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Nursing staff resources in direct patient care: comparison of TISS and ICNSS

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Abstract:

Background: 

The aim was to study the variation in the nursing workload and nursing staff resources in direct patient care. Methods: 

Nursing staff resources and the patient-nurse ratio (P/N) were compared between postoperative and mixed-type intensive care units (ICUs) using the Therapeutic Intervention Scoring System (TISS) and the Intensive Care Nursing Scoring System (ICNSS) during a 4-month period. Results: 

A total of 832 patients were treated. In the postoperative ICU, the mean daily TISS score per nurse was 41.1, corresponding to a P/N of 1 : 1, and the mean ICNSS score was 33.8, corresponding to a P/N of 1 : 1.5. In the mixed-type ICU, the mean TISS score per nurse was 34.7, corresponding to a P/N of 2 : 1, and the mean ICNSS score was 27.7, corresponding to a P/N of 1 : 1. In the postoperative unit, 50.4% of the patients would have required a 1 : 1 P/N ratio based on their TISS scores and 47.5% would have required 1.5 or two nurses as estimated by the ICNSS score. In the mixed ICU 57.1% of the patients would have required a P/N ratio of 1 : 1 based on TISS scores and 61.3% a ratio of 1 : 1.5 or 1 : 2 according to the ICNSS score. Conclusion: 

Intensive Care Nursing Scoring System gives additional information about the nursing staff resources and yields a higher number of nurses needed in direct patient care even when TISS scores show the number of nurses to be adequate.

Keywords: ICNSS; TISS; nursing workload

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.0001-5172.2004.00471.x

Affiliations: 1: Department of Nursing and Health Administration, 2: Department of Anaesthesiology, Division of Intensive Care, and 3: Department of Psychiatry, University of Oulu, Oulu, Finland

Publication date: September 1, 2004

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