RESUMEN
UNLABELLED: The Therapeutic Intervention Scoring System-28 (TISS-28) is an instrument that has been used to measure severity of illness and nursing workload in intensive care units (ICUs). OBJECTIVES: To characterize the severity of illness and nursing workload using the TISS-28 in 11 ICUs of a university hospital in the city of São Paulo, Brazil. METHODS: In a prospective study, data were collected from 271 patients admitted to the ICUs in December 2000 and the patients were followed up for 1 week. RESULTS AND CONCLUSIONS: Most of the patients were males (60.0%) and their mean age was 51(+20.6) years. Surgical treatment (66.8%) and admissions from the operating room were predominant. The mortality rate was 25.0% and the average length of stay was 7.7 (+10.4) days. The mean TISS-28 score was 23 (range: 14-32 points). The lowest mean score was observed for patients from the Burn ICU and the highest mean score was obtained for patients from the Liver Transplant ICU. A change in TISS-28 scores was observed in the same ICU over the 7-day study period. Units differed in terms of severity of illness and nursing workload. Patients who died received a higher TISS-28 score than patients who survived (p=0.00). As the nursing staff are the largest economic investment in an ICU, so measuring nursing workload in different ICUs from different centres can contribute to the estimation of nursing staff required according to the specific demands of the units.
Asunto(s)
Pacientes Internos/estadística & datos numéricos , Unidades de Cuidados Intensivos/organización & administración , Personal de Enfermería en Hospital/organización & administración , Índice de Severidad de la Enfermedad , Carga de Trabajo/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Análisis Costo-Beneficio , Femenino , Mortalidad Hospitalaria , Hospitales Universitarios , Humanos , Pacientes Internos/clasificación , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Rol de la Enfermera , Investigación en Administración de Enfermería , Investigación en Evaluación de Enfermería , Admisión y Programación de Personal/organización & administración , Estudios Prospectivos , Tasa de Supervivencia , Estudios de Tiempo y Movimiento , Carga de Trabajo/clasificaciónRESUMEN
This paper reports a descriptive study, based on nursing records, of nursing diagnoses documented three months after the implementation of the NANDA-I classification at the University of São Paulo's Hospital Universitário (HU-USP) and proposes outcomes and interventions for the 3 most frequent diagnoses. The convenience sample (34% of the month's admissions) consisted of 30 charts of patients admitted in the Medical Clinic in August of 2004 (60% female, average age 60.9 +/- 23.1 years, mean length of stay = 5.8 +/- 2.7 days). The diagnoses documented on the admission day were manually transcribed from the charts and analyzed according to their frequency. There were 144 diagnoses (31 categories), with an average of 4.8 +/- 4.0 diagnoses per patient (range = 1-10). The most frequent were: acute pain (66.7%), impaired tissue integrity (63.3%), ineffective airway clearance (43.3%), risk of impaired skin integrity (36.7%), and impaired skin integrity (33.3%). The proposed outcomes and interventions are presented.