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'''T'''herapeutic '''I'''ntervention''' S'''coring '''S'''ystem | '''T'''herapeutic '''I'''ntervention''' S'''coring '''S'''ystem | ||
=== Quality Control=== | === Quality Control=== |
Revision as of 01:28, 2009 January 31
Therapeutic Intervention Scoring System
Quality Control
- Data collectors are required to do quality control for the first 10 days of TISS.
<dig up quality control guide an insert here> TOstryzniuk 15:23, 3 December 2008 (CST)
- the data processor runs internal consistency checks on the TISS data and will flag patients whose TISS information is inconsistent with their collected information. For a list of data consistency checks and rules, see the Data Integrity Rules Category.
TISS Item Guideline
- TISS mutually exclusive items
- TISS 2 hour rule
- TISS 48 hour rule
- TISS Neurological
- TISS Cardiovascular
- TISS Blood Products
- TISS Respiratory
- TISS Gastrointestinal
- TISS Genitourinary
- TISS Fluid Lytes bloodsample
- TISS Meds_IVs
- TISS General Care
- TISS Procedures Interventions
- TISS Legacy
Background
- 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).
- Modified version in 1994 for use for intermediate and floor care nursing units (iTISS).
- Modified version in 1996. (TISS with 28 therapeutic variables).
- ICU in the City of Winnipeg uses a locally modified version of the 1983 TISS-76 and has a list of 83 therapeutic variables.
- TISS is a method of quantifying nursing and medical care required by
- TISS has become a widely accepted and validated method of classifying critically ill patients.
- TISS is utilized in the USA, Canada and abroad for many purposes:
- Determining severity of illness (NOTE: this capability of TISS has lost its application with the appearance of more specific scoring systems in the 1980).
- Establishing nurse-patient ratios in the ICU
- Assessing current utilization of ICU beds
- Establishing future needs and numbers of ICU beds
- 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.
- Each of the most common ICU nursing activities is weighted from 1 to 4 point. More points indicate that greater nursing management is required.
- A high daily TISS score indicates an increase in nursing workload.
Discussion
- As LKolesar points out, there is variation in how the TISS is collected in different centers. Is this something we should look at? Ttenbergen 00:04, 27 May 2008 (CDT)