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


CONCLUSIONS
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.
Department of Nursing and Health Administration, University of Oulu, Finland. anita.pyykko@diak.fi
A K
AK
Pyykkö
T I
TI
Ala-Kokko
J J
JJ
Laurila
J
J
Miettunen
M
M
Finnberg
M
M
Hentinen
D018806:APACHE; D003422:Critical Care / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005387:Finland; D007362:Intensive Care Units / Q000706:statistics & numerical data; D009732:Nursing Care; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D005791:Patient Care / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000451:nursing / Q000706:statistics & numerical data; D000078329:Workforce; D016526:Workload