TISS General Info

The Therapeutic Intervention Scoring System (TISS) is a method of quantifying nursing and medical care required by ICU patients.

ICU in the City of Winnipeg uses a locally modified version of the 1983 TISS-76 and has a list of 83 therapeutic variables.

Purpose

• TISS is utilized in the USA, Canada and abroad for many purposes:
  1. Determining severity of illness (NOTE: this capability of TISS has lost its application with the appearance of more specific scoring systems in the 1980).
  2. Establishing nurse-patient ratios in the ICU
  3. Assessing current utilization of ICU beds
  4. Establishing future needs and numbers of ICU beds
  5. Expresses work activities in statistical terms.

• TISS has been incorporated as an integral part of the Acute Physiologic and Chronic Health Evaluation APACHE II

• The comparative scores of TISS and APACHE enables us to see trends in the type of nursing care (TISS) provided for certain acuity levels (APACHE), for a specific type of diagnosis.

• Reviewing both scores can help determine whether certain nursing activities can be redirected or standardized in certain types of critically ill patients without affecting patient mortality or morbidity.

History

• TISS has become a widely accepted and validated method of classifying critically ill patients.

• First introduced in 1974 by Cullen DJ, Civetta JM, Briggs BA, et al: Therapeutic scoring systems: A method of quantitative comparison of patient care. Crit Care Med 2:57-60, 1974) at the Massachusetts General Hospital. (TISS with 70 therapeutic variables).

• Modified in 1983. (TISS with 76 therapeutic variables)
  • Keene AR, Cullen DJ. Therapeutic Intervention Scoring System: update 1983. Crit Care Med. 1983 Jan;11(1):1-3.
• Modified version in 1994 for use for intermediate and floor care nursing units (iTISS).
• Modified version in 1996. (TISS with 28 therapeutic variables).