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| Therapeutic Intervention Scoring System
| | #redirect:[[TISS General Info]] |
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| * First introduced in 1974 by David J. Cullen MD
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| * TISS is a method of quantifying nursing and medical care required by critically ill patients according to the number and type of therapeutic interventions employed.
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| * By quantifying nursing care, this helps reflect the amount of time as well as complexity of the care being given to a patient.
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| * TISS has become a widely accepted and validated method of classifying critically ill patients.
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| * TISS is utilized in the USA, Canada and abroad for many purposes:
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| * # Determining severity of illness
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| * # Establishing nurse’patient ratios in the ICU
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| * # Assessing current utilization of ICU beds
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| * # Establishing future needs and numbers of ICU beds
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| * # Expresses work activities in statistical terms.
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| * TISS has been incorporated as an intergral part of the Acute Physiologic and Chronic Health Evaluation (APACHE). Page 80.
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| * The comparative scores of TISS and APACHE enables us to see trends in the type of nursing care (TISS) provided for certain acutely levels (APACHE), for a specific type of diagnosis.
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| * 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.
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| * Each of the most common ICU nursing activities is weighted from 1 to 4 point. More points indicate that greater nursing management is required.
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| * A high daily TISS score indicates an increase in nursing workload.
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| * TISS is done retrospectively for the previous 24 hours of care in ICU.
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| * TISS is generally done by Night staff.
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| * Day and Evening staff are also required to fill out a TISS if a patient is discharge or passes away on their shift. TISS done on Day or Evening shift reflects the workload from midnight to time of discharge or death.
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| * If a patient is in the ICU a very short time, a TISS score is required to reflect nursing efforts during this time.
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| * Do not sent TISS form to the ward with the chart. Please hand it in to the Unit Clerk who will file it in the Research Forms binder.
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| * Once the first 5 days of TISS are cmpleted, please '''do not staple''' together. Hand in the completed form to the Unit Clerk and start a new form. Scanning of forms is affected if stapled.
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| * TISS is to be done for a patients entire length of stay in ICU.
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| * If a patient is transfered to another ICU, do not sent the form to the other center.
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| * If a patient is transfered to another ICU in your center and the Service looking after the patient changes, then a '''new''' TISS form is required. E.G., a patient who goes from MICU under Medical Service and is transferred to SICU under Surgical service.
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| * Shaded items on TISS are MUTUALLY EXCLUSIVE. You can only select ONE item in that group for a 24 hour day.
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| * Qualilty control of TISS required to be done by data collector for the first 10 days of TISS.
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| * NOTE: TISS 23 & 24 & Lab data collection of blood products
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| E.G. 1u FFP=350 mls
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| 1u PC,HSA 5%, Pentaspan = 250 mls
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| 1u HSA 25% = 100 mls
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| For the '''lab data''' collection of blood products, since the amount in a bag now varies in terms of volume, please record totals as follows:
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| E.g. FFP 350 + 150+175 =675 Divide by 350 (base amt.) = 1.9. Amount given ROUND OFF to = 2u.
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| We are looking at the number of bags hung not the exact volumes
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| Infused. If a person gets only half a bag of blood or only 2 mls for that matter, the cost is associated with hanging the product regardless of whether the volume is totally infused or not.
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| [[Category:TISS]] | |