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Nursing document generation method and system and computer readable storage medium

A document and data storage module technology, applied in the field of hospital clinical nursing informatization, can solve the problems of complexity, inconsistent business process, unavoidable, etc., and achieve the effect of improving quality, improving timeliness and accuracy, and improving the level.

Pending Publication Date: 2019-10-11
慕勇峰
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

The traditional way of generating nursing documents is to use paper forms to fill in by hand. Since the development and construction of modern hospital informatization, electronic "paper records" have begun to be used. major changes
Moreover, the content required by a nursing document form is often more complicated, and the content and results of many nursing measures filled in do not occur and be recorded at the same time, which is inconsistent with the nurse's daily nursing business process. Multiple original records, transcription and transcription can complete a complete nursing document form
[0004] Although there are already some informatization methods such as voice input, word association input, etc., which can assist nurses in the process of inputting form content, improve the accuracy and efficiency of input information, but in the actual business execution process, it is still unavoidable. Allow nursing staff to concentrate on filling out nursing documents for a long time

Method used

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  • Nursing document generation method and system and computer readable storage medium
  • Nursing document generation method and system and computer readable storage medium
  • Nursing document generation method and system and computer readable storage medium

Examples

Experimental program
Comparison scheme
Effect test

Embodiment 1

[0044] Embodiments of the present invention provide a method for generating nursing documents, such as figure 1 shown, including steps:

[0045] S1. Define and establish a nursing task and nursing task result data input view, create and bind a nursing record template table for the task, and store the task result data;

[0046] In the application process of the present invention, the definition of nursing task and nursing task result data input view should be based on the principle of "completing a diagnosis and nursing behavior" that is in line with the actual business execution of medical personnel. The result data input view is composed of one or Composed of multiple fields, forming a result record interface of the nursing task,

[0047] For example: a routine sign detection nursing task, including measuring a patient’s body temperature, pulse, respiration, blood pressure and recording the results, then define the data input view presented by the task on the information equ...

no. 1 example

[0074] First, define and establish 5 nursing tasks, "routine sign inspection task", "critical sign inspection task", "basic nursing task", "infusion doctor's order execution task", "blood transfusion doctor's order execution task", and define the nursing task result data The input views are: "General Signs Inspection Task": body temperature, respiration, pulse, blood pressure;

[0075] "Critical signs inspection task": body temperature, respiration, pulse, blood pressure, consciousness, blood oxygen saturation, pupil size, pupil response;

[0076] "Basic nursing tasks": stool frequency, output, output items, nursing type, condition observation nursing measures and effects;

[0077] "Infusion doctor's order execution task": infusion volume, infusion content, infusion route;

[0078] "Blood transfusion order execution task": blood transfusion volume, blood transfusion content;

[0079] Using the scheme that one nursing task corresponds to one or more nursing record template ta...

no. 2 example

[0090] First, define and establish 5 nursing tasks, "routine sign inspection task", "critical sign inspection task", "basic nursing task", "infusion doctor's order execution task", "blood transfusion doctor's order execution task", and define the nursing task result data The input views are: "General Signs Inspection Task": body temperature, respiration, pulse, blood pressure;

[0091] "Critical signs inspection task": body temperature, respiration, pulse, blood pressure, consciousness, blood oxygen saturation, pupil size, pupil response;

[0092] "Basic nursing tasks": stool frequency, output, output items, nursing type, condition observation nursing measures and effects;

[0093] "Infusion doctor's order execution task": infusion volume, infusion content, infusion route;

[0094] "Blood transfusion order execution task": blood transfusion volume, blood transfusion content;

[0095] The above nursing tasks can be reflected in nursing documents.

[0096] Using the scheme th...

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Abstract

The invention provides a nursing document generation method and system and a computer readable storage medium. The nursing document generation method comprises the following steps: constructing a plurality of nursing record template tables, wherein each nursing record template table comprises a plurality of nursing data, and the sources of the nursing data comprise but are not limited to hospitalinformation systems or external data entry; constructing a plurality of nursing documents, wherein each nursing document is associated with at least one nursing record template table, and the nursingdocument extracts related nursing data from the associated nursing record template table, and displays the related nursing data according to a user-defined mode. The implementation mode of the invention not only conforms to the actual business execution process of medical staff, but also can meet the requirement of generating nursing documents conforming to traditional habits.

Description

technical field [0001] The invention belongs to the technical field of hospital clinical nursing informatization, and relates to a method and system for generating nursing documents and a computer-readable storage medium. Background technique [0002] Nursing documents are the general term for words, symbols and diagrams formed by hospital medical staff in the process of nursing activities, observing the condition of nursing objects and implementing nursing measures and results. It is a comprehensive record of nursing work, a scientific basis for correct diagnosis, selection of treatment and nursing, and also reflects the hospital's medical treatment, nursing quality, management level and professional quality of nurses, and is also an important information for clinical, teaching, and scientific research. [0003] At present, nursing documents in hospitals mainly take the form of structured forms, which generally include temperature sheets, nursing records, evaluation sheets,...

Claims

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Application Information

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IPC IPC(8): G16H15/00G06F17/24
CPCG16H15/00G06F40/186
Inventor 慕勇峰
Owner 慕勇峰
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