Development of a Comprehensive Scoring System to Measure Multi-faceted Nursing Workloads in ICU and Apply to ICU medical evaluation

目的建立综合护理干预评分（CNIS），以量化护理工作量。日本医院的重症监护室（ICU）。设计=对ICU护士的调查和对大学医院ICU患者的回顾性统计分析。ICU设置在3所大学医院（护士调查）和1所大学医院（回顾性分析）。测量方法和主要结果参照TISS，编制了ICU内护理活动的8大类88个项目的清单。采用德尔菲法对每一个单项的护士人数、工作量、身体疲劳、心理压力和特殊技能5个方面进行评分，评分范围为0-3分。通过对118名ICU护士的调查，对父母比率进行统计学检验，以确定条目的效度。总体平均匹配率为73%（p < 0.001）。为了确定项目的可靠性，44名护士使用相同的问卷进行了两次调查，第一次和第二次测试之间的间隔为1周。总体匹配比的平均值为0.65（p < 0.01）。为了检查外部验证，计算了107名在ICU至少停留24小时的患者的CNIS和9个护理人力使用评分（NEMS）。对CNIS和NEMS计算了总共1160天的回归分析，相关系数为0.55（p < 0.001）。排除护理项目后的相关系数为0.75（p< 0.001）。结论：本量表共8大类73个项目，分6个方面进行评分，是一个有效、可靠的量表

Objective To develop a Comprehensive Nursing Intervention Score (CNIS) that includes the functions of nursing itself, in an effort to quantify nursing workload in.. the intensive care unit (ICU) of Japanese hospitals. Design= Investigation for ICU nurses and retrospective statistical analysis of ICU patients admitted to university hospital. Setting ICUs in 3 university hospitals, (investigation for nurses) and 1 university hospital (retrospective analysis). Measurements and Main Result With reference to the TISS, a list of 88 items in 8 categories was prepared for nursing activities undertaken within the ICU. For each individual item, 5 aspects were scored in a range of 0-3 using a Delphi process number of nurses, workload, physical fatigue, psychological stress, and special skills. To determine the validity of items, the parent ratio was statistically tested by investigation for 118 ICU nurses. The mean matching ratio was 73% overall (p < 0.001). To determine the reliability of items, 44 nurses were surveyed twice using the same questionnaire, with an interval of 1 week between first and second tests. The mean value of the matching ratio was 0.65 overall (p < 0.01). To examine external validation, CNIS and Nine Equivalents of Nursing Manpower Use Score (NEMS) were calculated for 107 patients who stayed in the ICU for at least 24 hours. Regression analysis was calculated for CNIS and NEMS for a total of 1160 days, and the correlation coefficient was 0.55 (p < 0.001). The correlation coefficient when nursing care items were excluded from the CNIS was 0.75 (p< 0.001). Conclusion= A final total of 73 items in 8 categories, scored for 6 aspects was designated as the CNIS and was found to be valid and reliable