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

Pyykkö, Anita K.; Ala‐Kokko, Tero; Laurila, Jouko; Finnberg, M; Hentinen, Maija

doi:10.1111/j.0001-5172.2004.00471.x

Cited by 8 publications

(9 citation statements)

References 6 publications

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“…Some data have not been accessed due to information attrition. Conditions that are not recorded in the charts cannot be adjusted in the statistical model, including the severity of ED overcrowding (for example, patient count, occupancy the ED and ICU) [23,24] or resources of the nursing staff [25,26]. …”

Section: Discussionmentioning

confidence: 99%

Determining delayed admission to the intensive care unit for mechanically ventilated patients in the emergency department

et al. 2014

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IntroductionThe adverse effects of delayed admission to the intensive care unit (ICU) have been recognized in previous studies. However, the definitions of delayed admission vary across studies. This study proposed a model to define ‘delayed admission’, and explored the effect of ICU waiting time on patients’ outcome.MethodsThis retrospective cohort study included nontraumatic adult patients on mechanical ventilation in the emergency department (ED), from July 2009 to June 2010. The primary outcomes measures were 21-ventilator-day mortality and prolonged hospital stays (over 30 days). Models of Cox regression and logistic regression were used for multivariate analysis. The non-delayed ICU waiting was defined as a period in which the time effect on mortality was not statistically significant in a Cox regression model. To identify a suitable cutoff point between ‘delayed’ and ‘non-delayed’ subsets from the overall data were made based on ICU waiting time and the hazard ratio of ICU waiting hour in each subset was iteratively calculated. The cutoff time was then used to evaluate the impact of delayed ICU admission on mortality and prolonged length of hospital stay.ResultsThe final analysis included 1,242 patients. The time effect on mortality emerged after 4 hours, thus we deduced ICU waiting time in the ED of >4 hours as delayed. By logistic regression analysis, delayed ICU admission affected the outcomes of 21-ventilator-day mortality and prolonged hospital stay, with an odds ratio of 1.41 (95% confidence interval, 1.05 to 1.89) and 1.56 (95% confidence interval, 1.07 to 2.27) respectively.ConclusionsFor patients on mechanical ventilation in the ED, delayed ICU admission is associated with higher probability of mortality and additional resource expenditure. A benchmark waiting time of no more than 4 hours for ICU admission is recommended.

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Section: Discussionmentioning

confidence: 99%

Determining delayed admission to the intensive care unit for mechanically ventilated patients in the emergency department

et al. 2014

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“…Considering that the workload models aim to provide predictions of the ICU nurse workload based on the ICU patient characteristics (Miranda et al, 1997;Miranda et al, 2003;Padilha et al, 2007;Pyykkö et al. 2004;Pyykkö, Laurila, Ala-Kokko & Hentinen, 2001;Volpatti, Leathley, Walley & Dodek, 2000;Walther et al, 2004) there is the challenge of finding the balance between safe quality care and fiscal accountability.…”

Section: Simultaneous Activities Of the Icu Nursementioning

confidence: 99%

“…Across the world there are different methods that have been developed to anticipate the required nursing workload for the patients in an ICU (Miranda et al, 1997;Miranda et al, 2003;Padilha et al, 2007;Pyykkö et al, 2004;Pykkö et al, 2001;Volpatti et al, 2000;Walther et al, 2004). These methods in general will consider what is involved for the ICU nurse to care for an ICU patient by identifying key activities and weighting the activities to indicate potential workload.…”

Section: Recommendation For Workload Modelsmentioning

confidence: 99%

Understanding the work of intensive care nurses: A time and motion study

Abbey

Chaboyer

Mitchell

2012

Australian Critical Care

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“…Augenscheinlich ist, dass die interventions-beziehungsweise tätig-keits-und verrichtungsbezogene Betrachtungsweise des TISS all das ausklammert, was nicht direkt messbar ist. Dies ist ein Kritikpunkt von Pyykkö et al [17], die das TISS als nicht ganzheitliches Instrument bezeichnen. Eine ähnliche Kritik formuliert auch Neander [25].…”

Section: Materials Und Methodenunclassified

“…Auch mit der zweiten Annahme, die dem TISS zugrunde liegtdass sich von den Interventionen auf den zeitlichen Pflegeaufwand schließen lasse -stößt das Instrument an Grenzen. Pyykkö et al in ihrer Untersuchung an[17]. Dabei sind es gerade diese Patienten, die in der Systematik des TISS mit hohen Punktwerten eingestuft werden.…”

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