In recent years, hospital informatization has become the focus of promotion in the hospital field. Information systems such as HIS, LIS, PACS, and EMR have emerged one after another, which have significantly improved the operational efficiency of hospital operations. As a part of the hospital information system, the surgical anesthesia system consists of two subsystems, the monitoring equipment data acquisition system and the anesthesia information management system.
1. Overview of clinical information management system for surgical anesthesia in hospitals
The clinical information management system for surgical anesthesia is developed on the basis of serving the clinical work in the perioperative period. It is highly integrated with bedside monitoring equipment and information systems such as hospital HIS, LIS, PACS, etc., fully realizes the automatic collection and sharing of perioperative patient data, and provides medical staff, business managers, and hospital leaders with process, information, and automation , Intelligent comprehensive management of clinical business. The hand anesthesia information system covers the preoperative, intraoperative and postoperative surgical procedures of patients, realizes the digitization of anesthesia information and the dynamic tracking of the whole process of surgical anesthesia, and makes the operating room management mode more scientific.
2. Informatization of the whole process of surgical operation arrangement
In the past, when medical staff arranged surgery, there was no information management of the whole process from the surgeon's doctor's order, operation application, arrangement to operation cancellation. Therefore, emergency surgery or surgery cancellation must be notified by telephone. In the process of information communication between multiple departments, patient information is prone to errors and cannot be traced. In addition, pure communication between people is not only a waste of time, but also prone to some misoperations. Now, the emergence of the hand anesthesia system has realized the informatization of the whole process of surgical scheduling and appointment, and improved the communication efficiency between departments.
Medical staff can apply, accept, and arrange surgery appointments through the hand anesthesia information system. From the issuance of medical orders by outpatient doctors to the initiation of surgery applications and approval by the head nurse, the information management of the whole process has been realized, which greatly reduces the procedures that need to be handled across departments, and the cost of cross-departmental communication and time costs.
3. Quickly input patient anesthesia information
Anesthesia documentation is an important part of the entire hospital documentation. It is a comprehensive and real-time record of all the conditions of the patient during anesthesia. Make timely, true and accurate records throughout the process. In this way, the patient's response to anesthesia and surgery can be kept abreast of, which is helpful for first aid.
The anesthetist will first read the patient's medical record information through the surgical anesthesia information system, and choose different types of anesthetic drugs and doses accordingly. After the operation begins, the anesthesiologist needs to ensure the safety of the patient under anesthesia. They will observe and monitor the patient's breathing, heart rate, blood pressure, blood oxygen and other important vital signs at any time, and keep them stable. Anesthesiologists can use the built-in anesthesia record sheet, resuscitation record sheet and various anesthesia document templates in the surgical anesthesia information system to fill in the patient's intraoperative anesthesia information in a timely and rapid manner, improving the efficiency and accuracy of document entry.
4. Anesthesia record sheet
It is used to manage patients' medication, output, monitoring, events and other operations during the operation.
5. Resuscitation record sheet
Used to manage operations such as medications, outputs, monitoring, and events during patient resuscitation.
6. Anesthesia documents
Documents used to manage the entire process of patient surgery.
Support expense inquiry and reimbursement.
The anesthesia fee for the patient's operation can be directly generated through the anesthesia record sheet of the operation anesthesia information system. Medical personnel can inquire about operation-related expenses through the system, and support recording expenses afterwards. All expenses can be automatically generated in the anesthesiology department. If too many expenses are found to be recorded, the patient can be refunded, which improves the real-time and accuracy of surgical anesthesia pricing and facilitates hospital cost accounting.
7. Development environment
Development language: PHP, js
Technical architecture: mysql+laravel+vue2
Development tools: oh-storm
Front-end framework: vue2 element
Backend framework: laralve
Database: mysql 8.0
8. Function introduction of clinical information management system for surgical anesthesia
Before anesthesia operation: 1. Surgical scheduling 2. Room selection 3. Surgery notice 4. Preoperative visit 5. Anesthesia consent 6. Medical record inquiry
7. Emergency surgery application 8. Risk assessment 9. Blood transfusion consent form 10. Catheter operation 11. Anesthesia operation plan
During anesthesia operation: 1. Anesthesia record sheet 2. Safety check 3. Prescription note 4. Device registration 5. Electronic medical record
6. Sample submission 7. Clinical blood use 8. Adverse events 9. Surgical nursing records
After anesthesia operation: 1. Recovery monitoring 2. Postoperative visit 3. Postoperative analgesia 4. Recovery records 5. Treatment consumables 6. Handover nursing records
7. Awakening score 8. Aldrete score 9. Pressure ulcer score 10. PADSS score 11. TISS score
12. Balthazan score 13. Anesthesia quality control index
Daily records: 1. Nurse scheduling 2. Doctor scheduling
Quality control statistics: 1. National standard quality control 2. Quality control statistics 3. Top three quality control statistics 4. Additional quality control
Statistical analysis: 1. Interval between receptions 2. Blood transfusion statistics 3. Anesthesia statistics 4. Duration statistics 5. Drug dosage statistics
System settings: 1. Operating room 2. Operation name 3. Document template 4. Staff 5. Anesthesia method
6. Common events 7. Drug management 8. Department management 9. Administrator list 10. Role list
The source code of the clinical information management system for surgical anesthesia is applicable to: tertiary hospitals and county-level hospitals
Conclusion: The clinical information system for surgical anesthesia further standardizes the workflow of anesthesiologists. Accurate and detailed anesthesia records can also help improve medical quality, reduce medical errors, improve medical service levels, and achieve scientific and efficient management of surgical anesthesia. Through this system, managers can quickly and conveniently understand the resource allocation, operation status and overall progress of each operating room, which is convenient for timely adjustment and rational arrangement of resources, so as to have a better management model and establish an anesthesia quality control system.
<?php
// 获取当前时间
$now = date('Y-m-d H:i:s');
// 获取患者信息
$patient_name = $_POST['patient_name'];
$patient_gender = $_POST['patient_gender'];
$patient_age = $_POST['patient_age'];
$patient_weight = $_POST['patient_weight'];
// 进行麻醉风险评估
$anesthesia_risk =评估麻醉风险($patient_name, $patient_gender, $patient_age, $patient_weight);
if ($anesthesia_risk == "高风险") {
// 麻醉风险较高，需要制定特殊的麻醉方案
$anesthesia_plan =制定特殊麻醉方案($patient_name, $patient_gender, $patient_age, $patient_weight);
// 记录麻醉方案
insert INTO anesthesia_plan (patient_name, plan) VALUES ('$patient_name', '$anesthesia_plan');
} else {
// 麻醉风险较低，使用常规麻醉方案
$anesthesia_plan = "常规麻醉方案";
}
// 记录患者信息和麻醉方案
insert INTO anesthesia_record (patient_name, gender, age, weight, anesthesia_plan, start_time) VALUES ('$patient_name', '$patient_gender', '$patient_age', '$patient_weight', '$anesthesia_plan', '$now');
function评估麻醉风险($patient_name, $patient_gender, $patient_age, $patient_weight) {
// 根据患者信息进行麻醉风险评估
// 这里只是一个示例，实际评估方法需要根据具体需求和数据进行分析
if ($patient_age > 60 || $patient_weight < 50) {
return "高风险";
} else {
return "低风险";
}
}
function制定特殊麻醉方案($patient_name, $patient_gender, $patient_age, $patient_weight) {
// 根据患者信息制定特殊的麻醉方案
// 这里只是一个示例，实际方案需要根据具体需求和数据进行分析
if ($patient_age > 60 || $patient_weight < 50) {
return "需要使用特殊的麻醉药物，并加强监测";
} else {
return "常规麻醉方案";
}
}
?>