WO2009139149A1 - Appareil de surveillance d'une médication - Google Patents

Appareil de surveillance d'une médication 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
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English (en)
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/fr

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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

L'invention concerne un dispositif (1) de surveillance d'une médication, doté d'une partie (57) d'introduction d'informations d'instruction dans lequel des informations d'instruction qui concernent la médication d'un patient et conservées dans un système (30) de tableau médical électronique sont introduites et une partie (58) d'introduction d'informations d'exécution dans laquelle des informations d'exécution qui concernent la médication qui doit être lancée par une pompe de perfusion sont introduites. Le dispositif (1) de surveillance d'une médication est doté d'une partie de commande (49) qui évalue si les informations d'exécution correspondent ou non aux informations d'instruction. La partie de commande (49) délivre un signal d'alarme lorsqu'elle évalue que les informations d'exécution ne correspondent pas aux informations d'instruction.
PCT/JP2009/002063 2008-05-12 2009-05-12 Appareil de surveillance d'une médication WO2009139149A1 (fr)

Applications Claiming Priority (2)

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JP2008124912A JP2009273502A (ja) 2008-05-12 2008-05-12 投薬監視装置
JP2008-124912 2008-05-12

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WO2009139149A1 true WO2009139149A1 (fr) 2009-11-19

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JPWO2019187689A1 (ja) * 2018-03-29 2021-03-18 テルモ株式会社 シリンジポンプシステム及びシリンジポンプ
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