JP2006268613A - Nursing support system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a nursing support system capable of efficiently creating a progress table.
A nursing support system 20 of the present invention includes a server 30 and a PC 60 as a client. In the server 30, the temporary DB 40 records nursing data of a plurality of patients. The search processing unit 33 searches the temporary DB 40 and acquires a plurality of nursing data of a patient who creates a progress table. The search processing unit 33 extracts nursing data based on a table in which items necessary for creating a progress table are indexed. The temporary DB 40 classifies and records nursing data of patients currently hospitalized and nursing data of patients who have already been discharged, and the search processing unit 33 limits the set of patients to be searched to patients currently hospitalized. To do. The progress table creation unit 64 of the PC 60 creates a progress table based on the nursing data acquired by the search processing unit 33.
[Selection] Figure 2

Description

  The present invention relates to a nursing support system that supports nursing actions by nurses and the like, and more particularly, to a nursing support system that creates a patient progress table.

A system for managing medical practice, in particular nursing practice, is composed of a personal computer (hereinafter referred to as “PC”), PDA (Personal Digital Assistants), etc., which are wired or wireless LAN (Local Area Network). Connected by. For example, in the system disclosed in Patent Document 1, a nurse carries a PDA as an information processing terminal device, refers to a work schedule list such as infusion or injection scheduled to be performed, and performs a nursing action on a patient To do. Further, after the nursing action is completed, the nurse inputs the result of the implementation to the PDA. The PDA transmits the input implementation result to the in-hospital information management system, and manages the implementation contents of the nursing action in the in-hospital information management system.
JP 2004-348717 A

  According to the technique disclosed in Patent Document 1, since the nurse checks the contents of nursing by operating the PDA at a place where the nursing action is performed, mistakes in the nursing action can be reduced. Further, immediately after the end of the nursing action, the nurse registers the result of the nursing action, that is, nursing data such as blood pressure and body temperature, so that the patient's nursing data can be managed efficiently.

  In order to express the progress of the medical condition of an inpatient, information display is generally performed using a progress table (also referred to as a “temperature plate”) in which nursing data is arranged in time series at a client terminal. Nursing data exists for each patient, and even when a patient is discharged from a hospital, the hospital is obliged to store nursing data, so the amount of nursing data in a large-scale hospital becomes enormous. Therefore, even if an attempt is made to create a progress table for a specific patient, it may take time to search for the patient, which may hinder the nursing work of busy nurses. In general, since there are several hundred items of nursing data, transferring all the nursing data from the server terminal to the client terminal not only takes a transfer time, but also increases the processing load on the client terminal.

  This invention is made | formed in view of such a condition, The objective is to provide the nursing assistance system which can produce a progress table efficiently.

  In order to solve the above-described problems, a nursing support system according to an aspect of the present invention includes a server and a client, and the server indicates a patient state by a storage unit that records nursing data of a plurality of patients, a graph, and a table. A search processing unit that retrieves and acquires a plurality of nursing data of a patient who creates a timeline showing a time series from a storage unit, and a transmission unit that transmits the acquired nursing data, and the client is transmitted from the transmission unit A receiving unit that receives the nursing data, and a progress table creation unit that creates a patient progress table based on the received nursing data. In the nursing support system of this aspect, the search processing unit extracts nursing data of items necessary for creating a graph and a table in a progress table from a plurality of items of nursing data recorded in the storage unit.

  According to the nursing support system of this aspect, it is possible to reduce the data transfer time from the server to the client and to reduce the processing load on the client by providing the client with nursing data of the items necessary for creating the graph and table in the progress table. Can be reduced.

  It should be noted that any combination of the above-described constituent elements and a conversion of the expression of the present invention between a method, an apparatus, a system, a recording medium, a computer program, etc. are also effective as an aspect of the present invention.

  According to the present invention, it is possible to provide a nursing support system capable of efficiently creating a progress table.

  FIG. 1 shows a configuration of a hospital information system 1 according to an embodiment of the present invention. The hospital information system 1 is installed in a medical facility such as a hospital, and includes a hospital information management system 10 that is a main system and a nursing support system 20 that is a subsystem. The hospital information management system 10 and the nursing support system 20 are communicably connected via a LAN (Local Area Network) 16. Although not shown, the LAN 16 may be connected to other subsystems in the medical facility, for example, an anesthesia support system that manages anesthesia procedures, a rehabilitation support system that manages a rehabilitation plan, and the like. The hospital information management system 10 has a function of centrally managing subsystems such as the nursing support system 20 connected via the LAN 16.

  The hospital information management system 10 includes a hospital information management server 12 that manages and controls the operation of a subsystem such as the nursing support system 20 and a master DB 14 that records data acquired in the subsystem such as the nursing support system 20. . Authentic data is recorded in the master DB 14, and advanced security measures are taken to prevent data tampering from the outside.

  The nursing support system 20 includes PDAs 70a to 70n (hereinafter referred to as “PDA70” representatively) which are portable terminals carried by a medical staff such as a server 30 that executes a nursing support function, a temporary DB 40 that records intended data, and a nurse. ), Access points 50a to 50n (hereinafter, referred to as “access point 50” as a representative) that establish a wireless LAN with the PDA 70 and transmit / receive data to / from the PDA 70, and input / output data. Personal computers 60a to 60n (hereinafter referred to as "PC60" as representative). Although the server 30 and the temporary DB 40 are illustrated as being separated from each other, the server 30 is actually configured to include the temporary DB 40, and the temporary DB 40 is under the management of the server 30.

  The PC 60 is a stationary terminal, and a medical staff such as a nurse performs data input, data reference, confirmation, and the like at the place where the PC 60 is installed. In this embodiment, the PC 60 and the PDA 70 function as clients with respect to the server 30. The PC 60 has a function of creating a patient progress table and displaying it on a monitor. The PDA 70 may have a progress table creation function and a display function.

  The progress table is also called a temperature plate, a nursing diary, or a temperature table, and shows a patient's state in time series by a graph and a table. Specifically, the progress table shows body temperature (T), pulse (P), respiration (R), blood pressure (BP) as a graph, as well as body temperature, pulse, respiration, blood pressure, urine volume, stool frequency, etc. . In the graph, the value of each item is connected by a broken line on the vertical axis, and the numerical value is plotted to express the patient's state in time series. In the table, the numerical value of each item is displayed to express the patient's condition in time series. The horizontal axis is set as the time axis.

  In addition to the functions of a normal PDA (for example, data input means using a touch panel, processing means such as a CPU for input data, data storage means, display means for displaying processed data, etc.), the PDA 70 is a wireless device. A wireless LAN card capable of wirelessly communicating with the access point 50 via a LAN and a reading means for reading identification information given to a patient, a medicine bottle, and the like are incorporated. The PDA 70 has a waterproof structure that is resistant to chemicals, and is easy to use in the medical field.

  The PDA 70 accesses the hospital information management system 10 via the server 30 at an arbitrary location within the access range from the access point 50, acquires the work schedule data stored in the master DB 14, and the acquired work schedule The data can be displayed on the display unit of the PDA 70. The work schedule data is an order describing work contents.

  The nursing support system 20 performs, for example, an outpatient system in which work schedule data such as injection is registered, a ward system, a drug department system that dispenses medicine by registering work schedule data such as injection, and accounting processing for medical practice. It is installed in a medical system to be performed, a nurse (station) system in which a nurse performs mixed injection and the like. In particular, many access points 50 and PCs 60 are installed in nurse systems and ward systems where nurses perform nursing actions. Each nurse carries the PDA 70 so that the nurse can go to the place where the nursing action is performed, specifically the bedside of the hospitalized patient, and perform input / output regarding the nursing action at that place. it can.

  As described above, the hospital information system 1 according to the present embodiment has a configuration in which the status of nursing action can be recorded or referred to in real time by using the PDA 70 efficiently. When a nurse carrying the PDA 70 performs a nursing action, the contents of the work schedule of the nursing action can be confirmed by the PDA 70, and after confirming the contents of the work schedule, the nursing action scheduled for the work can be performed. , The (scheduled) nursing action to be performed can be performed accurately and with few errors. In addition, since the contents of the nursing action can be easily input from the PDA 70 at the place where the nursing action is performed, the nursing action can be recorded accurately and with few errors.

  In addition, a nurse who carries a PDA 70 can refer to and confirm at any place and time using the carried PDA 70 when performing a nursing action, and can easily perform a nursing action. In addition, even when the work schedule contents are changed, the nurse carrying the PDA 70 can easily change the work schedule contents by checking the work schedule contents immediately before the execution at the place of execution. Can be dealt with.

  Patient nursing data input as a result of nursing practice from the PDA 70 is sent from the nearest access point 50 to the hospital information management system 10 via the server 30. In the hospital information management system 10, the hospital information management server 12 records nursing data in the master DB 14. Nursing data input from the PDA 70 includes nursing records such as the measured blood pressure value, pulse, urine volume, and meal intake of the patient. The nursing data recorded in the master DB 14 includes not only nursing records but also data such as nursing plans set for patients and comments from doctors, and includes all information related to patients. Although it depends on the hospital, there are various items of nursing data, and the number thereof may reach about 400, for example.

  In the hospital information system 1 of the present embodiment, the hospital information management system 10 centrally manages not only the nursing support system 20 but also other subsystems connected via the LAN 16. For this reason, access from the subsystems is concentrated in the hospital information management system 10, and the server 30 of the nursing support system 20 may not be able to read the nursing data recorded in the master DB 14 in a short time. Even if it is desired to immediately create and refer to the progress table of a specific patient, it takes time to read out the data from the master DB 14, which may hinder smooth nursing action.

  In the hospital information system 1 of the present embodiment, the nursing data recorded in the master DB 14 is also recorded in the temporary DB 40, thereby improving the data read response. The server 30 manages and controls the entire nursing support system 20, but still has a lower processing load than the hospital information management server 12 that manages the entire hospital information system 1. By recording nursing data in the temporary DB 40, the time for creating the progress table can be greatly reduced. It should be noted that it is preferable for the temporary DB 40 to take advanced security measures for preventing data tampering from the outside.

  FIG. 2 shows a configuration of a nursing support system according to the embodiment. FIG. 2 shows a PC 60 that executes a process for creating a progress table and a server 30 that supplies nursing data to the PC 60. FIG. 2 shows the temporary DB 40 as one of the components of the server 30. The PC 60 and the server 30 construct a client server system.

  The server 30 includes a transmission / reception unit 31, a request reception unit 32, a search processing unit 33, a table holding unit 34, and a temporary DB 40. The PC 60 includes an operation input unit 61, a transmission / reception unit 62, a nursing data acquisition unit 63, a progress table creation unit 64, and a monitor 65. The above configuration can be realized by a CPU, memory, or other LSI of an arbitrary computer in terms of hardware, and can be realized by a program loaded in the memory in terms of software. It depicts the functional blocks that are realized. Accordingly, those skilled in the art will understand that these functional blocks can be realized in various forms by hardware only, software only, or a combination thereof.

  The user generates a progress table creation request for a specific patient from the operation input unit 61. The operation input unit 61 is an input interface such as a keyboard and a mouse, and the user inputs a progress table creation request by operating the input interface. The progress table creation request is transmitted from the transmission / reception unit 62 to the transmission / reception unit 31 of the server 30 via the LAN.

  The progress table creation request received by the transmission / reception unit 31 is supplied to the request reception unit 32. When receiving the progress table creation request, the request receiving unit 32 causes the search processing unit 33 to search for nursing data of a patient for which a progress table is to be created. The search processing unit 33 searches and acquires a plurality of nursing data recorded for the patient from the temporary DB 40 using the identification information of the patient creating the progress table as a key.

  FIG. 3 shows the storage area of the temporary DB. The temporary DB 40 holds all nursing data recorded in the master DB 14 in synchronization, and has nursing data for all patients including discharged patients. The temporary DB 40 of this embodiment divides the nursing data storage area into two areas, a DB area 41 and a backup area 42. In general, progress tables are created to check changes in the time situation of inpatients, and there are few occasions for creating a progress table for patients who have already been discharged from the hospital. The

  Therefore, the temporary DB 40 classifies and records nursing data into nursing data for patients currently hospitalized and nursing data for patients who have already been discharged. Nursing data of a hospitalized patient is recorded in the DB area 41, and nursing data of a patient who has been discharged is recorded in a backup area 42. Therefore, while the patient is hospitalized, the nursing data is recorded in the DB area 41. However, when the patient is discharged from the hospital, the nursing data is saved in the backup area. The DB area 41 and the backup area 42 may be formed by dividing the address area of the temporary DB 40, but may be logically classified by setting a flag, for example. For example, a flag value 0 may be set for nursing data of hospitalized patients, and a flag value 1 may be set for nursing data of discharged patients so that the status of hospitalization or discharge can be logically confirmed. The discharged patient nursing data may be recorded not in the temporary DB 40 but in an external recording medium and stored offline in the hospital facility.

  FIG. 4 shows the hospitalization status of seven patients A to G recorded in the temporary DB. In FIG. 4, August 30 is today's date, and for convenience of explanation, only the hospitalization situation from August 10 to September 1 is shown, but in fact nursing data before August 10 is also shown. Existing. In FIG. 4, a day with a check indicates that the patient was hospitalized, and a day with a check after today indicates that the patient is scheduled to be hospitalized. In addition, nursing data has already been acquired on the hospitalization date before today.

  Assume that on August 30 (today), the user generates a progress table creation request for patient F from PC 60. Since patients B, D, and G have been discharged from the hospital, it is not necessary to include them in the set of patients to be searched. Therefore, in the temporary DB 40 of the present embodiment, the nursing data of the patients A, C, E, and F are recorded in the DB area 41, and the nursing data of the patients B, D, and G are recorded in the backup area 42. When creating a table, the search processing unit 33 searches only the DB area 41.

FIG. 5 shows the hospitalization status of patients recorded in the DB area of the temporary DB. In the DB area 41, only patients who are hospitalized on August 30 (today) are recorded.
For example, when searching for the patient F from the seven patients A to G, the patient A, the patient B, the patient C, the patient D, the patient E, the patient F, and the sixth person are searched in order from the patient A. And the search process is completed. On the other hand, as shown in FIG. 5, when searching for the patient F from the four patients, the patient A, the patient C, the patient E, and the patient F can be found as the fourth person. Thus, by limiting the set of patients to be searched to the patients recorded in the DB area 41, the search time can be shortened. In the actual temporary DB 40, nursing data of thousands to tens of thousands of patients is recorded, and considering that the majority are already discharged patients, the set of patients to be searched is narrowed down. As a result, it is possible to greatly shorten the search time for a patient who creates a progress table.

  FIG. 6 shows nursing data recorded for the retrieved patient F. In the figure, items with a check indicate that nursing data has been acquired. Patient F has been hospitalized for 15 days from August 16 to August 30, and therefore, nursing data for 15 days of patient F exists in DB area 41 of temporary DB 40.

  Nursing data includes patient status, comments from doctors, etc. As described above, the number of items is several hundred. Since there are a lot of unnecessary data for creating graphs and tables in the progress table, it is useless to send all items of nursing data to the PC 60 that requested the sending of nursing data. It takes time. Furthermore, the traffic on the LAN in the nursing support system 20 is also increased.

  Returning to FIG. 2, the search processing unit 33 extracts, from the nursing data of the patient F, the nursing data of items necessary for creating a graph and a table in the progress table. The table holding unit 34 holds a table in which items necessary for creating the progress table are indexed, and supplies the table to the search processing unit 33 during the search processing in the search processing unit 33.

  FIG. 7 shows an index table held in the table holding unit. The index table lists the graphs and the items used to create the table in the progress table, and the search processing unit 33 extracts the data of the items listed in the index table from hundreds of items of nursing data To do. Thereby, only the nursing data of the items necessary for creating the progress table can be extracted, and the data transfer rate to the PC 60 can be shortened. Note that the index table shown in FIG. 7 includes items not shown in FIG. 6 in consideration of the items in the actual progress table.

  The search processing unit 33 extracts nursing data for a set number of days from nursing data for a plurality of days. For example, the search processing unit 33 extracts nursing data for today, two days in the future from today, and five days in the past from today. In the example shown in FIG. 6, nursing data from August 25 to September 1 is extracted. Referring to the index table shown in FIG. 7, nursing data in a range surrounded by a frame 80 in FIG. 6 is acquired by the search processing unit 33. As described above, since some items of nursing data are omitted in FIG. 6, the nursing data of the items shown in FIG. 7 is actually acquired by the search processing unit 33. The acquired nursing data is transmitted by the transmission / reception unit 31 to the transmission / reception unit 62 of the PC 60.

  The transmission / reception unit 62 receives the nursing data acquired by the server 30. The nursing data acquisition unit 63 acquires nursing data from the transmission / reception unit 62 and supplies the nursing data to the progress table creation unit 64. The progress table creation unit 64 creates a patient progress table based on the acquired nursing data. Since the nursing data transmitted from the server 30 is limited to the data necessary for creating the progress table, the PC 60 requires less memory for developing the nursing data, and the display process can be speeded up. .

  FIG. 8 shows an example of a progress table screen. The progress table created by the progress table creating unit 64 is displayed on the monitor 65. The progress table includes a graph display area 92 that shows a patient's state in a time series as a graph, and a table area 94 that shows the patient's state in a time series in numerical values describing the table. The progress table creation unit 64 extracts items to be displayed as a graph, and displays the extracted nursing data in the graph display area 92 in time series. In the progress table shown in FIG. 8, the progress table creation unit 64 displays nursing data on body temperature (T), pulse (P), respiration (R), and blood pressure (BP) in the graph display area 92. Among these, body temperature (T), pulse (P), and respiration (R) are displayed as a line graph, and blood pressure (BP) is a numerical value of maximum blood pressure (systolic blood pressure) and minimum blood pressure (diastolic blood pressure). Is plotted in the graph. In the present embodiment, the progress table creation unit 64 displays the numerical values of all the nursing data acquired by the nursing data acquisition unit 63 in the table region 94. Accordingly, the items displayed in the table include items that are graphed. The progress table creation unit 64 may store the items of nursing data displayed in the graph display area 92 as a table, and may extract the nursing data to be displayed in a graph from the nursing data acquired by the nursing data acquisition unit 63.

  The screen size of the monitor 65 is limited, and in the example of FIG. 8, only the nursing data for 8 days is displayed. The search processing unit 33 extracts nursing data for a total of 8 days for today, for the future 2 days from today, and for the past 5 days from today. Therefore, the nursing data transmitted by the server 30 is extracted. All data can be displayed in a timeline. As described above, by extracting only data necessary for creating the progress table on the server 30 side and transmitting it to the PC 60, efficient data processing without waste can be realized.

  The user can change the date of the nursing data to be displayed by depressing the date change key 90 using the operation input unit 61. Also at this time, the search processing unit 33 acquires nursing data for 8 days from the DB area 41 and realizes data processing without waste.

  In the above, this invention was demonstrated based on the Example. This embodiment is merely an example, and it will be understood by those skilled in the art that various modifications can be made to the combination of each component and each processing process, and such modifications are within the scope of the present invention. is there.

  In the embodiment, the table holding unit 34 holds the index table shown in FIG. 7 in the server 30, but the PC 60 may include this index table. The index table may be prepared as a setting file in which, for example, a graph in the progress table and items necessary for creating the table are described in XML. This setting file uses information on whether to graph each item as a flag. You may have the area to memorize. In this case, the PC 60 transmits a search request for the items recorded in the setting file to the server 30, and the search processing unit 33 selects items necessary for creating the graph of the progress table and the table based on the search request. The data is extracted from the temporary DB 40 for a predetermined period and transmitted from the transmission / reception unit 31 to the transmission / reception unit 62 of the PC 60. The progress table creation unit 64 refers to the flag stored in the setting file, extracts nursing data of items to be graphed, and displays them in the graph display area 92. As described above, nursing data of items to be graphed is used not only for display in the graph display area 92 but also for display in the table area 94.

  In the embodiments, the client server system has been described. However, the present invention can also be applied to a stand-alone nursing support system. At this time, the nursing support system configured as a single terminal device searches the temporary DB 40 for recording nursing data of a plurality of patients and the search for acquiring a plurality of nursing data of patients creating a progress table from the temporary DB 40. The processing unit 33, a memory for developing the nursing data acquired by the search processing unit 33, and a progress table creation unit 64 for creating a patient progress table based on the nursing data developed in the memory are configured. The The retrieval processing unit 33 extracts nursing data of items necessary for creating a graph and a table in a progress table from a plurality of items of nursing data recorded in the temporary DB 40. As a result, the amount of nursing data developed in the memory can be reduced, the memory can be used efficiently, and the processing load on the system can be reduced.

It is a figure which shows the structure of the hospital information system concerning the Example of this invention. It is a figure which shows the structure of the nursing assistance system concerning an Example. It is a figure which shows the storage area of temporary DB. It is a figure which shows the hospitalization situation of patient A-patient G currently recorded on temporary DB. It is a figure which shows the hospitalization situation of the patient currently recorded on DB area | region of temporary DB. It is a figure which shows the nursing data currently recorded with respect to the searched patient F. FIG. It is a figure which shows the index table hold | maintained at the table holding part. It is a figure which shows the example of a screen of a progress table.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Hospital information system, 10 ... Hospital information management system, 12 ... Hospital information management server, 14 ... Master DB, 16 ... LAN, 20 ... Nursing support system, 30 ... Server 31 Transmission / reception unit 32 Request acceptance unit 33 Search processing unit 34 Table holding unit 40 Temporary DB 41 DB region 42 ..Backup area 50 ... Access point 60 ... PC 61 ... Operation input unit 62 ... Transmission / reception unit 63 ... Nursing data acquisition unit 64 ... Procedure table creation unit , 65... Monitor, 70... PDA, 90.

Claims (4)

A nursing support system comprising a server and a client,
The server
A storage unit for recording nursing data of a plurality of patients;
A search processing unit that searches and acquires a plurality of nursing data of a patient that creates a progress table showing a patient's state in time series by a graph and a table;
A transmission unit for transmitting the acquired nursing data,
The client
A receiving unit for receiving nursing data transmitted from the transmitting unit;
Based on the received nursing data, it has a progress table creation unit that creates a patient progress table,
The retrieval processing unit extracts nursing data of items necessary for creating a graph and a table in a progress table from a plurality of items of nursing data recorded in the storage unit.   The nursing support system according to claim 1, wherein the search processing unit extracts nursing data based on a graph in a progress table and a table in which items necessary for creating the table are indexed. The storage unit classifies and records nursing data of patients currently hospitalized and nursing data of patients who have been discharged,
The nursing support system according to claim 1, wherein the search processing unit limits a set of patients to be searched to patients who are currently hospitalized. The nursing support system according to any one of claims 1 to 3, wherein the search processing unit extracts nursing data for a set number of days from nursing data for a plurality of days.

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