TISS76-Cardiovascular: Difference between revisions

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Legacy article
TISS therapeutic variables: T9 to T16
TISS therapeutic variables: T9 to T16


T15 & 16 are '''[[TISS mutually exclusive items | mutually exclusive]]'''. Select only ONE item per day that will give you the most points.
'''T15''' & '''T16''' are '''[[TISS76-mutually exclusive items | mutually exclusive]]'''. Select only ONE item per day that will give you the most points.


*T9 - ECG monitoring
*T9 - ECG monitoring
*T10 - Hourly Vital signs -Must include hourly BP (blood pressure) every hour for 6 consecutively hours in the first 24 hours in ICU to get points.--[[User:TOstryzniuk|TOstryzniuk]] 16:42, 2 February 2009 (CST)
*T10 - Hourly Vital signs -Must include hourly BP (blood pressure) every hour for 6 consecutively hours in ICU to get points.--[[User:TOstryzniuk|TOstryzniuk]] 16:42, 2 February 2009 (CST)
*T11 - Peripheral arterial line
*T11 - Peripheral arterial line
*T12 - Pulmonary arterial line
*T12 - Pulmonary arterial line ([http://en.wikipedia.org/wiki/Pulmonary_artery_catheter Swan Ganz Catheter])
*T13 - Measurement of CVP (any method)
*T13 - Measurement of CVP (any method)
*T14 - Measurement of Cardiac Output
*T14 - Measurement of Cardiac Output
*T15 - Temporary Pacemaker-'''Standby''' (includes external) - wires hooked up but pace not turned on.
*'''T15''' - Temporary Pacemaker-'''Standby''' (includes external) - wires hooked up but pace not turned on.
*T16 - Temporary Pacemaker-'''Active''' (includes external) -  turned on but may not be pacing all the time.   
*'''T16''' - Temporary Pacemaker-'''Active''' (includes external) -  turned on but may not be pacing all the time.   
** The testing for "capture" not counted as active pacing.   
** The testing for "capture" not counted as active pacing.   
**Permanent pacer not included.
**Permanent pacer not included.


*T17 - Post Cardiac Arrest - (first 48 hours) mark for 2 days
*T17 - Post Cardiac Arrest - (first 48 hours) mark for 2 days.  Also see: [[TISS76-48 hour rule]]


*T18 - Cardioversion/Defibrillation - While in ICU only
*T18 - Cardioversion/Defibrillation - While in ICU only
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*T19 - IABP
*T19 - IABP


**NOTE: Community hospitals (Oaks, Grace, Concordia, Victoria).  If a patient goes from your center to STB or HSC for an angiogram/plasty, has an IABP inserted in the angio department and is either admitted for HSC or STB ICU/CCU or goes directly to the OR from there, please do not put on your TISS item # 19 -IABP.Discharge to should be coded using the codes for HSC or STB for OR , CCU , SICU or MICU.
*NOTE: Community hospitals (Oaks, Grace, Concordia, Victoria).  If a patient goes from your center to STB or HSC for an angiogram/plasty, has an IABP inserted in the angio department and is either admitted for HSC or STB ICU/CCU or goes directly to the OR from there, please do not put on your TISS item # 19 -IABP.Discharge to should be coded using the codes for HSC or STB for OR , CCU , SICU or MICU.


*Also see:
*Also see:
**[[TISS Neurological]]
**[[TISS76-Neurological]]
**[[TISS Blood Products]]
**[[TISS76-Blood Products]]
**[[TISS Respiratory]]
**[[TISS76-Respiratory]]
**[[TISS Gastrointestinal]]
**[[TISS76-Gastrointestinal]]
**[[TISS Genitourinary]]
**[[TISS76-Genitourinary]]
**[[TISS Fluid Lytes bloodsample]]
**[[TISS76-Fluid Lytes bloodsample]]
**[[TISS Meds IVs]]
**[[TISS76-Meds IVs]]
**[[TISS General Care]]
**[[TISS76-General Care]]
**[[TISS Procedures Interventions]]
**[[TISS76-Procedures Interventions]]
**[[TISS Collection Guide]]
**[[! TISS76 Collection Guide]]
**[http://ltc.umanitoba.ca/wikis/ccmdb/images/7/7b/TISS_FORM_for_ICU_citywide2.pdf ICU TISS form]
**[[TISS76-Points]]
**[[File:TISS76-FORM for ICU citywide2.pdf]]


==previous comments==


*HOURLY vital signs on TISS
==discussion==
**Do other centres mark hourly vital signs on the TISS if only the screen pulse is marked every hour on the nurses' flow sheet and BP recorded every 4 hours?--[[User:MWaschuk|MWaschuk]] 20:18, 29 September 2008 (CDT)
*Hourly vital signs essentially means that a pt is not that stable and requires frequent vital signs.  If a pt comes in at 2100 hrs for example, they may require hourly vitals but by the above definition will not get tiss points for hourly vitals simply because there are only 3 hours in that day on the first day of tiss. 
*For all the other items on the form, an intervention can be used only briefly in order to count it.  Why is 6 hours of all vital signs needed for the hourly vital signs?  A pt may be very unstable for only 2 hours requiring frequent vital signs and then go back to vital signs every 2 hours following this, then they do not get any tiss points for this either.  Would like your feedback on this question.--[[User:LKolesar|LKolesar]] 13:11, 2012 February 21 (CST)  


***MaryLou, I think as long as some vital signs are done hourly it should still count as the nurse must still document this.  --[[User:LKolesar|LKolesar]] 07:21, 30 September 2008 (CDT)
[[Category:TISS76 Legacy-Elements]]
 
[[Category:TISS76 Legacy]]
****I agree. I always mark hourly vitals if the pulse has been documented hourly. I don't worry so much about the other vitals.  My thinking is that the nurse is monitoring for arrythmias as well, and dealing with whatever alarms may be generated. That all takes time as well. [[User:BDeVlaming|BDeVlaming]] 11:45, 30 September 2008 (CDT)
 
*****No!!!The nurse must do the BP as well for at least 6 consecutive hours to qualify for hourly VS. --[[User:LBilesky|LBilesky]] 15:59, 30 January 2009 (CST)
******Our guideline is as stated by Lois.  Details updated in this category for Tiss item 10.--[[User:TOstryzniuk|TOstryzniuk]] 16:42, 2 February 2009 (CST)
 
[[Category: TISS Elements]]

Latest revision as of 18:52, 2017 March 2

Legacy article

TISS therapeutic variables: T9 to T16

T15 & T16 are mutually exclusive. Select only ONE item per day that will give you the most points.

  • T9 - ECG monitoring
  • T10 - Hourly Vital signs -Must include hourly BP (blood pressure) every hour for 6 consecutively hours in ICU to get points.--TOstryzniuk 16:42, 2 February 2009 (CST)
  • T11 - Peripheral arterial line
  • T12 - Pulmonary arterial line (Swan Ganz Catheter)
  • T13 - Measurement of CVP (any method)
  • T14 - Measurement of Cardiac Output
  • T15 - Temporary Pacemaker-Standby (includes external) - wires hooked up but pace not turned on.
  • T16 - Temporary Pacemaker-Active (includes external) - turned on but may not be pacing all the time.
    • The testing for "capture" not counted as active pacing.
    • Permanent pacer not included.
  • T18 - Cardioversion/Defibrillation - While in ICU only
  • T19 - IABP
  • NOTE: Community hospitals (Oaks, Grace, Concordia, Victoria). If a patient goes from your center to STB or HSC for an angiogram/plasty, has an IABP inserted in the angio department and is either admitted for HSC or STB ICU/CCU or goes directly to the OR from there, please do not put on your TISS item # 19 -IABP.Discharge to should be coded using the codes for HSC or STB for OR , CCU , SICU or MICU.


discussion

  • Hourly vital signs essentially means that a pt is not that stable and requires frequent vital signs. If a pt comes in at 2100 hrs for example, they may require hourly vitals but by the above definition will not get tiss points for hourly vitals simply because there are only 3 hours in that day on the first day of tiss.
  • For all the other items on the form, an intervention can be used only briefly in order to count it. Why is 6 hours of all vital signs needed for the hourly vital signs? A pt may be very unstable for only 2 hours requiring frequent vital signs and then go back to vital signs every 2 hours following this, then they do not get any tiss points for this either. Would like your feedback on this question.--LKolesar 13:11, 2012 February 21 (CST)
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