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Titre du document / Document title

Nine equivalents of nursing manpower use score (NEMS)

Auteur(s) / Author(s)

REIS MIRANDA D. (1) ; MORENO R. (2) ; IAPICHINO G. (3) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) ICU Research Group, Department of Surgery, University Hospital Groningen, P.O. Box 30.001, 9700 RB Groningen, PAYS-BAS
(2) Intensive Care Unit, St. Antonio dos Capuchos Hospital, Lisbon, PORTUGAL
(3) Intensive Care Unit, San Paolo Hospital, Milan, ITALIE

Résumé / Abstract

Objectives: To develop a simplified Therapeutic Intervention Scoring System (TISS) based on the TISS-28 items and to validate the new score in an independent database. Design: Retrospective statistical analysis of a database and a prospective multicentre study. Setting: Development in the database of the Foundation for Research on Intensive Care in Europe with external validation in 64 intensive care units (ICUs) of 11 European countries. Measurements and results: Development of NEMS on a random sample of TISS-28 items, cross validation on another random sample of TISS-28, and external validation of NEMS in comparison with TISS-28 scored by two independent raters on the day of the visit to the ICUs participating in an international study. Multivariable regression techniques, Pearson's correlation, and paired sample t-tests were used (significance at p < 0.05 level). Intraclass correlation, rate of agreement, and kappa statistics were used for interrater reliability tests. The TISS-28 items were reduced to NEMS (9 items) in a random sample of 2000 records; the means of the two scores were no different: TISS-28 26.23 ± 10.38, NEMS 26.19 ± 9.12, NS. Cross-validation in a random sample of 996 records; mean TISS-28 26.13 ± 10.38, NEMS 26.17 ± 9.38, NS; R2 = 0.76. External validation on 369 pairs of TISS-28 and NEMS has shown that the means of the two scores were no different: TISS-28 27.56 ± 11.03, NEMS 27.02 ± 8.98, NS; R2 = 0.59. Reliability tests have shown an almost perfect interrater correlation. Similar to studies correlating TISS with Simplified Acute Physiology Score (SAPS)-I and/or Acute Physiology and Chronic Health Evaluation II scores, the value of NEMS scored on the first day accounts for 30.4 % of the variation of SAPS-II score. Conclusions: NEMS is a suitable therapeutic index to measure nursing workload at the ICU level. The use of NEMS is indicated for: (a) multicentre ICU studies; (b) management purposes in the general (macro) evaluation and comparison of workload at the ICU level; (c) the prediction of workload and planning of nursing staff allocation at the individual patient level.

Revue / Journal Title

Intensive care medicine    ISSN  0342-4642   CODEN ICMED9 

Source / Source

1997, vol. 23, no7, pp. 760-765 (13 ref.)

Langue / Language

Anglais

Editeur / Publisher

Springer, Heidelberg, ALLEMAGNE  (1977) (Revue)

Mots-clés anglais / English Keywords

Intensive care unit

;

Nursing

;

Workload

;

Manpower

;

Measurement method

;

Validation

;

Human

;

Mots-clés français / French Keywords

Unité soin intensif

;

Nursing

;

Charge travail

;

Main d'oeuvre

;

Méthode mesure

;

Validation

;

Homme

;

Mots-clés espagnols / Spanish Keywords

Unidad terapia intensiva

;

Enfermería

;

Carga trabajo

;

Mano de obra

;

Método medida

;

Validación

;

Hombre

;

Localisation / Location

INIST-CNRS, Cote INIST : 16256, 35400006790183.0080

Nº notice refdoc (ud4) : 2761521



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