PMID- 26253516
OWN - NLM
STAT- MEDLINE
DCOM- 20170315
LR  - 20181113
IS  - 2193-6226 (Electronic)
IS  - 2193-6218 (Linking)
VI  - 111
IP  - 1
DP  - 2016 Feb
TI  - [Nursing workload indices TISS-10, TISS-28, and NEMS : Higher workload with 
      agitation and delirium is not reflected].
PG  - 57-64
LID - 10.1007/s00063-015-0056-5 [doi]
AB  - BACKGROUND: Financial resources for the treatment of ICU patients requiring high 
      nursing workload are allocated within the German diagnostic-related groups (DRG) 
      system in part through the Therapeutic Intervention Scoring System-10 (TISS-10). 
      TISS-10, however, has never been validated. This study evaluated whether delirium 
      and agitation in ICU were reflected by TISS-10, and also by the established 
      workload indices TISS-28 and Nine Equivalents of Nursing Manpower (NEMS). 
      Secondary aims were if indices correlated, and what effects delirium and 
      agitation had on financial balances. MATERIALS AND METHODS: Analyses were 
      performed retrospectively in 521 datasets from 152 patients. Nursing workload was 
      assessed with TISS-28, TISS-10, and NEMS, delirium with the Confusion Assessment 
      Method for Intensive Care Units (CAM-ICU), and vigilance with the Richmond 
      Agitation-Sedation Scale (RASS). Revenues were retrieved from the institution's 
      patient data management system, and costs calculated with the Budget Calculation 
      Tool 2007 provided by the German Society of Anaesthesiologists. RESULTS: Delirium 
      was found in 36.2 % of patients (n = 55). TISS-28, TISS-10, and NEMS were not 
      higher in patients with delirium, if corrected for mechanical ventilation. 
      TISS-28, TISS-10, and NEMS were significantly higher in deeply sedated and 
      comatose patients (RASS </= - 3, p < 0.001), but not in agitated (RASS >/= 1) and 
      lightly sedated patients (RASS - 1/- 2). TISS-10 and TISS-28 had a linear 
      correlation (r (2)  = 0.864). Median financial balances were negative, but much 
      more pronounced in patients with delirium that without (- 3174 euro with delirium 
      vs. - 1721 euro without delirium, p = 0.0147). CONCLUSION: The standard 
      workload-scores (TISS-10, TISS-28, NEMS) do not reflect higher daily workload 
      associated with patients with delirium and agitation.
FAU - Guenther, U
AU  - Guenther U
AD  - Klinik und Poliklinik fur Anasthesiologie und operative Intensivmedizin, 
      Universitatsklinikum der Rheinischen Friedrich-Wilhelms-Universitat, 
      Sigmund-Freud-Strasse 25, 53105, Bonn, Deutschland. u.guenther@uni-bonn.de.
FAU - Koegl, F
AU  - Koegl F
AD  - Klinik und Poliklinik fur Anasthesiologie und operative Intensivmedizin, 
      Universitatsklinikum der Rheinischen Friedrich-Wilhelms-Universitat, 
      Sigmund-Freud-Strasse 25, 53105, Bonn, Deutschland.
FAU - Theuerkauf, N
AU  - Theuerkauf N
AD  - Klinik und Poliklinik fur Anasthesiologie und operative Intensivmedizin, 
      Universitatsklinikum der Rheinischen Friedrich-Wilhelms-Universitat, 
      Sigmund-Freud-Strasse 25, 53105, Bonn, Deutschland.
FAU - Maylahn, J
AU  - Maylahn J
AD  - Klinik und Poliklinik fur Anasthesiologie und operative Intensivmedizin, 
      Universitatsklinikum der Rheinischen Friedrich-Wilhelms-Universitat, 
      Sigmund-Freud-Strasse 25, 53105, Bonn, Deutschland.
FAU - Andorfer, U
AU  - Andorfer U
AD  - Klinik und Poliklinik fur Anasthesiologie und operative Intensivmedizin, 
      Universitatsklinikum der Rheinischen Friedrich-Wilhelms-Universitat, 
      Sigmund-Freud-Strasse 25, 53105, Bonn, Deutschland.
FAU - Weykam, J
AU  - Weykam J
AD  - Klinik und Poliklinik fur Anasthesiologie und operative Intensivmedizin, 
      Universitatsklinikum der Rheinischen Friedrich-Wilhelms-Universitat, 
      Sigmund-Freud-Strasse 25, 53105, Bonn, Deutschland.
FAU - Muders, T
AU  - Muders T
AD  - Klinik und Poliklinik fur Anasthesiologie und operative Intensivmedizin, 
      Universitatsklinikum der Rheinischen Friedrich-Wilhelms-Universitat, 
      Sigmund-Freud-Strasse 25, 53105, Bonn, Deutschland.
FAU - Putensen, C
AU  - Putensen C
AD  - Klinik und Poliklinik fur Anasthesiologie und operative Intensivmedizin, 
      Universitatsklinikum der Rheinischen Friedrich-Wilhelms-Universitat, 
      Sigmund-Freud-Strasse 25, 53105, Bonn, Deutschland.
LA  - ger
PT  - Journal Article
TT  - Pflegeaufwandsindizes TISS-10, TISS-28 und NEMS : Erhohter Arbeitsaufwand bei 
      Agitation und Delir wird nicht erfasst.
DEP - 20150808
PL  - Germany
TA  - Med Klin Intensivmed Notfmed
JT  - Medizinische Klinik, Intensivmedizin und Notfallmedizin
JID - 101575086
SB  - IM
MH  - Costs and Cost Analysis/economics
MH  - Critical Care Nursing/*economics/*methods
MH  - Cross-Sectional Studies
MH  - Delirium/diagnosis/*economics/epidemiology/*nursing
MH  - Diagnosis-Related Groups/economics
MH  - Germany
MH  - Humans
MH  - National Health Programs/economics
MH  - Psychomotor Agitation/diagnosis/*economics/epidemiology/*nursing
MH  - Retrospective Studies
MH  - *Workload
OTO - NOTNLM
OT  - Confusion
OT  - Costs and cost analysis
OT  - Nursing
OT  - Restlessness
OT  - Scoring methods
EDAT- 2015/08/09 06:00
MHDA- 2017/03/16 06:00
CRDT- 2015/08/09 06:00
PHST- 2014/12/21 00:00 [received]
PHST- 2015/05/15 00:00 [accepted]
PHST- 2015/05/10 00:00 [revised]
PHST- 2015/08/09 06:00 [entrez]
PHST- 2015/08/09 06:00 [pubmed]
PHST- 2017/03/16 06:00 [medline]
AID - 10.1007/s00063-015-0056-5 [pii]
AID - 10.1007/s00063-015-0056-5 [doi]
PST - ppublish
SO  - Med Klin Intensivmed Notfmed. 2016 Feb;111(1):57-64. doi: 
      10.1007/s00063-015-0056-5. Epub 2015 Aug 8.