TISS76-Points

 Legacy article

• 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 TISS76 score indicates an increase in nursing workload.
  • 35 TISS76 points per day is being used to correspond to the work of one nurse per shift

TISS76 (includes customization for WRHA Critical Care) Point Table

Tiss No	Label	Points
T1	Label row-Neurological
T2	Hourly neuro checks	2
T3	Intracranial pressure monitoring	4
T4	Mannitol infusion for cerebral edema	4
T5	RX of seizures, metabolic encehphalopathy (1st 48 hrs)	3
T6	Hypo/hyperthermic blanket	2
T7	Patient restraint (to prevent harm)	1
T8	Label row_Cardiovascular
T9	ECG monitoring	1
T10	Hourly vital signs	1
T11	Peripheral arterial line	3
T12	Pulmonary arterial line	4
T13	Measurement CVP (any method)	2
T14	Measurement of Cardiac output	3
T15	Temporary pacemaker-standby	3
T16	Temporary pacemaker-active	4
T17	Post cardiac or respiratory arrest (1st 48 hrs)	4
T18	Cardioversion/Defibrillation for arrhythmias	3
T19	(IABP) Intraaortic ballon pump	4
T20	Pressurized blood transfusion	4
T21	Mast trousers	4	LEGACY-NOT USED
T22	Platelet Infusion	4
T23	Infusion of blood products (<=5/24 hrs) not including platelets	2
T24	Infusion of blood products (>=5/24 hrs) not including platelets	3
T25	IV replacement of excess fluids (>6L/24hrs	2
T26	Label row-Respiratory
T27		4	LEGACY-NOT USED
T28		4	LEGACY-NOT USED
T29	A/C, SIMV, PSV with muscle relaxant/sedation	4
T30	A/C, SIMV, PSV without muscle relaxant/sedation	4
T31	Spontaneous CPAP or BIPAP - NON VENTILATED	3
T32	Spontaneous respiration via ET tube	2
T33	Intubation-nasal or tracheal performed in ICU	3
T34	Fresh tracheostomy -1st 48 hours	2
T35	Tracheostomy care over 48 hours	1
T36	Chest physiotherapy	1
T37	Incentive spirometry/IPPB/inhalation therapy (e.g. ventolin)	1
T38	tracheal suctioning of NON intubated patient	3
T39	Oxygen by mask or nasal prongs	1
T40	Chest tube(s)	3
T41	Label row-Gastrointesinal
T42	Tube feedings	2
T43	Central IV hyperalimentation	3
T44	Peripheral IV hyperalimentation	1
T45	Oral/MG replacement of fluids above maintenance	2
T46	Balloon tamponade of varices (blakemore)	4
T47	Gastric lavage for active bleeding	4
T48	Kayexalate/colonic enema	2
T49	Label row -Genitourinary
T50	Urnary-Foley catheter	1
T51	Dipstick Urine testing (S&K)	1
T52	Peritoneal dialysis	4
T53	Hemodialysis-stable patient	2
T54	Hemodialysis-unstable patient	4
T55	CVVHD	4
T56	Label row -Metabolic/Fluids/Electrolytes/Blood work
T57	Intake and output	1
T58	Blood samples-TOTAL <=12/24 hrs	1
T59	Blood samples-TOTAL 13 or more /24 hrs	3
T60
T61	Treatment of metabolic acidosis or alkalsosis	3
T62	Active diuesis (e.g. Lasix, diamox etc.)	3
T63	Label row - Med's/IV's
T64	Peripheral venous catheter: 1 (not central lines)	1
T65	Peripheral venous catheter: 2 or more (not central lines)	2
T66	Pump regulated IV infusion (initial onset)	2
T67	Vasoactive drug infusion: 1 drug	3
T68	Vasoactive drug infusion: 2 or more drugs	4
T69	Continuous antiarrhythic infusion(s)	3
T70	Intravenous Petressin infusion	2
T71	Postassium infusion via central line	3
T72	Anticoagulation: acute (first 24 hrs)	3
T73	Anticoagulation: chronic (over 24 hrs)	1
T74	Acute digitalization (first 48 hrs)	3
T75	Parenteral chemotherapy	2
T76	IV anitbiotics/antifungals: 1 or 2	1
T77	IV anitbiotics/antifungals: 3 or more	3
T78	Unscheduled Bolus meds (stats, PRNs)	3
T79	Scheduled IV meds (including IV antibiotic doses)	1
T80	Label row - General
T81	Dressing changes: routine	1
T82	Dressing changes: multiple	2
T83	Extensive wound care, irrigation, packing	1
T84	Decubitus care (not preventative)	1
T85	Ostomy drainage	1
T86	Drainage tubes/Hemovacs/any type of tube (not foley)	1
T87	Orthopedic traction: standard	1
T88	Orthopedic traction: complex	3
T89	Isolation of patient	2
T90	Label row - Procedures
T91	Diagnositic procedure (outside of ICU e.g. CT, angio, MRI etc)	4
T92	Bronchoscopy	4
T93	Cardiocentesis	3
T94	Endoscopy	4
T95	Thoracentesis	3
T96	Operative procedure (day of surgery only)	4