Regular Article
Utilizing TISS to differentiate between intensive care and high-dependency patients and to identify nursing skill requirements

https://doi.org/10.1054/iccn.2002.1617Get rights and content

Abstract

Introduction: An identification system utilizing the therapeutic intervention scoring system (TISS) was developed to differentiate between intensive care and high-dependency unit (HDU) patients.

Objective: To overcome the staff recruitment and retention problem, ward nursing staff were recruited into the unit. To ensure patient care requirements did not exceed nursing skill level, TISS was utilized to differentiate ICU from HDU patients and to identify nursing skill requirements.

Method: All patients admitted to the unit over a 23-month period were concurrently TISS scored utilizing TISS -76 on admission (O/A), at 4–6 hours, day 1, day 2 and on discharge. Concurrent data on age, medical history, type of surgery and length of stay were collected.

Results: There were a total of 450 patients. Interventions utilized were mainly 1-, 2- and 3-point TISS values. The study identified the HDU patient group as being older, having a higher incidence of cardiac history and a shorter length of stay. The ICU patient group was identified as having undergone more major surgery.

Conclusion: TISS is an effective triage tool for differentiating between ICU and HDU patients and identifying nursing skill requirements to care for the ICU and HDU patient groups.

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    Citation Excerpt :

    After considering previous work on staphylococcal incubation, we chose 4 days as an average time interval between first acquisition of a few colony forming units of MRSA and laboratory isolation from a clinical sample.13,14 Clinical data, including Therapeutic Intervention Scores (TIS) for each patient, were retrieved from the ICU database.15 Weekly workloads were calculated by adding the number of patients in the ICU for a particular week multiplied by their dependency level (1, 2, or 3) according to individual TIS7 and then by the number of days they were in ICU (see Table 1).

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