Nine equivalents of nursing manpower use score (NEMS)
Nine equivalents of nursing manpower use score (NEMS)
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DOI：
10.1007/s001340050406
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发表时间：
1997-07-01
影响因子：
38.9
通讯作者：
Iapichino, G
中科院分区：
文献类型：
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作者：
Miranda, DR;Moreno, R;Iapichino, G
目的：建立基于TISS-28条目的简化治疗干预评分系统，并在独立的数据库中验证新的评分。设计：对数据库进行回顾性统计分析和前瞻性多中心研究。设置：在欧洲重症监护研究基金会的数据库中开发，并在11个欧洲国家的重症监护病房(ICU)进行外部验证。测量和结果：在随机抽样的TISS-28条目上开发新的治疗干预评分系统，在TISS-28的另一个随机样本上进行交叉验证，以及NEMS的外部验证，与参加国际研究的两名独立评分者在访问ICU当天获得的TISS-28评分进行比较。使用了多变量回归技术、皮尔逊相关性和配对样本t检验(显著性在p<；0.05水平)。组内相关性、符合率和kappa统计用于评价者间的可靠性测试。在随机抽取的2000份记录中，TISS-28条目被简化为NEMS(9个条目)，两个条目的平均数没有差别：TISS-28 26.23+/-10.38，NEMS 26.19+/-9.12，NS。996条记录的随机样本的交叉验证；平均TISS-28 26.13+/-10.38，NEMS 26.17+/-9.38，NS；R-2=0.76。对369对TISS-28和NEMS的外部效度检验表明，两者的均分没有差异：TISS-28 27.56+/-11.03，NEMS 27.02+/-8.98，NS；R-2=0.59。可靠性测试显示，评分者之间的相关性几乎是完美的。与TISS与简化急性生理学评分(SAPS-I)和/或急性生理学和慢性健康评估II评分的相关研究相似，NEMS首日评分可解释SAPS-II评分变异的30.4%。结论：NEMS是一种适合ICU水平衡量护理工作量的治疗指标。使用NEMS的目的是：(A)多中心ICU研究；(B)一般(宏观)评估和比较ICU工作量的管理目的；(C)预测工作量和规划个别病人一级的护理人员分配。
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 dat abase.Design: Retrospective statistical analysis of a database and a prospective multicentre study.Setting: Development in the data base 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; R-2 = 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; R-2 = 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.