ArticleMedizinische Klinik, Intensivmedizin und Notfallmedizin2016
[Nursing workload indices TISS-10, TISS-28, and NEMS : Higher workload with agitation and delirium is not reflected].
Article in Medizinische Klinik, Intensivmedizin und Notfallmedizin, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Nursing workload during delirium: a systematic literature review.Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Pooled it
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- Intensive care unit caseload and workload and their association with outcomes in critically unwell patients: a large registry-based cohort analysis.Critical care (London, England) · 2024Article
- A world-wide study on delirium assessments and presence of protocols.Age and ageing · 2024Article
- COVID-19 Is an Independent Risk Factor for Detrimental Invasive Fungal Disease in Patients on Veno-Venous Extracorporeal Membrane Oxygenation: A Retrospective Study.Journal of fungi (Basel, Switzerland) · 2023Article
- Article
- [Disorientation and delirium assessment : A secondary analysis of a prospective, observational study].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2022Observational
- Impact of Invasive Fungal Diseases on Survival under Veno-Venous Extracorporeal Membrane Oxygenation for ARDS.Journal of clinical medicine · 2022Article
- [Discussion paper for a hospital financing reform in Germany from the perspective of intensive care medicine].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2020Article
- [Reimbursement of intensive care services in the German DRG system : Current problems and possible solutions].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2018Article
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Authors and funding
8 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundFinancial resources for the treatment of ICU patients requiring high nursing workload are allocated within the German diagnostic-related groups (DRG) system in part through the Therapeutic Intervention Scoring System-10 (TISS-10). TISS-10, however, has never been validated. This study evaluated whether delirium and agitation in ICU were reflected by TISS-10, and also by the established workload indices TISS-28 and Nine Equivalents of Nursing Manpower (NEMS). Secondary aims were if indices correlated, and what effects delirium and agitation had on financial balances. MATERIALS AND
methodsAnalyses were performed retrospectively in 521 datasets from 152 patients. Nursing workload was assessed with TISS-28, TISS-10, and NEMS, delirium with the Confusion Assessment Method for Intensive Care Units (CAM-ICU), and vigilance with the Richmond Agitation-Sedation Scale (RASS). Revenues were retrieved from the institution's patient data management system, and costs calculated with the Budget Calculation Tool 2007 provided by the German Society of Anaesthesiologists.
resultsDelirium was found in 36.2 % of patients (n = 55). TISS-28, TISS-10, and NEMS were not higher in patients with delirium, if corrected for mechanical ventilation. TISS-28, TISS-10, and NEMS were significantly higher in deeply sedated and comatose patients (RASS ≤ - 3, p < 0.001), but not in agitated (RASS ≥ 1) and lightly sedated patients (RASS - 1/- 2). TISS-10 and TISS-28 had a linear correlation (r (2) = 0.864). Median financial balances were negative, but much more pronounced in patients with delirium that without (- 3174 € with delirium vs. - 1721 € without delirium, p = 0.0147).
conclusionThe standard workload-scores (TISS-10, TISS-28, NEMS) do not reflect higher daily workload associated with patients with delirium and agitation.
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