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Ressources et utilitaires

Scoring systems for ICU and surgical patients:

TISS-28 (Therapeutic Intervention Scoring System-28)


Basic Activities
Points
  Ventilatory Support
Points
 
Standard monitoring. Hourly vital signs, regular registration and calculation of fluid balance.
5
yesno Mechanical ventilation. Any form of mechanical or assisted ventilation with or without PEEP; with or without muscle relaxants; spontaneous breathing with PEEP).
5
yes no
Laboratory. Biochemical and microbiological investigations.
1
yesno Supplementary ventilatory support. Breathing spontaneously through endotracheal tube without PEEP; supplementary oxygen by any method except if mechanical ventilation parameters apply.
2
yes
Single medication, any route (IV, PO, IM, etc.).
2
yes no Care of artificial airways. Endotracheal tube or tracheostoma.
1
yesno
Multiple intravenous medications (more than 1 drug, single shots, or continuously)
3
yes Treatment for improving lung function. Thorax physiotherapy, incentive spirometry, inhalation therapy, intratracheal suctioning.
1
yesno
Routine dressing changes. Care and prevention of decubitus and daily dressing change.
1
yesno Renal Support
Frequent dressing changes (at least one time per each nursing shift) and/or extensive wound care
1
yesno Hemofiltration techniques. Dialytic techniques.
3
yesno
Care of drains. All (except gastric tube).
3
yesno Quantitative urine output measurement.
2
yesno
Cardiovascular Support Active diuresis (e.g. furosemid > 0.5 mg/kg/day for overload).
3
yesno
Single vasoactive medication. Any vasoactive drug.
3
yes no Neurologic Support
Multiple vasoactive medications. More than1 vasoactive drug, disregard type and dose.
4
yes Measurement of intracranial pressure.
4
yesno
Intravenous replacement of large fluid losses. Fluid replacement > 3 liters per square meter per day, disregard type of fluid administered.
4
yesno Metabolic Support
Peripheral arterial catheter.
5
yesno Treatment of complicated metabolic acidosis/alkalosis.
4
yesno
Left atrium monitoring. Pulmonary artery flotation catheter with or without cardiac output measurement.
8
yesno Intravenous hyperalimentation
3
yesno
Central venous line.
2
yesno Enteral feeding. Through gastric tube or other GI route (e.g. jejunostomy).
2
yesno
Cardiopulmonary resuscitation after arrest in the past 24 hours (single precordial percussion not included)
3
yesno
  TISS-28 =
TISS-28 = SUM (points for activities performed)   
Time of nurse's care =
(One TISS-28 point equals 10.6 minutes of each 8 h nurse's shift)
TISS-76 correlation =  
(Correlation beetwen TISS-28 and TISS-76: r = 0.93, r2 = 0.86)
(TISS-28) = 3.33 + 0.97* (TISS-76)    
Specific Interventions
Single specific interventions in the ICU. Naso or orotracheal intubation, introduction of a pacemaker, cardioversion, endoscopies, emergency surgery in the past 24 hours, gastric lavage. Routine interventions without consequences to the clinical condition of the patient, such as radiographs, echography, EKG, dressings or introduction of venous or arterial catheters, are not included.
3
yes no
Multiple specific interventions in the ICU. More than one, as described above.
5
yes
Specific interventions outside of ICU. Surgery or diagnostic procedures.
5
yesno

Criteria of exclusion are applied in four conditions :

References

 

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