Utilizing TISS to differentiate between intensive care and high-dependency patients and to identify nursing skill requirements

Intensive Crit Care Nurs. 2002 Feb;18(1):19-26. doi: 10.1054/iccn.2002.1617.


Introduction: An identification system utilizing the therapeutic intervention scoring system (TISS) was developed to differentiate between intensive care and high-dependency unit (HDU) patients.

Objective: To overcome the staff recruitment and retention problem, ward nursing staff were recruited into the unit. To ensure patient care requirements did not exceed nursing skill level, TISS was utilized to differentiate ICU from HDU patients and to identify nursing skill requirements.

Method: All patients admitted to the unit over a 23-month period were concurrently TISS scored utilizing TISS -76 on admission (O/A), at 4-6 hours, day 1, day 2 and on discharge. Concurrent data on age, medical history, type of surgery and length of stay were collected.

Results: There were a total of 450 patients. Interventions utilized were mainly 1-, 2- and 3-point TISS values. The study identified the HDU patient group as being older, having a higher incidence of cardiac history and a shorter length of stay. The ICU patient group was identified as having undergone more major surgery.

Conclusion: TISS is an effective triage tool for differentiating between ICU and HDU patients and identifying nursing skill requirements to care for the ICU and HDU patient groups.

MeSH terms

  • Clinical Competence*
  • Critical Care / classification*
  • Humans
  • Inpatients / classification
  • Intensive Care Units* / standards
  • Intensive Care Units* / statistics & numerical data
  • Nursing Staff, Hospital / standards
  • Nursing Staff, Hospital / supply & distribution*
  • Patient Care Planning*
  • Personnel Staffing and Scheduling
  • Triage*
  • United Kingdom
  • Workforce