Marga Hoogendoorn

37 Table 3. Validation of quantification of the need for nursing time Scoring system Quantification need for nursing time Validation method Results validation TISS-76 1 Nurse/shift= 40-50 TISS points/shift Class I: < 10 TISS points – Nurse:Patient-ratio = 1:4 Class II: 10-19 TISS points – Nurse:Patient-ratio = 1:2 Class III: 20-39 TISS points – Nurse:Patient-ratio = 1:1+1 Class IV: >39 points – Nurse:Patient-ratio = 1:1 Compared with time measurements 46 Need for nursing staff with TISS-76 < measured time 46 PRN-system 1 point = 5 minutes Compared with planned nursing staff 82 PRN-system: good correlation with planned staff 82 NISS 1 nurse = 480 minutes 1 NISS-point = 6.75 minutes of care Compared with actual nursing staff 52 NISS: reasonable estimate of time 52 Jackson MMC Scoring system 1 point =4 minutes nursing time, 1 nurse=195 points Class I-serious: £12h care/24 h = Nurse:Patient-ratio 2:1 Class II-critical: 12-24h care/24h = Nurse:Patient-ratio 1:0.75 Class III-Crisis: ³ 24h care/24h = Nurse:Patient-ratio 1:1.2 Compared with actual and planned nursing staff 18 Need for nursing time according scoring system in 57-92% of the patients more than actual staff 18 NDS Score 1-6 = Nurse:Patient-ratio 0.5:1 Score 7-13 = Nurse:Patient-ratio 1:1 Score 13-20 = Nurse:Patient-ratio 1.5:1 Score 21-28 = Nurse:Patient-ratio 2:1 Not described PINI Level 1: 0.5 – 1h nursing care Level 2: 1-1.5h nursing care Level 3: 1.5 – 2.5h nursing care Level 4: 2.5 – 4h nursing care Level 5: > 4h nursing care Compared with time measurements 42 Overall agreement of 69% Level 1: 92%. Level 2: 64%, Level 3: 38%, Level 4: 60%. In 70% of the disagreements overestimation with PINI 42 TOSS TOSS £ 360 minutes = Nurse:Patient-ratio 1:4 TOSS 361-480 minutes = Nurse:Patient-ratio 1:3 TOSS 481-720 minutes = Nurse:Patient-ratio 1:2 TOSS 721-1170 minutes = Nurse:Patient-ratio 1:1+1 TOSS ³ 1171 minutes = Nurse:Patient-ratio 1:1 Compared with other system; TISS 22 Nurse:Patient-ratio with TISS 2:1, Nurse:Patient-ratio with TOSS 3:1 in the same patients 22