TISS-28

Parameter

Action

Points

basic activities

standard monitoring (hourly vital signs, calculation of fluid balance, regular registration)

5

laboratory investigations

1

[1] single medication, any route (IV, po, IM, etc.)

2

[1] multiple intravenous medications (more than 1 drug, single injections, or continuously)

3

routine dressing changes (care and prevention of decubitus and daily dressing change)

1

frequent dressing changes (at least one time per nursing shift and/or extensive wound care)

1

care of drains (all except gastric tube)

3

ventilatory support

[2] mechanical ventilation (any form of mechanical or assisted ventilation with or without PEE), with or without muscle relaxants; spontaneous breathing with PEEP)

5

[2] supplementary ventilatory support (breathing spontaneously through endotracheal tube without PEEP; supplementary oxygen by any method except if mechanical ventilation used)

2

care of artificial airways (endotracheal tube or tracheostoma)

1

treatment for improving lung function (thorax physiotherapy, incentive spirometry, inhalation therapy)

1

cardiovascular support

[3] single vasoactive medication (any vasoactive drug)

3

[3] multiple vasoactive medications (more than1 vasoactive drug)

4

intravenous replacement of large fluid losses; fluid replacement > 3 liters per square meter per day; disregard type of fluid administered

4

peripheral arterial catheter

5

left atrium monitoring; pulmonary artery flotation catheter with or without cardiac output measurement

8

central venous line

2

cardiopulmonary resuscitation after arrest in the past 24 hours (a single precordial percussion not included)

3

renal support

hemofiltration techniques. Dialytic techniques

3

quantitative urine output measurement

2

active diuresis

3

neurologic support

measurement of intracranial pressure

4

metabolic support

treatment of complicated metabolic acidosis/alkalosis

4

intravenous hyperalimentation

3

enteral feeding (through gastric tube or other GI route such as jejunostomy)

2

specific interventions

[4] single specific intervention

3

[4] multiple specific interventions

5

specific interventions outside of ICU (surgery, diagnostic procedures)

5