clogged, and such an abnormality has occurred. An alarm signal is issued. In addition, even when the infusion pump 10 breaks down and the operation state becomes abnormal, the flow rate of the medicine detected by the flow sensor 41 may change abruptly. In this case, an alarm signal is generated. It has become.
　また、患者への薬剤の投与が開始された後、気泡センサ４２により気泡が検出された場合、及び輸液ポンプ１０の電源電圧が低下した場合も、制御部４９により、互いに異なる警報信号が発せられるようになっている。さらに、輸液バッグＣの薬剤が無くなった場合にも、警報信号が発せられるようになっている。また、制御部４９は、輸液バッグＣの薬剤が無くなった場合にも警報信号を発するようになっている。 Also, when air bubbles are detected by the air bubble sensor 42 after administration of the medicine to the patient is started, and when the power supply voltage of the infusion pump 10 is lowered, the control unit 49 also generates different alarm signals. It is like that. Furthermore, an alarm signal is also issued when the medicine in the infusion bag C runs out. The control unit 49 also issues an alarm signal even when the medicine in the infusion bag C runs out.
　次に、上記のように構成された投薬監視装置１を使用する場合について説明する。この投薬監視装置１は、１台の輸液ポンプ１０またはシリンジポンプ２０につき１台取り付けて使用する。一方、看護師は、例えば、これから投与する患者がＢ病室の患者であれば、電子カルテシステム３０のナースステーション用操作端末３３を操作して、その患者の処方箋を入手する。看護師は、この処方箋に基づいて、調剤室で例えば輸液バッグＣを準備し、Ｂ病室まで運び、患者の輸液ポンプ１０にセットする。 Next, the case where the medication monitoring apparatus 1 configured as described above is used will be described. One medication monitoring apparatus 1 is attached to one infusion pump 10 or one syringe pump 20 for use. On the other hand, for example, if the patient to be administered is a patient in the B room, the nurse operates the nurse station operation terminal 33 of the electronic medical record system 30 to obtain the prescription of the patient. Based on this prescription, the nurse prepares, for example, an infusion bag C in the dispensing room, carries it to the B room, and sets it in the infusion pump 10 of the patient.
　この輸液バッグＣをセットする際、看護師は、始めに、投薬監視装置１のバーコードリーダ４０により、患者のベッドに付されている患者用バーコードの読み込み作業を行う。このバーコードリーダ４０により読み込まれた患者用バーコードの情報は、電子カルテシステム３０に送信され、電子カルテシステム３０からは、その患者への投薬に関する指示情報が投薬監視装置１に送信される。指示情報は、制御部４９の指示情報入力部５７に入力されて記憶される。 When the infusion bag C is set, the nurse first reads the patient barcode attached to the patient's bed by the barcode reader 40 of the medication monitoring apparatus 1. Information on the patient bar code read by the bar code reader 40 is transmitted to the electronic medical chart system 30, and instruction information related to medication to the patient is transmitted from the electronic medical chart system 30 to the medication monitoring apparatus 1. The instruction information is input and stored in the instruction information input unit 57 of the control unit 49.
　その後、看護師は、輸液バッグＣの輸液用バーコードＦを読み込ませる。この輸液用バーコードＦにより、セットされる輸液バッグＣの薬剤の種類が分かり、これが、制御部４９の実行情報入力部５８に入力されて記憶される。この時点で、制御部４９の判定部５５は、輸液用バーコード４０で得られた薬剤の種類が指示情報に基づく薬剤の種類と異なっている場合には、薬剤の種類が指示情報に対応していないと判定する。すると、制御部４９は、警報信号を発する。これにより、警報ランプ４５が点灯又は点滅し、スピーカー４６から警報音が発せられ、薬剤の種類が間違っていることが、看護師をはじめ、投薬監視装置１の周囲の者に報知される。さらに、警報信号は、電子カルテサーバ３１へ送信され、電子カルテサーバ３１は警報信号を受信すると、診察室用操作端末３２及びナースステーション用操作端末３３の表示画面３２ａ、３３ａに警報表示を行う。これにより、操作端末３２、３３の周囲の者に薬剤の種類が異なっていることが報知される。電子カルテサーバ３１は、薬剤の種類が間違っている場合の警報信号を受信した場合には、例えば、図８に示すような警報マークを表示画面３２ａ、３３ａの全体に亘るように大きく表示させるとともに、患者を特定する情報を表示させる。この警報マークの表示とともに、操作端末３２、３３のスピーカー（図示せず）から警報音を発するようにしてもよい。 After that, the nurse reads infusion barcode F of infusion bag C. The infusion bar code F indicates the type of medicine in the infusion bag C to be set, and this is input to the execution information input unit 58 of the control unit 49 and stored. At this time, the determination unit 55 of the control unit 49 determines that the type of medicine corresponds to the instruction information when the kind of medicine obtained by the infusion barcode 40 is different from the kind of medicine based on the instruction information. Judge that it is not. Then, the control unit 49 issues an alarm signal. As a result, the alarm lamp 45 is turned on or blinks, an alarm sound is emitted from the speaker 46, and the nurse and other persons around the medication monitoring apparatus 1 are notified that the type of medicine is wrong. Further, the warning signal is transmitted to the electronic medical record server 31. When the electronic medical record server 31 receives the warning signal, the warning signal is displayed on the display screens 32a and 33a of the examination room operation terminal 32 and the nurse station operation terminal 33. As a result, the person around the operation terminals 32 and 33 is notified that the type of medicine is different. When the electronic medical record server 31 receives an alarm signal when the type of medicine is wrong, for example, the electronic medical record server 31 displays an alarm mark as shown in FIG. 8 over the entire display screens 32a and 33a. To display information identifying the patient. An alarm sound may be emitted from a speaker (not shown) of the operation terminals 32 and 33 together with the display of the alarm mark.
　輸液用バーコード４０で得られた薬剤の種類が指示情報に基づく薬剤の種類と同じであれば、制御部４９は警報信号を発しないので、看護師は、次に、薬剤の注入速度及び注入量を輸液ポンプ１０に入力する。すなわち、看護師は、輸液ポンプ１０の表示パネル１７を見ながら操作スイッチ１５を操作して、注入速度及び注入量が処方箋通りの値となるように設定する。制御部４９の判定部５５は、このとき入力された注入速度の値が、指示情報に基づく注入速度と異なっている場合には、注入速度が指示情報に対応していないと判定する。また、注入量についても同様に判定する。判定部５５が指示情報に対応していないと判定すると、制御部４９は、上記のように警報信号を発する。電子カルテサーバ３１が、薬剤の注入速度が間違っている場合の警報信号を受信した場合には、例えば、図９に示すようなマークが表示画面３２ａ、３３ａの全体に亘るように大きく表示される。また、電子カルテサーバ３１が、薬剤の注入量が間違っている場合の警報信号を受信した場合には、例えば、図１０に示すようなマークが表示画面３２ａ、３３ａの全体に亘るように大きく表示される。これらマークの表示とともに、操作端末３２、３３のスピーカーから警報音を発するようにしてもよい。 If the type of drug obtained with the infusion barcode 40 is the same as the type of drug based on the instruction information, the control unit 49 does not issue an alarm signal. The amount is input to the infusion pump 10. That is, the nurse operates the operation switch 15 while looking at the display panel 17 of the infusion pump 10 to set the infusion rate and the infusion amount to values as prescribed. The determination unit 55 of the control unit 49 determines that the injection rate does not correspond to the instruction information when the value of the injection rate input at this time is different from the injection rate based on the instruction information. Further, the injection amount is similarly determined. When the determination unit 55 determines that it does not correspond to the instruction information, the control unit 49 issues an alarm signal as described above. When the electronic medical record server 31 receives an alarm signal when the injection rate of the medicine is wrong, for example, a mark as shown in FIG. 9 is displayed large over the entire display screens 32a and 33a. . Further, when the electronic medical record server 31 receives an alarm signal when the injection amount of the medicine is wrong, for example, a mark as shown in FIG. 10 is displayed so as to cover the entire display screens 32a and 33a. Is done. An alarm sound may be emitted from the speakers of the operation terminals 32 and 33 together with the display of these marks.
　つまり、薬剤の種類、注入速度及び注入量が少なくとも１つが間違っていると、投薬を開始する前に、警報信号を発して投薬監視装置１の周囲の者や、操作端末３２、３３の周囲の者に報知することが可能になる。これにより、薬剤が、指示情報と異なる注入速度や注入量で患者に投与されることや、患者に間違った薬剤が投与されることをなくすことが可能になる。 That is, if at least one of the medicine type, the injection speed, and the injection amount is wrong, an alarm signal is issued before starting the medication, and people around the medication monitoring device 1 and the operation terminals 32 and 33 It becomes possible to notify the person. As a result, it is possible to prevent the drug from being administered to the patient at an injection rate or an injection volume different from the instruction information, or to prevent the wrong drug from being administered to the patient.
　また、表示パネル１７を撮影するカメラ５１を備え、このカメラ５１で撮影した表示パネル１７の数値を制御部４９で認識するようにしているので、看護師が入力操作して表示パネル１７に表示された数値が指示情報と異なっている場合にも、制御部４９は警報信号を発することが可能になる。 In addition, since the camera 51 for photographing the display panel 17 is provided, and the numerical value of the display panel 17 photographed by the camera 51 is recognized by the control unit 49, the nurse performs an input operation and is displayed on the display panel 17. Even when the numerical value is different from the instruction information, the control unit 49 can issue an alarm signal.
　一方、上記のようにして各バーコードＦを読み込ませて、注入速度及び注入量を設定した後、判定部５５が、薬剤の注入速度及び注入量が指示情報と同じであり、指示情報に対応していると判定した場合には、制御部４９は、警報信号を発しない。従って、看護師は、次に、輸液ポンプ１０の開始スイッチを操作する。すると、輸液ポンプ１０が作動して、患者へ薬剤の投与が開始される。この薬剤の投与中における注入速度の変化は記憶部５６に記憶される。制御部４９は、薬剤の注入速度が、指示情報の値に対し、例えば、５％以上ずれた場合には、警報信号を発する。 On the other hand, after reading each barcode F as described above and setting the injection rate and the injection amount, the determination unit 55 has the same drug injection rate and injection amount as the instruction information and corresponds to the instruction information. When it determines with having carried out, the control part 49 does not emit an alarm signal. Therefore, the nurse next operates the start switch of the infusion pump 10. Then, the infusion pump 10 operates and administration of the medicine to the patient is started. Changes in the injection rate during the administration of the drug are stored in the storage unit 56. The control unit 49 issues an alarm signal when the injection rate of the drug is deviated by, for example, 5% or more from the value of the instruction information.
　また、患者への薬剤の投与が開始されてから終了予定時間よりも前に、流量センサ４１により検出される薬剤の流量が急激に減少した場合には、制御部４９により、流量減少の警報信号が発せられる。電子カルテサーバ３１は、流量減少の警報信号を受信した場合には、例えば、図１１に示すような警報マークを表示画面３２ａ、３３ａの全体に亘るように大きく表示させる。 In addition, when the flow rate of the drug detected by the flow sensor 41 is suddenly reduced before the scheduled end time from the start of the administration of the drug to the patient, the control unit 49 gives a warning signal of the flow rate decrease. Is emitted. When the electronic medical record server 31 receives an alarm signal for reducing the flow rate, for example, an alarm mark as shown in FIG. 11 is displayed so as to extend over the entire display screens 32a and 33a.
　また、患者への薬剤の投与が開始された後、気泡センサ４２により気泡が検出された場合には、制御部４９により、気泡検出の警報信号が発せられる。電子カルテサーバ３１は、気泡検出の警報信号を受信した場合には、例えば、図１２に示すようなマークを表示画面３２ａ、３３ａの全体に亘るように大きく表示させる。 In addition, when air bubbles are detected by the air bubble sensor 42 after the administration of the medicine to the patient is started, the control unit 49 issues an air bubble detection alarm signal. When the electronic medical record server 31 receives an alarm signal for detecting a bubble, for example, a mark as shown in FIG. 12 is displayed large over the entire display screen 32a, 33a.
　位置情報取得部４４で取得された位置情報は、上述した電子カルテサーバ３１の輸液ポンプ・シリンジポンプ管理データベース３７に、輸液ポンプ１０のＩＤと共に現在位置して記憶される。この位置情報は、所定時間経過後に更新されるようになっている。これにより、操作端末３２、３３で、輸液ポンプ１０の所在を把握することが可能になる。また
、輸液ポンプ１０を使用することで、注入開始信号及び注入終了信号が電子カルテサーバ３１に送信される。電子カルテサーバ３１は、これら信号に基づいて輸液ポンプ１０の使用期間、使用回数を得る。このようにして得られた使用期間及び使用回数は、輸液ポンプ・シリンジポンプ管理データベース３７に記憶される。さらに、輸液ポンプ１０を点検及び修理した場合には、操作端末３２、３３を操作して、保守情報として、輸液ポンプ・シリンジポンプ管理データベース３７に記憶される。 The position information acquired by the position information acquisition unit 44 is stored in the above-described infusion pump / syringe pump management database 37 of the electronic medical record server 31 together with the ID of the infusion pump 10. This position information is updated after a predetermined time has elapsed. Thereby, it is possible to grasp the location of the infusion pump 10 with the operation terminals 32 and 33. Further, by using the infusion pump 10, an injection start signal and an injection end signal are transmitted to the electronic medical record server 31. The electronic medical record server 31 obtains the use period and the number of uses of the infusion pump 10 based on these signals. The use period and the number of uses obtained in this way are stored in the infusion pump / syringe pump management database 37. Furthermore, when the infusion pump 10 is inspected and repaired, the operation terminals 32 and 33 are operated and stored as maintenance information in the infusion pump / syringe pump management database 37.
　また、電子カルテサーバ３１は、輸液バッグＣ内の薬剤が無くなったことの警報信号を受信すると、図１３に示すようなマークを表示画面３２ａ、３３ａの全体に亘るように大きく表示させる。 Further, when the electronic medical record server 31 receives an alarm signal indicating that the medicine in the infusion bag C has run out, the electronic medical record server 31 displays a large mark as shown in FIG. 13 over the entire display screens 32a and 33a.
　また、電子カルテサーバ３１は、輸液ポンプ１０の電源電圧に関する信号を受信して、輸液ポンプ１０の電源電圧が低下していると判断した場合には、図１４に示すようなマークを表示画面３２ａ、３３ａの全体に亘るように大きく表示させる。 When the electronic medical record server 31 receives a signal related to the power supply voltage of the infusion pump 10 and determines that the power supply voltage of the infusion pump 10 has decreased, a mark as shown in FIG. 14 is displayed on the display screen 32a. , 33a is displayed large.
　尚、シリンジポンプ２０を使用する場合も、上述した輸液ポンプ１０の場合と同様に、制御部４９は、各種警報信号を発することが可能である。 In addition, also when using the syringe pump 20, the control part 49 can emit various alarm signals similarly to the case of the infusion pump 10 mentioned above.
　したがって、この実施形態によれば、輸液ポンプ１０により開始される投薬の実行情報が、電子カルテシステム３０に記憶されている患者の投薬に関する指示情報に対応していない場合に警報信号を発することができる。これにより、薬剤の注入速度や注入量の設定、薬剤の種類等を間違えたままで患者に投薬が開始されることはなく、よって、投薬時における医療事故を防止することができる。 Therefore, according to this embodiment, when the execution information of the medication started by the infusion pump 10 does not correspond to the instruction information regarding the medication of the patient stored in the electronic medical chart system 30, the alarm signal can be issued. it can. Thereby, medication is not started to the patient while setting the injection speed and the injection amount of the medicine, the kind of the medicine, etc., and therefore a medical accident at the time of medication can be prevented.
　また、投薬監視装置１が警報ランプ４５及びスピーカー４６を備えているので、薬剤の注入速度や注入量、薬剤の種類等が間違っていることを周囲の者に報知することができ、医療事故を確実に防止することができる。尚、警報ランプ４５とスピーカー４６とは、いずれか一方のみを設けるようにしてもよい。 In addition, since the medication monitoring device 1 is provided with an alarm lamp 45 and a speaker 46, it is possible to notify the surrounding people that the injection rate, the injection amount, the type of the drug, etc. of the drug are wrong, and a medical accident can be reported. It can be surely prevented. Only one of the alarm lamp 45 and the speaker 46 may be provided.
　また、制御部４９が発した警報信号を電子カルテシステム３０に送信するようにしたので、薬剤の注入速度や注入量、薬剤の種類等が間違っていることを、電子カルテシステム３０の操作者やその周りの者に知らせることができ、このことによっても、医療事故を確実に防止することができる。 In addition, since the alarm signal issued by the control unit 49 is transmitted to the electronic medical record system 30, the operator of the electronic medical record system 30 can confirm that the injection rate, the injection amount, the type of the drug, etc. are incorrect. The person around it can be informed, and this can also reliably prevent medical accidents.
　また、薬剤の注入速度の変化を投薬監視装置１に記憶するようにしたので、投薬中に注入速度が指示情報の値から大きく外れた場合に、警報信号を発することができる。また、投薬後においても、薬剤が指示情報通りに投与されていたかを否かを確認することができる。 Further, since the change in the injection rate of the medicine is stored in the medication monitoring apparatus 1, an alarm signal can be issued when the injection rate greatly deviates from the value of the instruction information during the medication. Further, it is possible to confirm whether or not the medicine has been administered according to the instruction information even after the medication.
　また、輸液ポンプ１０の動作状態が正常でない場合に制御部４９が警報信号を発するので、輸液ポンプ１０の異常動作による医療事故の発生も防止することができる。 In addition, since the control unit 49 issues an alarm signal when the operation state of the infusion pump 10 is not normal, it is possible to prevent the occurrence of a medical accident due to the abnormal operation of the infusion pump 10.
　また、投薬監視装置１の現在位置情報を取得して電子カルテシステム３０に送信するようにしたので、投薬監視装置１の所在を電子カルテシステム３０上で把握でき、所在管理を容易にすることができる。 Further, since the current position information of the medication monitoring apparatus 1 is acquired and transmitted to the electronic medical record system 30, the location of the medication monitoring apparatus 1 can be grasped on the electronic medical record system 30 and the location management can be facilitated. it can.
　尚、上記実施形態では、輸液バッグＣに薬剤用バーコードＦを付し、患者のベッドに患者用バーコードを付しているが、これに限らず、輸液バッグＣにＩＣタグを付け、患者のベッドにＩＣタグを付けるようにしてもよい。この場合、投薬監視装置１のバーコードリーダ４０をＩＣタグリーダに変更すればよい。 In the above embodiment, the drug barcode F is attached to the infusion bag C and the patient barcode is attached to the patient's bed. However, the present invention is not limited thereto, and an IC tag is attached to the infusion bag C to An IC tag may be attached to the bed. In this case, the barcode reader 40 of the medication monitoring apparatus 1 may be changed to an IC tag reader.
　また、この実施形態では、投薬監視装置１を輸液ポンプ１０及びシリンジポンプ２０と別体にして後付けできるようにしているが、これに限らず、投薬監視装置１を輸液ポンプ１０やシリンジポンプ１１に内蔵するようにしてもよい。 Further, in this embodiment, the medication monitoring device 1 is separated from the infusion pump 10 and the syringe pump 20 and can be retrofitted. However, the present invention is not limited to this, and the medication monitoring device 1 is attached to the infusion pump 10 and the syringe pump 11. It may be built in.
　以上説明したように、本発明に係る投薬監視装置は、例えば、病院内で輸液ポンプやシリンジポンプを使用して患者に投薬する場合に用いることができる。 As described above, the medication monitoring apparatus according to the present invention can be used, for example, when medication is given to a patient using an infusion pump or a syringe pump in a hospital.
１　　　　　　　投薬監視装置
１０　　　　　　輸液ポンプ（投薬機器）
２０　　　　　　シリンジポンプ（投薬機器）
３０　　　　　　電子カルテシステム
３１　　　　　　電子カルテサーバ
３２　　　　　　診察室用操作端末
３３　　　　　　ナースステーション用操作端末
４４　　　　　　位置情報取得部
４５　　　　　　警報ランプ（報知部）
４６　　　　　　スピーカ（報知部）
４９　　　　　　制御部
５５　　　　　　判定部
５６　　　　　　記憶部
５７　　　　　　指示情報入力部
５８　　　　　　実行情報入力部 1 medication monitoring device 10 infusion pump (medication device)
20 Syringe pump (medication device)
30 Electronic Medical Record System 31 Electronic Medical Record Server 32 Examination Room Operation Terminal 33 Nurse Station Operation Terminal 44 Position Information Acquisition Unit 45 Alarm Lamp (Notification Unit)
46 Speaker (notification part)
49 control unit 55 determination unit 56 storage unit 57 instruction information input unit 58 execution information input unit

Claims (7)

  1. 　患者に行われる投薬を監視する投薬監視装置において、
    　電子カルテシステムに接続され、該電子カルテシステムに記憶されている患者への投薬に関する指示情報が入力される指示情報入力部と、
    　患者に投与するための薬剤がセットされる投薬機器に接続され、該投薬機器により開始される投薬の実行情報が入力される実行情報入力部と、
    　上記指示情報入力部及び上記実行情報入力部に接続され、これら入力部に入力された情報に基づいて上記実行情報が上記指示情報に対応しているか否かを判定する制御部とを備え、
    　上記制御部は、上記実行情報入力部に入力された実行情報が上記指示情報入力部に入力された指示情報に対応していないと判定すると、警報信号を発するように構成されていることを特徴とする投薬監視装置。     In a medication monitoring device for monitoring medication administered to a patient,
    An instruction information input unit connected to an electronic medical record system and for receiving instruction information relating to medication stored in the electronic medical record system;
    An execution information input unit that is connected to a medication device in which a medicine to be administered to a patient is set, and into which medication execution information started by the medication device is input;
    A controller that is connected to the instruction information input unit and the execution information input unit, and that determines whether the execution information corresponds to the instruction information based on information input to the input unit;
    The control unit is configured to issue an alarm signal when it is determined that the execution information input to the execution information input unit does not correspond to the instruction information input to the instruction information input unit. A medication monitoring device.
  2. 　請求項１に記載の投薬監視装置において、
    　実行情報は、薬剤の種類、薬剤を患者に投与する際の注入速度及びその注入量のうち、少なくとも１つであることを特徴とする投薬監視装置。     The medication monitoring device according to claim 1,
    The execution information is at least one of a kind of medicine, an infusion speed when the medicine is administered to a patient, and an infusion amount thereof.
  3. 　請求項１または２に記載の投薬監視装置において、
    　制御部に接続され、該制御部が発した警報信号を周囲に報知する報知部を備えていることを特徴とする投薬監視装置。     The medication monitoring device according to claim 1 or 2,
    A medication monitoring apparatus, comprising: a notification unit that is connected to the control unit and notifies an alarm signal issued by the control unit to the surroundings.
  4. 　請求項１から３のいずれか１つに記載の投薬監視装置において、
    　制御部は、警報信号を電子カルテシステムに送信するように構成されていることを特徴とする投薬監視装置。     The medication monitoring device according to any one of claims 1 to 3,
    The medication monitoring apparatus, wherein the control unit is configured to transmit an alarm signal to the electronic medical chart system.
  5. 　請求項１から４のいずれか１つに記載の投薬監視装置において、
    　薬剤の注入速度の変化を記憶する記憶部を備えていることを特徴とする投薬監視装置。     The medication monitoring device according to any one of claims 1 to 4,
    A medication monitoring device comprising a storage unit for storing a change in an injection rate of a medicine.
  6. 　請求項１から５のいずれか１つに記載の投薬監視装置において、
    　制御部は、投薬機器の動作状態が正常であるか否かを判定し、動作状態が正常でない場合に警報信号を発するように構成されていることを特徴とする投薬監視装置。     The medication monitoring device according to any one of claims 1 to 5,
    The medication monitoring device, wherein the control unit is configured to determine whether or not the operation state of the medication device is normal, and to issue an alarm signal when the operation state is not normal.
  7. 　請求項１から６のいずれか１つに記載の投薬監視装置において、
    　現在位置情報を取得する位置情報取得部を備え、
    　制御部は、上記位置情報取得部で取得された現在位置情報を電子カルテシステムに送信するように構成されていることを特徴とする投薬監視装置。     The medication monitoring device according to any one of claims 1 to 6,
    A location information acquisition unit that acquires current location information is provided.
    The medication monitoring device, wherein the control unit is configured to transmit the current position information acquired by the position information acquisition unit to an electronic medical record system.
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