Intervenções terapêuticas em Unidade de Terapia Intensiva: análise segundo o Therapeutic Intervention Scoring System-28 (TISS-28)

Abstract

O presente estudo teve como objetivos descrever a prevalência diária das categorias de intervenções terapêuticas e identificar a prevalência dos itens componentes de cada categoria de intervenções terapêuticas, segundo o TISS-28. A amostra incluiu 89 admissões consecutivas na UTI geral de um Hospital Universitário do município de São Paulo. Das 7 categorias do TISS-28, houve prevalência na pontuação das categorias Atividades Básicas e Suportes Ventilatório, Cardiovascular e Renal, com freqüência entre 73,0% e 100,0%. A freqüência dos itens componentes da categoria Atividades Básicas foi maior do que 90,0%. O sub-iten medida quantitativa do débito urinário foi pontuado em 98,2% na categoria Suporte Renal. Os resultados obtidos podem imprimir qualidade a assistência prestada aos clientes, na medida em que contribuem para a previsão de recursos humanos e materiais na UTI.

Correlation between the TISS‐28 and NEMS indicators in an intensive care unit

“…When looking at the scores for the two instruments, it can be seen that the TISS‐28 had a lower mean value (19.1 points on admission and 16.8 points on discharge) than has been observed in other studies, with one research finding a mean TISS‐28 score of 21.9 points, another of 23.1 points and a third of 21.4 points . Likewise, higher NEMS scores were shown in this study than for the TISS‐28 for both admission and discharge (22.4 points and 19.0 points, respectively).…”

“…Another research concluded that the mean TISS-28 score in relation to the discharge status of the ICU patients was 31.1 ± 3.9 points for non-survivors, with this being significantly higher (P = 0.039) than for survivors (22.5 ± 6.0 points). 12 In yet another study, a mean TISS-28 score of 17.9 ± 6.8 points was found for survivors and a mean of 24.3 ± 5.4 points for non-survivors. 16 This study found after analysis of NEMS, a mean of 30.7 ± 9.0 points on admission and 31.7 ± 8.0 points on discharge for patients who subsequently died.…”

“…When analysing the association between the two instruments with the occurrence of death, a statistically significant association was found by this study in the TISS‐28 scores of 26.4 ± 7.8 points on admission and 26.8 ± 6.1 points on discharge. Another research concluded that the mean TISS‐28 score in relation to the discharge status of the ICU patients was 31.1 ± 3.9 points for non‐survivors, with this being significantly higher ( P = 0.039) than for survivors (22.5 ± 6.0 points) . In yet another study, a mean TISS‐28 score of 17.9 ± 6.8 points was found for survivors and a mean of 24.3 ± 5.4 points for non‐survivors …”

Validação Concorrente de Escores de Enfermagem (NEMS e TISS-28) em terapia intensiva pediátrica

“…(18) The finding that patients who do not survive obtain higher scores has also been verified in other studies. (18)(19)(20)(21) When the PRISM was higher than ten, mortality was 25.9%, and when the PRISM was lower than ten, the mortality observed was 3.4%. The averages of the NEMS and TISS-28 for patients who obtained a PRISM>10 was also higher when related to length of hospitalization.…”

Gravidade De Pacientes E Carga De Trabalho De Enfermagem Em Unidade De Terapia Intensiva

“…O referido hospital, não possui Unidades de Terapia Semi-Intensiva (USI). Estudos mencionam que 54% a 58,4%, dos pacientes que receberam alta das UTI são encaminhados para a USI (15)(16)(17) . Indubitavelmente se a instituição hospitalar disponibilizasse de um a USI, haveria uma maior rotatividade de pacientes na UTI e consequentemente diminuiria o tempo de espera por cuidados intensivos nas unidades de emergência e centro cirúrgicos.…”