JP2007200030A - Medical information management device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical information management device producing a temperature plate cooperating with an order. <P>SOLUTION: An order registration part 88 registers a nursing order to a patient, including at least one medical item. An extraction part 90 extracts at least the one medical item from the registered nursing order. A temperature plate production part 92 sets at least the one medical item as a display item when displaying an execution result corresponding to at least the one extracted medical item. The temperature plate production part 92 displays the execution result on a display device 98 while associating it to the set display item. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a medical information management apparatus, and more particularly to a medical management apparatus that creates a temperature plate for a patient.

A system for managing medical practices, particularly nursing practices, is composed of personal computers (hereinafter referred to as “PCs”), PDAs (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 (see, for example, Patent Document 1).
Japanese Patent Laid-Open No. 2004-110819

  The nursing action is generally performed according to the order issued by the order system. Nursing observation information, which is information obtained by observing a patient in nursing action, and nursing measurement information, which is a result of measurement performed on a patient, are acquired and recorded in a format called “temperature plate”. Displayed. The temperature plate is a progress table in which nursing data such as nursing observation information and nursing measurement information are arranged in time series. The display items on the temperature plate correspond to medical items corresponding to the order. However, since the order and the temperature plate are not linked, both were managed separately.

  This invention is made | formed in view of such a condition, The objective is to provide the medical information management apparatus which produces the temperature board cooperated with the order.

  In order to solve the above-described problem, a medical information management apparatus according to an aspect of the present invention is an instruction information registration unit that registers instruction information that is medical instruction instruction information for a patient and includes at least one medical item. And, from the instruction information registered in the instruction information registration unit, an extraction unit that extracts at least one of the medical items, and a display item when displaying an implementation result corresponding to at least one medical item extracted in the extraction unit, A display item setting unit configured to set at least one medical item; and a display unit configured to display an implementation result while being associated with the display item set in the display item setting unit.

  The “medical practice instruction information” is information for instructing what kind of medical practice should be performed, and information that should be registered before the medical practice is performed. The “medical item” is a content to be implemented in a medical practice or an item to be measured, such as blood pressure and pulse.

  According to this aspect, when the medical practice instruction information is registered, the temperature plate is created while using the medical items included in the instruction information as display items, so that the temperature plate in cooperation with the order can be created.

  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, a temperature plate linked to an order can be created.

  Before describing the present invention in detail, an outline will be described. Embodiments of the present invention relate to a nursing support system that manages nursing actions performed on a patient and nursing actions to be performed on the patient. The nursing support system includes a PC installed in a nurse station or the like, a PDA carried by the nurse, and a server for recording data used in the nursing support system, which are connected by a LAN. In the nursing support system according to the present embodiment, a nursing order is registered. In order to create a temperature plate associated with the registered nursing order, the nursing support system operates as follows.

  A user such as a nurse registers a nursing order with the nursing support system. Here, the nursing order is registered as a clinical path. That is, a nursing order is formed by a combination of a plurality of medical items (hereinafter referred to as “medical items”) to be executed over a plurality of dates. The nursing support system extracts a plurality of medical items included in the clinical path, and sets the extracted medical items as items (hereinafter referred to as “display items”) when creating a temperature plate. In addition, the date and time when each of the plurality of medical items is to be performed is also extracted from the clinical path and then used on the temperature plate. The nursing support system creates a temperature plate and displays it while associating the measurement result with the display item and the execution date and time.

  Moreover, the term prescribed | regulated in the nursing support system is demonstrated. The “nursing problem” indicates symptoms that should be the subject of nursing, and corresponds to a problem to be solved by the nurse's independent activities. Examples of nursing problems are "I have anxiety about rebleeding and treatment", "I can't maintain a comfortable environment due to vomiting and melena", and "I am mentally upset by a lot of blood and melena" A challenge that may affect the extent of patient recovery. When a nursing problem includes a plurality of items, each item is indicated as “nursing problem item”.

  The “nursing plan” indicates a nursing policy for a patient and corresponds to a nursing schedule. The nursing plan consists of four items: a plan for solving the nursing problem that obstructs the goal, the expected effect when the solution is made, the condition of the target patient, and the evaluation. The goal represents the expected state for a single nursing problem and corresponds to the desired patient state. Examples of goals include: “Can accept and coexist with disease”, “Can understand the need for long-term treatment and actively participate in treatment”, “Awareness of self-care “I am motivated and can take daily life behaviors according to my symptoms”.

  The plan includes an observation plan (OP), a care plan (CP), and an education / teaching plan (EP). The OP indicates an observation item for determining the course of progress, and the CP indicates nursing care, EP indicates treatment, treatment, etc. EP shows education and guidance on knowledge, methods, techniques, etc. necessary to face problem prevention, mitigation, and resolution. Examples of OP are “upper airway obstruction, nighttime respiratory distress (sinking of tongue base, snoring-like breathing)”, “breathing status (number, depth, rhythm, chest movement, presence or absence of effort-like breathing)” An example of CP is “a posture that does not impose a burden on the rib cage exercise”, “promotes coughing, and fixes and supports the abdomen with both hands at the time of sputum”. Explain the condition and get cooperation. "

  The “medical item” indicates the content of nursing for the patient. Nursing items are included in the nursing plan and correspond to the aforementioned plan. Here, the nursing items include OP, CP, and EP included in the above-described plan. Any other content may be used as long as it should be actually executed by the nurse.

  FIG. 1 shows a configuration of a hospital information system 100 according to an embodiment of the present invention. The hospital information system 100 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 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. Further, the server 30 manages the record information of all patients in the temporary DB 40.

  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. For example, the PC 60 performs tasks such as referring to a patient temperature plate and registering a nursing record at a nurse station. 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 temperature plate and displaying it on a monitor. The PDA 70 and the server 30 may have a temperature plate creation function and a display function.

  The temperature plate is also called a progress table, a nursing diary, and a thermometer table, and shows a patient's state in time series with a graph and a table. Specifically, the temperature plate shows body temperature (T), pulse (P), respiration (R), blood pressure (BP) in a graph, as well as a table showing 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. 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. It incorporates a wireless LAN function capable of wirelessly communicating with the access point 50 via a LAN, and a means for reading identification information given to a patient or a medicine bottle. 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. It should be noted that the input related to nursing action includes recording of patient observation / measurement information.

  As described above, the hospital information system 100 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 100 of this 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 temperature plate of a specific patient, it takes time to read out data from the master DB 14, which may hinder smooth nursing action.

  In the hospital information system 100 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 reading 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 and manages the entire hospital information system 100. By recording nursing data in the temporary DB 40, the time for creating the temperature plate 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.

  In the above configuration, the nursing support system 20 executes the following process in order to create a temperature plate. In the PC 60, an order for each target patient is registered by a nursing order issuing function described later. The server 30 receives the nursing order from the PC 60 and records it in the temporary DB 40. The PDA 70 displays information on the nursing orders recorded in the temporary DB 40, thereby displaying the unexecuted orders. The display prompts the nurse to perform the work. Further, the PDA 70 prompts the user to input an execution result for an unexecuted order, and instructs to register the contents in the recording area of the server 30, that is, the temporary DB 40. The PC 60 acquires the medical item from the data stored in the temporary DB 40 and sets the medical item as a display item, thereby displaying the implementation result in a temperature plate format. That is, when the nursing order is issued, the PC 60 extracts “items relating to information obtained from the implementation results associated with the nursing order” recorded in advance, and displays the items displayed on the temperature plate to the user. Encourage selection. Furthermore, the PC 60 confirms the issued nursing order at the stage of displaying the temperature plate after the execution of the order is completed, and sets items to be displayed.

  In the configuration of FIG. 1, the nursing order is registered and issued, and a temperature plate is created by cooperation of the server 30, the PC 60, and the PDA 70. Here, in order to clarify the description, a case where the above processing is executed by the PC 60 will be described. However, each component in the configuration of the PC 60 described later may be included in the server 30 or the PDA 70.

  FIG. 2 shows the configuration of the PC 60. The PC 60 includes a control unit 80, a communication unit 82, an input control unit 84, a screen creation unit 86, an order registration unit 88, an extraction unit 90, a temperature plate creation unit 92, and a recording unit 94. Further, the PC 60 connects an operation device 96 and a display device 98.

  The display device 98 displays predetermined information. The display device 98 may be configured integrally with the PC 60. The screen creation unit 86 generates a screen to be displayed on the display device 98. The screen creation unit 86 receives information for generating a screen to be displayed from the control unit 80. In the present embodiment, the screen generated by the screen creation unit 86 is configured to list each content at a plurality of stages of nursing. The configuration of the screen will be described later.

  The operation device 96 is operated by a nurse and inputs predetermined information to the PC 60. The operation device 96 is configured by a keyboard, a mouse, and the like. The operation device 96 may also be configured integrally with the PC 60. The input control unit 84 receives information input by the operation device 96. Further, the input control unit 84 outputs the received information to the control unit 80. In general, the nurse inputs predetermined information using the operation device 96 while confirming the screen displayed on the display device 98. Therefore, in order to recognize which part of the screen the information input by the operation device 96 corresponds to, the input control unit 84 receives information on the screen configuration from the screen creation unit 86.

  The communication unit 82 is connected to the LAN 16 in FIG. 1 and communicates with the server 30, another PC 60, and the PDA 70 via the LAN 16. The communication unit 82 receives information to be transmitted from the control unit 80 and outputs the received information to the control unit 80. The communication unit 82 communicates with the PDA 70 at a predetermined timing in order to realize data synchronization between the PC 60 and the server 30. The control unit 80 controls input / output of predetermined information between components included in the PC 60. That is, the control unit 80 receives information from one component and outputs information to another component. In addition, one component and another component are appropriately switched according to the function to be realized. Therefore, the control unit 80 has a switch function. Hereinafter, for the sake of clarity, the operation of one component and another component will be described, and the description of the operation of the control unit 80 will be omitted.

  The order registration unit 88 registers a nursing order that is a nursing order of a medical practice for a patient and includes at least one medical item. Details of registration and issuance of nursing orders by the user will be described later. Here, the registered nursing order includes a plurality of nursing orders. That is, the order registration unit 88 registers a clinical path. The order registration unit 88 receives a nursing order from the user via the control unit 80, the input control unit 84, and the operation device 96. The order registration unit 88 may receive a nursing order via the control unit 80 and the communication unit 82.

  The extraction unit 90 extracts at least one medical item from the clinical path registered in the order registration unit 88. Further, the extraction unit 90 extracts the implementation date and time associated with each of a plurality of nursing orders included in the clinical path. FIG. 3 shows a data structure of medical items to be extracted as display items on the temperature plate in the extraction unit 90. That is, FIG. 3 corresponds to a medical item that may be included in the clinical path. As shown in FIG. 3, medical items such as “blood pressure (systole)” are included, and the extraction unit 90 selects an item included in the clinical path registered by the order registration unit 88 in FIG. 3. To do. Returning to FIG.

  The temperature plate creation unit 92 sets at least one medical item as a display item when displaying an implementation result corresponding to at least one medical item extracted by the extraction unit 90. Further, the temperature plate creation unit 92 sets the implementation date and time as a display item together with the medical item. At that time, the temperature plate creation unit 92 sets the value corresponding to each of the medical items on one axis and sets the implementation date and time on the other axis, thereby displaying the implementation result value while plotting. Set the 2D coordinate area.

  In addition, the temperature plate creating unit 92 acquires the medical item implementation result via the control unit 80, the input control unit 84, and the operation device 96, and causes the recording unit 94 to record the result. The temperature plate creation unit 92 displays the implementation result on the display device 98 via the control unit 80 and the screen creation unit 86 while associating with the set display item. Here, the temperature plate creation unit 92 displays past implementation results, and also displays a nursing order of medical practices to be implemented in the future among the clinical paths registered in the order registration unit 88. That is, when displaying the temperature plate, the temperature plate creation unit 92 extracts past data and future orders recorded in the recording unit 94, and display items related to the past data and future orders. And display in the temperature plate format.

  The temperature plate is displayed in time series. Furthermore, the temperature plate creation unit 92 executes graph display for the value of the implementation result in the set two-dimensional coordinate area. Therefore, the temperature plate creation unit 92 plots the medical practice (measured value and date / time) in the two-dimensional coordinate area based on the upper / lower limit value information and time scale of the implementation item, and displays the plotted value as a line. Execute graphing with knot. In addition, when the clinical path is applied in the order registration unit 88, the temperature plate creation unit 92 performs development according to the path.

  After the temperature plate is created by the processing as described above, the clinical path may be changed depending on how the patient recovers. For example, when the clinical path is shortened or when the clinical path is postponed. Nursing orders differ depending on the implementation date and time, so if a nursing order for an arbitrary implementation date and time is deleted or used at another implementation date and time, nursing may be affected. Here, a case where the clinical path is postponed will be described, but the same process may be performed when the clinical path is shortened.

  The temperature plate creation unit 92 receives an instruction to postpone the clinical path via the control unit 80, the input control unit 84, and the operation device 96. The instruction corresponds to an instruction to postpone the implementation date corresponding to at least one of the plurality of nursing orders registered in the order registration unit 88. As will be described later, at least one of a plurality of nursing orders included in the clinical path is defined to be duplicated. When receiving a postponement instruction, the temperature plate creation unit 92 selects a nursing order that is defined as being duplicatable as a nursing order corresponding to the postponed implementation date and time. For example, a nursing order that is assigned to the day before the postponed execution date and that is defined to be duplicated is selected. The temperature plate creation unit 92 inserts the selected nursing order, and updates the display of the temperature plate by shifting the nursing order to be placed at a later date than the inserted nursing order. Further, the order registration unit 88 is notified of the update of the temperature plate display from the temperature plate creation unit 92 via the control unit 80. The order registration unit 88 registers the nursing order according to the notification.

  This configuration can be realized in terms of hardware by a CPU, memory, or other LSI of any computer, and in terms of software, it is realized by a program loaded with memory. Draw functional blocks. 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.

  FIG. 4 shows the structure of data recorded in the recording unit 94 and associated with nursing problems from the medical department. The data includes a medical department column 200, a disease column 202, and a nursing problem column 204. The medical department column 200 includes “first internal medicine”, “third internal medicine”, “second surgery”, and the like. Each item included in the disease column 202 is associated with one of the items included in the medical department column 200. For example, "nursing Shydragia" is associated with "Third internal medicine". Items included in the nursing problem column 204 are associated with any of the items included in the disease column 202. For example, “Pass: Shydragia Pass A” is associated with “Shydragia”. Here, “Pass: Shydragia Path A” in the nursing problem column 204 corresponds to a clinical path, but “Problem: There is orthostatic blood pressure and there is a risk of falling” is not a clinical path. It corresponds to an individual nursing problem. Here, the clinical path corresponds to a combination of individual nursing problems. The department, disease, and nursing problem are associated with each other by the above data structure.

  FIG. 5 shows the structure of data recorded in the recording unit 94 and associated with a path name, a nursing plan, and a nursing order. The data includes a path name column 206, a nursing plan column 208, and a nursing order column 210. The path name column 206 includes a clinical path, and the clinical path corresponds to the clinical path included in the nursing problem column 204 of FIG. The nursing plan column 208 and the nursing order column 210 include a nursing plan and a nursing order, respectively. Here, the nursing plan is collectively referred to as “A1” or the like, and the nursing order is collectively referred to as “B1” or the like. The clinical path, the nursing plan, and the nursing order are associated with each other. That is, when one of the path name fields 206 is selected, a nursing plan and a nursing order are also uniquely selected.

  FIG. 6 shows the data structure recorded in the recording unit 94 and related to the nursing order. Here, as an example, the nursing order corresponding to the “Shydragia path B” in FIG. 5, that is, “B2” in FIG. 5 is shown. The data includes an implementation date / time column 212, a medical item column 214, and a replication column 216. The implementation date and time column 212 includes the date and time when the medical item should be performed, and here, the date and time based on the date of surgery is included. The medical item column 214 includes medical items while being associated with each of the implementation dates. It is assumed that the medical item included in the medical item column 214 is one of the medical items shown in FIG. The duplication column 216 indicates whether or not the medical item at the related execution date can be duplicated. If it can be replicated, it may be used when the clinical path is postponed as described above.

  The operation of the PC 60 having the above configuration will be described. FIG. 7 is a flowchart showing a procedure until the nursing order is determined by the PC 60. The order registration unit 88 causes the display device 64 to display an initial screen. FIG. 8 shows a screen displayed on the display device 98 when input of a nursing problem is started. On the screen, a nursing target column 110, a nursing problem column 112, a nursing plan column 114, and a nursing record column 116 are displayed. In each of these, a nursing target, a nursing problem, a nursing plan, and a nursing record are displayed. . As shown in the figure, nursing goals, nursing problems, nursing plans, and nursing records are arranged so that they can be listed. Returning to FIG. The order registration unit 88 presents a plurality of departments on the display device 64 (S10). This corresponds to the presentation in the clinical department column 200 of FIG. The clinical department is selected by the nurse via the operation device 96 (S12).

  Subsequently, the order registration unit 88 presents a plurality of diseases on the display device 64 (S14). This corresponds to the presentation of the disease column 202 in FIG. A disease is selected by the nurse via the operation device 62 (S16). Further, the order registration unit 88 presents a plurality of types of items of nursing problems on the display device 64 (S18). The nursing problem item or clinical path is selected by the nurse via the operation device 62 (S20). FIG. 9 shows a screen displayed on the display device 98 when a nursing problem is selected. A nursing problem selection window 118 is displayed at the center of the screen. In the nursing problem selection window 118, the medical department column 200, the disease column 202, and the nursing problem column 204 of FIG. 4 are displayed.

  FIG. 9 corresponds to the state of step 20 and “third internal medicine”, “Shydragia disease”, and “Shydragia path B” are already selected. As described above, since the clinical department column 200, the disease column 202, and the nursing problem column 204 in FIG. 4 are associated with each other, when the order registration unit 88 selects any of the clinical department columns 200, The options of the corresponding disease column 202 are displayed. In addition, when any one of the disease columns 202 is selected, the order registration unit 88 displays one of the nursing problem columns 204 corresponding thereto. That is, when one option is selected, the subsequent options are displayed.

  Returning to FIG. If the clinical path is selected, the order registration unit 88 refers to the recording unit 94 and acquires a nursing plan and a nursing order corresponding to the clinical path (S22). Here, the data of FIG. 5 is used. FIG. 10 shows a screen displayed on the display device 98 when a nursing problem is selected. As shown, the selected clinical path is displayed in the nursing problem column 112, and the nursing plan corresponding to the clinical path is displayed in the nursing plan column 114. Returning to FIG. If there is a change in the nursing order (Y in S24), the order registration unit 88 receives the change of the nursing order from the nurse (S26). FIG. 11 shows a screen displayed when the nursing order is edited on the display device 98. A candidate order column 120 and a decision order column 122 are displayed, and the candidate order column 120 shows the nursing orders included in the clinical path and editable. On the other hand, in the decision order column 122, nursing orders whose implementation has been decided by editing are shown. Returning to FIG. If there is no change in the nursing order (N in S24), the order registration unit 88 ends the process.

  Next, processing when a nursing order registered as described above is issued will be described. FIG. 12 is a schematic diagram for illustrating order issue processing in the nursing support system. The figure shows injection order issue as order issue. The nurse creates an order (S80) and registers the order (S82). In the case of injection, when an order is registered, the process branches as follows. First, the ward system (not shown) is instructed to receive instructions in the ward (S84). The instruction reception is executed by the nurse. Second, the medicine department system (not shown) is instructed to dispense medicines in the medicine department (S86). The payout is performed by a pharmacist.

  Third, the ward system (not shown) is instructed to mix the drugs in the ward (S88). Mixed injection is also called mixing. The mixed injection is performed by a nurse. Fourth, the nursing support system 20 is instructed to start injection to the patient in the ward (S90). Fifth, the nursing support system 20 is instructed to end the injection to the patient in the ward (S92). The injection is performed by a nurse. Here, the injection includes both drip injection and one-shot injection. In the case of drip injection, since administration is performed over time, generally, in the case of one-shot injection in which the work of starting and ending administration is performed separately, the administration is completed in one action. Administration starts and ends almost simultaneously. The fourth is used for temperature plate creation (S94). In other words, the extraction unit 90 is notified of the issue of the nursing order.

  Next, a process from when a nursing order is registered and issued until a temperature plate is created will be described. FIG. 13 is a flowchart showing a procedure until a temperature plate is created by the PC 60. The extraction unit 90 extracts the medical item and the implementation date from the nursing order registered in the order registration unit 88, here the clinical path (S100). The temperature plate creation unit 92 sets the medical item on the Y axis and the implementation date on the X axis for the medical item and the implementation date and time extracted by the extraction unit 90 (S102). FIG. 14 shows the format of the temperature plate displayed on the display device 98. The temperature plate includes a graph area 130 that shows the patient's condition in a time series as a graph, and a table area 132 that shows the patient's condition in a time series in numerical values. As shown in the figure, the implementation date and time such as “2004/8/26 (Thu)” is displayed on the X axis, and the medical item such as “blood pressure (systole)” is displayed on the Y axis. Returning to FIG. If there is an execution result (Y in S104), the temperature plate creation unit 92 associates the execution result with the format of the temperature plate (S106), and creates a graph to be displayed in the graph area 130 (S108). On the other hand, if there is no implementation result (N of S104), the temperature plate creation unit 92 ends the process.

  FIG. 15 shows a temperature plate screen displayed on the display device 98. The temperature plate creation unit 92 extracts items to be displayed as a graph, and displays the extracted nursing data in time series in the graph area 130. In the temperature plate shown in FIG. 15, the temperature plate creation unit 92 displays the results of body temperature (T), pulse (P), respiration (R), and blood pressure (BP), that is, nursing data, in the graph area 130. . 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 temperature plate creation unit 92 displays the numerical values of all acquired nursing data in the table area 132. Accordingly, the items displayed in the table include items that are graphed. The temperature plate creation unit 92 may hold nursing data items to be displayed in the graph area 130 as a table, and may extract nursing data to be displayed in a graph from the acquired nursing data.

  FIG. 16 is a flowchart showing a procedure for postponing a clinical path by the PC 60. If an instruction to postpone the clinical path is received via the operation device 96 or the like (Y in S120), the temperature plate creation unit 92 searches for a nursing order that can be duplicated with reference to the recording unit 94 (S122). . The temperature plate creation unit 92 identifies the immediately preceding nursing order among the implementation dates and times to be postponed among the searched nursing orders, and duplicates this (S124). The temperature plate creation unit 92 updates the temperature plate (S126). Further, the order registration unit 88 registers the copied nursing order (S128). On the other hand, if the instruction to postpone the clinical path is not received (N in S120), the temperature plate creating unit 92 ends the process.

  According to the embodiment of the present invention, when a nursing order is registered, the temperature plate is created while using the medical items included in the nursing order as display items, so that a temperature plate linked to the nursing order can be created. Further, since the nursing order is registered as a clinical path, it is possible to create a temperature plate corresponding to a plurality of nursing orders included in the clinical path. Further, since a plurality of nursing orders included in the clinical path are displayed together with the implementation date, the information listing property can be improved. In addition, since the clinical path is selected by selecting the medical department, the disease, and the clinical path in this order, an appropriate clinical path can be selected. Also, since nursing orders standardized by the clinical path are registered, erroneous registration of nursing orders can be reduced. Moreover, since erroneous registration of nursing orders is reduced, an accurate temperature plate can be created.

  Moreover, since past implementation results and nursing orders to be implemented in the future are displayed, it is possible to recognize both while associating them. In addition, it is possible to easily postpone a clinical path by prescribing a nursing order that can be duplicated and using the nursing order that can be duplicated when the clinical path is postponed. In addition, by predefining a nursing order that can be duplicated, it is possible to prevent the clinical path from being postponed by a nursing order that is not suitable for duplication. Also, since the clinical path can be easily changed, a temperature plate suitable for the actual nursing situation can be created. Moreover, nursing information can be accurately transmitted by using a graph and a table together on the temperature plate.

  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 also within the scope of the present invention. is there.

  In the embodiment of the present invention, a nursing order that can be duplicated is defined among the nursing orders recorded by the recording unit 94, and the temperature plate creating unit 92 performs the nursing order when the clinical path is postponed. Is used. However, the present invention is not limited to this. For example, the recording unit 94 records a postponement nursing order separately, and the temperature plate creation unit 92 may use the postponement nursing order when postponing the clinical path. . Further, a plurality of postponement nursing orders are recorded in the recording unit 94, and the temperature plate creation unit 92 may select one of the plurality of nursing orders according to the postponement timing. Along with the postponement of the clinical path, the order registration unit 88 may accept registration of a nursing order from the temperature plate. When a new nursing order is registered, the extraction unit 90 extracts a new medical item associated with the nursing order, and the temperature plate creation unit 92 extracts the medical item in addition to the already set medical item. The new medical item extracted in the unit 90 may be set as a display item. According to this modification, a nursing order suitable for postponement can be defined. That is, when the clinical pass is postponed, a nursing order that is not suitable for postponement may not be used.

  In the embodiment of the present invention, the recording unit 94 records a plurality of standardized nursing orders as clinical paths. However, the present invention is not limited to this, and the clinical path may be updated by accumulating data using the temperature plate. According to this modification, even if medicine advances, a clinical path can be handled.

  In the embodiment of the present invention, a case where one problem exists as a nursing problem is described. However, the present invention is not limited to this. For example, a plurality of nursing problems, that is, a plurality of clinical paths may exist. In this case, at least one of the order registration unit 88, the extraction unit 90, and the temperature plate creation unit 92 merges the same nursing order. In addition, when there are a plurality of clinical paths, the temperature plate creating unit 92 may emphasize the corresponding item on the temperature plate if the corresponding clinical path is selected. According to this modification, it is possible to avoid the situation where the same vital data is measured a plurality of times according to a plurality of clinical paths. In other words, it should be in line with the nursing situation.

  In the embodiment of the present invention, the temperature plate creation unit 92 displays the temperature plate, but the change of the display item is not described. However, the present invention is not limited to this, and for example, the temperature plate creation unit 92 may receive an instruction related to a change in display items. The temperature plate creation unit 92 changes the medical item to be displayed in a graph according to the instruction. In addition, the temperature plate creation unit 92 changes the medical item to be a display item according to the change. Furthermore, the temperature plate creation unit 92 sets upper and lower limit values corresponding to the medical item to be changed, and sets a mark for plotting the value of the implementation result corresponding to the medical item to be changed in the two-dimensional coordinate area. . According to this modification, a temperature plate suitable for the situation can be created.

  In the embodiment of the present invention, the PC 60 includes an order registration unit 88, an extraction unit 90, and a temperature plate creation unit 92. However, the present invention is not limited thereto. For example, the server 30 may include an order registration unit 88, and the PC 60 may include an extraction unit 90 and a temperature plate creation unit 92. In that case, the PC 60 communicates with the server 30 via the communication unit 82. According to this modification, when the server 30 already has the order registration unit 88, it can be used. That is, the function of the nursing support system 20 may be realized by a combination of the server 30, the PC 60, and the PDA 70.

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 PC of FIG. It is a figure which shows the structure of the data of the medical item which should be extracted as a display item of a temperature board in the extraction part of FIG. FIG. 3 is a diagram showing the structure of data recorded in the recording unit of FIG. 2 and associated with nursing problems from a medical department. FIG. 3 is a diagram showing the structure of data recorded in the recording unit of FIG. 2 and associated with a path name, a nursing plan, and a nursing order. It is the data currently recorded on the recording part of FIG. 2, and is a figure which shows the structure of the data regarding a nursing order. It is a flowchart which shows the procedure until it determines the nursing order by PC of FIG. FIG. 3 is a diagram showing a screen displayed when input of a nursing problem is started in the display device of FIG. 2. It is a figure which shows the screen displayed when a nursing problem is selected in the display apparatus of FIG. It is a figure which shows the screen displayed when the nursing problem is selected in the display apparatus of FIG. FIG. 3 is a diagram showing a screen displayed when a nursing order is edited in the display device of FIG. 2. It is a schematic diagram for showing the process of order issue in the nursing support system of FIG. It is a flowchart which shows the procedure until producing the temperature board by PC of FIG. It is a figure which shows the format of the temperature plate displayed in the display apparatus of FIG. It is a figure which shows the screen of the temperature board displayed in the display apparatus of FIG. It is a flowchart which shows the postponement procedure of the clinical path | pass by PC of FIG.

Explanation of symbols

  10 hospital information management system, 12 hospital information management server, 14 master DB, 20 nursing support system, 30 server, 40 temporary DB, 50 access point, 60 PC, 70 PDA, 80 control unit, 82 communication unit, 84 input control unit 86 screen creation unit, 88 order registration unit, 90 extraction unit, 92 temperature plate creation unit, 94 recording unit, 96 operation device, 98 display device, 100 hospital information system.

Claims (7)

An instruction information registration unit for registering instruction information that is instruction information of a medical practice for a patient and includes at least one medical item;
An extraction unit that extracts at least one of the medical items from the instruction information registered in the instruction information registration unit;
A display item setting unit for setting at least one medical item as a display item when displaying an implementation result corresponding to at least one medical item extracted by the extraction unit;
A display unit for displaying an implementation result while associating with the display item set in the display item setting unit;
A medical information management apparatus comprising:   The display unit displays past implementation results, and among the instruction information registered in the instruction information registration unit, displays instruction information on medical practices to be performed on the patient in the future. The medical information management device according to claim 1. When the instruction information of a new medical practice is registered for the patient, the extraction unit extracts a new medical item associated with the instruction information,
The medical information management according to claim 1, wherein the display item setting unit sets a new medical item extracted by the extraction unit as a display item in addition to the medical item that has already been set. apparatus. The instruction information registered in the instruction information registration unit includes a plurality of instruction information,
The extraction unit extracts an execution date and time associated with each of a plurality of instruction information,
The medical information management apparatus according to any one of claims 1 to 3, wherein the display item setting unit sets an implementation date and time as a display item together with a medical item. A deferral receiving unit that receives an instruction to postpone the implementation date corresponding to at least one of the plurality of instruction information registered in the instruction information registration unit;
At least one of the plurality of instruction information registered in the instruction information registration unit is defined to be copyable,
The display unit, when the postponement accepting unit receives a postponement instruction, displays the instruction information defined to be duplicated as the instruction information corresponding to the implementation date and time to be postponed. Item 5. The medical information management device according to Item 4. The display item setting unit sets a value corresponding to each of the medical items on one axis, and sets the execution date and time on the other axis, thereby displaying two-dimensional coordinates for plotting and displaying the value of the execution result Set the area
The medical information management apparatus according to claim 4, wherein the display unit displays a graph on the value of the execution result in the two-dimensional coordinate area set by the display item setting unit. The display unit further comprises a changing unit for changing medical items to be displayed in a graph,
The display item setting unit includes a unit that changes a medical item to be a display item according to the change in the change unit, a unit that sets upper and lower limit values corresponding to the medical item to be changed, and a medical item that is changed. The medical information management apparatus according to claim 6, further comprising means for setting a mark when plotting a value of an implementation result corresponding to the two-dimensional coordinate area.

Images