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

Abstract

Objective: Examine the concurrent validity of the Nine Equivalents of Nursing Manpower Use Score (NEMS) in comparison to the Therapeutic Intervention Scoring System-28 (TISS-28) in a Pediatric Intensive Care Unit (PICU). Methods: Prospective observational cohort study conducted in a PICU of a Brazilian university hospital over a period of two years with a sample of 816 patients. A total of 7,702 observations were obtained for each of the scores. Results: The average maximum score of the NEMS was 26.6±9.2 and for the TISS-28 it was 21.3±8.2. The TISS-28 was lower than the NEMS (p<0.001) for all the averages. A good correlation was observed between them (r2=0.704) for all observations. Agreement between the TISS-28 and the NEMS was good, presenting only a 6.2% difference between the scores. Conclusion: The results show good correlation and agreement between the TISS-28 and the NEMS, enabling the NEMS validation in this population of pediatric patients. Resumo Objetivo: Examinar a validade concorrente do escore Nine Equivalents of Nursing Manpower Use Score (NEMS) em comparação ao Therapeutic Intervention Scoring System-28 (TISS-28) em uma Unidade de Terapia Intensiva Pediátrica (UTIP).Métodos: Estudo de coorte prospectivo observacional, realizado na UTIP de um hospital universitário brasileiro, no período de dois anos, com uma amostra de 816 pacientes. Foram realizadas 7.702 observações de cada um dos escores. Resultados: A média da pontuação máxima do NEMS foi 26,6±9,2 e do TISS-28 21,3±8,2. Em todas as médias, o TISS-28 foi inferior ao NEMS (p<0,001). Houve uma boa correlação entre eles (r 2 =0,704 para todas as observações). A concordância entre o TISS-28 e o NEMS foi boa, apresentando apenas 6,2% de diferença entre os escores. Conclusão: Os resultados mostraram boa correlação e concordância entre o TISS-28 e o NEMS, permitindo validar o NEMS nessa população de pacientes pediátricos.

Comparison of nursing workload in a Pediatric Intensive Care Unit estimated by three instruments

“…The instruments TISS-28 and NEMS showed good correlation and agreement in our study, and this result was already found in another study carried out in the same hospital unit (26) . It can be inferred that the basis of this result lies in the fact that the latter instrument is derived from the former, and though NEMS evaluates only nine items, a score adjustment was performed to compensate for this and maintain balance for the total workload between TISS-28 and NEMS.…”

Use of scores to calculate the nursing workload in a pediatric intensive care unit

“…In other studies, the average scores varied from 26.2 to 29.8. ( 20 , 24 , 25 ) In one study conducted at a PICU in 2009, ( 26 ) the average score was 19.3.…”

“…The scores of both instruments at admission and the maximum scores exhibited satisfactory discrimination of the mortality outcomes as shown by the ROC curve. One study conducted in 2009 ( 26 ) found that the scores of both Nine Equivalents of Nursing Manpower Use Score (NEMS) and TISS-28 at admission and at their maximum levels exhibited satisfactory discrimination of mortality outcomes during the stay at the ICU as assessed by the ROC curve (AUROC of TISS-28 at admission 0.68; AUROC of the maximum score 0.76).…”

Tools for managing childcare in the postoperative period of cardiac surgery: an integrative review

“…The expectation of fast access and quality health care, especially in Intensive Care Units (ICU), is increasing in our country (40) . This requires pediatric nursing professionals to use tools to enable the provision of quality care to children in the postoperative period of cardiac surgery (41) .…”