TISS在SICU护理工作量评定与分析中的应用  

Using Therapeutic Intervention Scoring System to assess the nursing workload in a surgical intensive care unit

作　　者：张彦虎[1] 周苗苗[1] 吴晓英[2] 

机构地区：[1]北京大学护理学院,100191 [2]北京大学人民医院

出　　处：《中国护理管理》2008年第11期41-44,共4页Chinese Nursing Management

摘　　要：目的:应用治疗干预计分系统(TISS)评定、分析外科重症监护病房(SICU)的护理工作量,为临床管理提供客观参考依据。方法:观察北京某三级甲等医院SICU半年内每天的护理记录并收集366例患者每天的TISS计分,统计SICU病房每天所有患者的TISS总分。结果:根据TISS给定的分级方法,826例次SICU患者的TISS计分均数为39.52,约需要1:1的护患比。其中有46.97%例次的TISS计分在40～87分之间,属于TISS分类Ⅳ级的重患者,需要1名或者1名以上的护士直接护理。SICU每天护理工作总量的TISS计分均数为195.74,每天满足患者直接护理需要的护士岗位职数为15人。TISS的76个护理干预项目中,心电图监护、每24小时的常规摄入及排出、留置导尿管的操作频次占前3位。结论:SICU护士处于超负荷工作状态。TISS为SICU护理工作量的评估和人力资源的合理使用提供了有力的依据;护患比例失调,护士编制不足,是监护病房亟待解决的问题。Objective： To assess the nursing workload of a surgical intensive care unit in a university hospital utilizing the Therapeutic Intervention Scoring System （TISS）. Methods： By assessing the nursing records during a 6-month period, the TISS scores of 366 patients were obtained by experienced observers using the Therapeutic Intervention Scoring System, and everyday TISS scores were summed up. Results： The mean daily TISS score per patient was 39.52, which need 1 nurse per patient. The score of 46. 97%patients ranged from 40 to 87, which required one or more nurses to provide direct care. The mean daily TISS score in the SICU was 195.74, which required 15 nurses per 24 hours for direct patient care. Among the 76 interventions, ECG monitoring, daily input and output, and indwelling catheter had the highest frequencies. Conclusion： SICU nurses were overloading .TISS was an easily applicable method to measure nursing workload and was a reliable indicator of the nursing manpower in SICU. The inappropriate nurse-to-patient ratio and inadequate nurse staff were the problems which needed to be resolved as soon as possible.

关 键 词：治疗干预评分 护理工作量 护患比 外科重症监护病房 

分 类 号：R47[医药卫生—护理学] R605.97[医药卫生—临床医学]