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Therapeutic intervention scoring system-28 (TISS-28): diretrizes para aplica??o
Padilha, Katia Grillo;Sousa, Regina Marcia Cardoso de;Miyadahira, Ana Maria Kazue;Cruz, Diná de Almeida Lopes Monteiro da;Vattimo, Maria de Fátima Fernandes;Kimura, Miako;Grossi, Sonia Aurora Alves;Silva, Maria Claudia Moreira da;Cruz, Valéria Ferraz;Ducci, Adriana Janzanti;
Revista da Escola de Enfermagem da USP , 2005, DOI: 10.1590/S0080-62342005000200014
Abstract: therapeutic intervention scoring system-28 (tiss-28) is a tool that enables the measurement of the nursing work load in intensive care units and the estimate of how grave the disease is. in this study are presented the operational definitions for its application, proposed by a group of specialists in the area, with the aim of rendering uniform the meaning of each of the items and preventing interpretation biases.
Validity and reliability of the simplified Therapeutic Intervention Scoring System in intensive care units of a public sector hospital in Johannesburg
LC Kisorio, P Becker
Southern African Journal of Critical Care , 2009,
Abstract: Purpose. To introduce the simplified Therapeutic Intervention Scoring System (TISS-28) and to employ the original Therapeutic Intervention Scoring System (TISS-76) and Simplified Acute Physiological Score (SAPS) version II in critically ill adult patients in order to describe the validity and reliability of TISS-28 as a suitable measure of quantifying nursing workload in the adult intensive care units (ICUs) of a public sector hospital in Johannesburg. Objectives. To describe the profile of patient admissions to the ICUs, to investigate the impact of the patients’ profile on the requirements for nursing workload, and to validate the use of the TISS-28 as a measure for quantifying nursing workload in this setting. Design. A non-experimental, comparative, correlation and prospective two-staged design was utilised to meet the study objectives. Stage I involved face and content validation of TISS-28 by a panel of 6 ICU nurse experts. Stage II involved assessment of concurrent and construct validity as well as inter-rater reliability of TISS-28 using 105 participants drawn from trauma, cardiothoracic and multidisciplinary ICUs. Data necessary for the calculation of TISS-28, TISS-76 and SAPS II were recorded for each patient in the ICU at 24 and 48 hours after admission and in the wards after discharge within 24 - 48 hours. Descriptive and inferential statistics were used to analyse data. Results. A content validity index (CVI) of 0.93 was found for TISS-28. A significant positive correlation was found between TISS-28 and TISS-76 scores (r=0.7857, p=0.0001). Although the correlation between TISS-28 and SAPS II was significant (p=0.0317), it was small (r=0.2098). A significant intra-class correlation (ICC) was found for the data collected from a sample of patients by the researcher and expert assistant researcher (ICC=0.99; p=0.0001). Conclusions. The findings support the validity and reliability of TISS-28 and hence its feasibility for use in South African ICUs. Recommendations for nursing education, practice, management and research are proposed.
A systematic review study of therapeutic intervention scoring system — 28
Daniela Soares Santos, Tania Couto Machado Chianca, Andreza Werli
Revista de Enfermagem UFPE On Line , 2010,
Abstract: Objective: to show the effectiveness of TISS – 28 in the evaluation of patient severity and the nursing work load in ICU’s. Methodology: this is a systematic review in six electronic database and a reverse literature review, 38 abstracts of interest were found, selected by criteria of eligibility and quality. Eighteen studies were considered eligible, of which sixteen were primary and two meta-analyses. Results: TISS – 28 made it possible to estimate the severity of the patients, evaluate the nursing workload, as well as to show the frequency between death and high values of this score in ICU’s. Conclusion: the instrument is highly correlated with the original version, practical and easy to use, making possible the relevant evaluation of the severity of the patient and the nursing work load, as well as to assist in planning personnel and materials for a more humanized and quality care.
Therapeutic intervention scoring system application in a pediatric intensive care unit Aplica o do índice de interven o terapêutica em unidade de terapia intensiva pediátrica  [cached]
Simone Travi Canabarro,Mariana Parode Bandeira,Kelly Dayane Stochero Velozo,Olga Rosária Eidt
Ciência & Saúde , 2009,
Abstract: Introduction: Indices of gravity aim to estimate the disease’s severity. The Therapeutic Intervention Scoring System – 28 (TISS-28) is used in Intensive Care Units as an indirect index to estimate the disease`s gravity interval, which has also been recently used to relate the nursing workload Objective: To review each operational item/definition of the Therapeutic Intervention Scoring System (TISS-28), making a re-reading in order to systematize the data collection practice in Pediatric Intensive Care Units (PICUs). Materials and Methods: An integrative revision research of medical and nursing literature through the base of data from Medical Literature Analysis and Retrieval System Online (MEDLINE) and Scientific Electronic Library Online (SciELO) using the terms Intensive Care Units, scales and Therapeutic Intervention Scoring System-28 or TISS-28. The articles were selected according to their relevance, as the authors opinion. Results: Preliminary studies show that the use of TISS-28 in ICU of adults patients, has helped in the evolutionary clinical assessment of the patient’s worsening, besides associations between death and elevated scores. The items/operational definitions evaluated in this score are reviewed in order to facilitate the interpretation of each item in the TISS -28 daily application in Pediatric Intensive Care Unit (PICU). Conclusion: The daily assessment of the 28 TISS variables allows the acquirement of an evolutionary profile of hospitalized children, which can help to increase the knowledge of the hospitalized child clinical picture and its prognosis. Introdu o: índices de gravidade buscam estimar a severidade da doen a, sendo o Therapeutic Intenvention Scoring System-28 (Sistema de Escore de Interven o Terapêutica - TISS-28), usado em Unidades de Terapia Intensiva, um índice indireto para estimar intervalos de gravidade da doen a que mais recentemente tem sido usado para relacionar a carga de trabalho de enfermagem. Objetivo: Revisar cada item/defini o operacional do índice de interven o terapêutica (TISS- 28) procedendo-se uma releitura com o objetivo de sistematizar a prática da coleta de dados em Unidade de Terapia Intensiva Pediátrica (UTIP). Materiais e Métodos: Pesquisa de revis o integrativa de literatura médica e de enfermagem por meio da base de dados Medical Literature Analysis and Retrieval System Online (MEDLINE) e Scientific Electronic Library Online (SciELO) usando os termos Unidades de terapia intensiva (Intensive care units), Escalas (scales) e Therapeutic Intervention Scoring System-28 ou TISS-28. Os artigos
Valida o Concorrente de Escores de Enfermagem (NEMS e TISS-28) em terapia intensiva pediátrica Concurrent Validation of Nursing Scores (NEMS and TISS-28) in pediatric intensive care  [cached]
Simone Travi Canabarro,Kelly Dayane Stochero Velozo,Olga Rosária Eidt,Jefferson Pedro Piva
Acta Paulista de Enfermagem , 2013,
Abstract: OBJETIVO: Examinar a validade concorrente do escore Nine Equivalents of Nursing Manpower Use Score (NEMS) em compara o ao Therapeutic Intervention Scoring System-28 (TISS-28) em uma Unidade de Terapia Intensiva Pediátrica (UTIP). MéTODOS: Estudo de coorte prospectivo observacional, realizado na UTIP de um hospital universitário brasileiro, no período de dois anos, com uma amostra de 816 pacientes. Foram realizadas 7.702 observa es de cada um dos escores. RESULTADOS: A média da pontua o máxima do NEMS foi 26,6±9,2 e do TISS-28 21,3±8,2. Em todas as médias, o TISS-28 foi inferior ao NEMS (p<0,001). Houve uma boa correla o entre eles (r2=0,704 para todas as observa es). A concordancia entre o TISS-28 e o NEMS foi boa, apresentando apenas 6,2% de diferen a entre os escores. CONCLUS O: Os resultados mostraram boa correla o e concordancia entre o TISS-28 e o NEMS, permitindo validar o NEMS nessa popula o de pacientes pediátricos. OBJECTIVE: Examine the concurrent validity of the Nine Equivalents of Nursing Manpower Use Score (NEMS) in comparison to the Therapeutic Intervention Scoring System-28 (TISS-28) in a Pediatric Intensive Care Unit (PICU). METHODS: Prospective observational cohort study conducted in a PICU of a Brazilian university hospital over a period of two years with a sample of 816 patients. A total of 7,702 observations were obtained for each of the scores. RESULTS: The average maximum score of the NEMS was 26.6±9.2 and for the TISS-28 it was 21.3±8.2. The TISS-28 was lower than the NEMS (p<0.001) for all the averages. A good correlation was observed between them (r2=0.704) for all observations. Agreement between the TISS-28 and the NEMS was good, presenting only a 6.2% difference between the scores. CONCLUSION: The results show good correlation and agreement between the TISS-28 and the NEMS, enabling the NEMS validation in this population of pediatric patients.
Interven??es terapêuticas em Unidade de Terapia Intensiva: análise segundo o Therapeutic Intervention Scoring System-28 (TISS-28)
Garcia, Paulo Carlos;Gon?alves, Leilane Andrade;Ducci, Adriana Janzantte;Toffoleto, Maria Cecília;Ribeiro, Sandra Cristina;Padilha, Kátia Grillo;
Revista Brasileira de Enfermagem , 2005, DOI: 10.1590/S0034-71672005000200013
Abstract: the present study aimed to identify the therapeutic interventions categories carried out in intensive care units (icu), finding out their prevalence and identifying their components according to tiss-28. the sample was composed of 89 adult patients who were consecutively admitted to the icu of a university hospital in s?o paulo city. basic and supportive activities, ventilatory, cardiovascular and renal were the tiss-28 that prevailed with a frequency of 73.0% and 100%. the frequency of the items considered basic activities were prevalent, that is, higher than 90.0%. the quantitative average of urinary debt was 98.2% concerning renal support. the results may mean quality of assistance provided o the clients, as they contribute to the human resources estimative and materials in the icu as well.
Clinical review: Scoring systems in the critically ill
Jean-Louis Vincent, Rui Moreno
Critical Care , 2010, DOI: 10.1186/cc8204
Abstract: Scoring systems used in critically ill patients can be broadly divided into those that are specific for an organ or disease (for example, the Glasgow Coma Scale (GCS)) and those that are generic for all ICU patients. In this article, we focus on the generic scores, which can broadly be divided into scores that assess disease severity on admission and use it to predict outcome (for example, Acute Physiology and Chronic Health Evaluation (APACHE), Simplified Acute Physiology Score (SAPS), Mortality Probability Model (MPM)), scores that assess the presence and severity of organ dysfunction (for example, Multiple Organ Dysfunction Score (MODS), Sequential Organ Failure Assessment (SOFA)), and scores that assess nursing workload use (for example, Therapeutic Intervention Scoring System (TISS), Nine Equivalents of Nursing Manpower Use Score (NEMS)).The objective of this review is to give the intensivist without any particular knowledge or expertise in this area an overview of the current status of these instruments and their possible applications. For a more detailed explanation of the development, application and limitations of these models, the reader is referred to a recent review [1].The original outcome prediction scores were developed more than 25 years ago to provide an indication of the risk of death of groups of ICU patients; they were not designed for individual prognostication. Patient demographics, disease prevalence, and intensive care practice have changed considerably since [2], and statistical and computational techniques have also progressed. As a result, all three of the major scores in this category have been recently updated to ensure their continued accuracy in today's ICU (Table 1).The original APACHE score was developed in 1981 to classify groups of patients according to severity of illness and was divided into two sections: a physiology score to assess the degree of acute illness; and a preadmission evaluation to determine the chronic health status
Aplica??o do sistema de pontua??o de interven??es terapêuticas (TISS 28) em unidade de terapia intensiva para avalia??o da gravidade do paciente
Elias, Adriana Cristina Galbiatti Parminondi;Tiemi, Matsuo;Cardoso, Lucienne Tibery Queiroz;Grion, Cíntia Magalh?es Carvalho;
Revista Latino-Americana de Enfermagem , 2006, DOI: 10.1590/S0104-11692006000300004
Abstract: prospective cohort study realized in the adult intensive care unit (icu) of a university hospital to evaluate the utility of the tiss 28 score, using a protocol applied to 1641 patients from january 2000 to december 2002, based on the direct observation of patients and medical and nurse registers of therapeutic procedures and monitoring. the chi-square test, student's t test and kruskal-wallis were used to compare the tiss 28 score and some characteristics of survivors and no survivors patients. the results showed that the tiss 28 score stratified the patients by severity level and evidenced the relation between high scores and mortality of the analyzed patients.
Nine Equivalents of Nursing Manpower Use Score (NEMS): um estudo de seu processo histórico
Canabarro, Simone Travi;Velozo, Kelly Dayane Stochero;Eidt, Olga Rosária;Piva, Jefferson Pedro;Garcia, Pedro Celiny Ramos;
Revista Gaúcha de Enfermagem , 2010, DOI: 10.1590/S1983-14472010000300025
Abstract: this study conducted a integrative review of the literature with the objective of describing the historical trajectory of therapeutic interventions scores with emphasis on nine equivalents of nursing manpower use score in intensive care units. the descriptors used were "intensive care units" and "scales", for publications issued between 2000 and 2009. the sensitized terms were: "nine equivalents of nursing manpower use score" or "nems", "unidade de terapia intensiva", "therapeutic intervention scoring system-76", "therapeutic intervention scoring system-28 or "tiss-28". medical literature analysis and retrieval system online (medline) and literatura latino-americana e do caribe em ciências da saúde (lilacs) publications were selected. among the 295 papers reviewed, 18 were chosen, of which 55,5% were in english. the studies approach nems (33,3%), therapeutic intervention scoring system-76 (11,1%), tiss-28 (33,3%), among others. researches emphasized that nems has been a useful, operational and succinct tool.
Adapta??o de instrumento para dimensionar horas diárias de assistência de enfermagem residencial
Dal Ben, Luiza Watanabe;Sousa, Regina Márcia Cardoso de;
Revista da Escola de Enfermagem da USP , 2004, DOI: 10.1590/S0080-62342004000100010
Abstract: the therapeutic intervention scoring system intermediate: tiss-intermediate, was translated into portuguese and adapted to establish the number of hours daily of home care. the adaptation process of the instrument, developed with the delphi technique, used 16 nurses, who work in home care service providers and helped in calculating the number of nursing care hours for patients at their home after a period of hospitalization. at the end of the study, a 104 item-instrument was obtained for future clinical validation. this instrument will help nurses to extend nursing care to patients in their homes after they are discharged from hospitals, especially in regard to their decision-making concerning patient assessment.
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