title: Validation of the new Intensive Care Nursing Scoring System (ICNSS).
abstract: OBJECTIVE
  To validate a new Intensive Care Nursing Scoring System (ICNSS).
  
  
  METHODS
  Retrospective data collection.
  
  
  METHODS
  Adult 19-bed intensive care unit (ICU) in a tertiary care university hospital.
  
  
  METHODS
  A total of 1,538 patient records of which 30 documents were included in the validation.
  
  
  RESULTS
  Data included admission scores of the Acute Physiology and Chronic Health Evaluation II (APACHE II) and the Simplified Acute Physiology Scores II (SAPS II), daily Therapeutic Intervention Scores (TISS) and ICNSS scores. Data were compared using Spearman's correlation, t-test and chi-square test. Receiver operating characteristics (ROC) curve analysis was used to assess the ability of ICNSS and TISS to predict mortality. Intra-class correlation, percentage agreement and kappa statistics were used to test the validity of given scores. Nursing workload assessment using ICNSS showed that medical and emergency-operated patients caused a greater nursing workload than electively operated patients (p<0.001). Six variables of the sub-scale that described vital function nursing accounted for 27.4% of the variation of SAPS II and for 37% of the variation of APACHE II. The ICNSS sub-scale of vital function nursing accounted for a ROC area of 0.91. In the validity of the given ICNSS scores, kappa was 0.81 and weighted kappa 0.82.
  
  
  CONCLUSIONS
  Nursing workload varied between the different admission types. ICNSS explained a similar percentage of the variation of the admission scores of APACHE II and SAPSS II as TISS and discriminated between non-survivors and survivors. ICNSS is a suitable nursing workload instrument to be used with the TISS score.
authors.affiliation: Department of Nursing and Health Administration, PL 5300 , University of Oulu, 90014, Oulu, Finland. anita.pyykko@diak.fi.
authors.forename: Anita K
authors.initials: AK
authors.lastname: Pyykkö
authors.affiliation: Department of Anesthesiology, PL 21 University of Oulu, 90029, Oulu, Finland.
authors.forename: Tero I
authors.initials: TI
authors.lastname: Ala-Kokko
authors.affiliation: Department of Anesthesiology, PL 21 University of Oulu, 90029, Oulu, Finland.
authors.forename: Jouko J
authors.initials: JJ
authors.lastname: Laurila
authors.affiliation: Department of Psychiatry, PL 26 University of Oulu, 90029, Oulu, Finland.
authors.forename: Jouko
authors.initials: J
authors.lastname: Miettunen
authors.affiliation: Department of Anesthesiology, PL 21 University of Oulu, 90029, Oulu, Finland.
authors.forename: Maarit
authors.initials: M
authors.lastname: Finnberg
authors.affiliation: Department of Nursing and Health Administration, PL 5300 , University of Oulu, 90014, Oulu, Finland.
authors.forename: Maija
authors.initials: M
authors.lastname: Hentinen
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003422:Critical Care; D006801:Humans; D007362:Intensive Care Units / Q000592:standards / Q000706:statistics & numerical data*; D008875:Middle Aged; D009726:Nurses; D009732:Nursing Care; D012189:Retrospective Studies