Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.
Intensive Crit Care Nurs. 2020 Dec;61:102917. doi: 10.1016/j.iccn.2020.102917. Epub 2020 Aug 24.
The Simplified Therapeutic Intervention Scoring System adapted to liver transplantation by King's College Hospital rank 138 activities to determine the nursing workload, diagnostic, monitoring and therapeutic needs.
To evaluate nursing activities of "King's-TISS" score grouped in organ systems and nurse patient ratio in the perioperative 48 hours of blood product free liver transplantations (LT).
The "King's-TISS" score's were analysed by nursing procedures and grouped, scored according to organ systems. The nursing workloads were studied during LT (T1), on arrival on the ICU (T2) and 12-24-48 hours after LT (T3-T4-T5).
The total of "King's-TISS" score points were decreased by ≥20% daily (p = 0.001). The mean score of 104 ± 3.5 points (CI:104-105) during LT decreased to 84.7 ± 12 points (CI:83-86) in 48 hours (T5). The "metabolic" and "haemostasis" points increased (p = ).01), the "immunology" points unchanged (T2-T5) postoperatively. A slight decrease was observed in case of "basic nursing care", "monitoring", "neurologic support", "renal support" and "cardiovascular support" points (T2-T5, p < .01). The "invasive intervention" and "ventilatory support" points strongly decreased (T2-T5, p < .001). One "King's-TISS" point was found to equal 7.4 minutes with a nurse patient ratio of 2:1 intraoperatively and 1:1 postoperatively.
Absence of blood product administration in LT decreases the total and organ specific workload, except the metabolic, haemostasis, immunology and basic support requirement. It was not within the scope of the King's-TISS score to analyse the application of viscoelastic haemostasis test and coagulation factor concentrate administration.
英国国王学院医院的简化治疗干预评分系统（Simplified Therapeutic Intervention Scoring System）对肝移植进行了适应性调整，将 138 项活动分为护理工作量、诊断、监测和治疗需求。
评估无血制品肝移植（Liver Transplantation，LT）围手术期 48 小时内“King's-TISS”评分的护理活动，分组为器官系统和护士患者比例。
根据护理程序对“King's-TISS”评分进行分析，并按器官系统进行评分。在 LT（T1）、到达 ICU（T2）和 LT 后 12-24-48 小时（T3-T4-T5）期间研究护理工作量。
每天“King's-TISS”评分减少≥20%（p=0.001）。LT 期间平均评分 104±3.5 分（CI：104-105），48 小时（T5）降至 84.7±12 分（CI：83-86）。“代谢”和“止血”评分增加（p=）。术后“免疫”评分不变（T2-T5）。“基础护理”、“监测”、“神经支持”、“肾脏支持”和“心血管支持”评分略有下降（T2-T5，p<.01）。“侵入性干预”和“通气支持”评分明显下降（T2-T5，p<.001）。术中每 1 个“King's-TISS”评分相当于 7.4 分钟，护士患者比例为 2:1，术后为 1:1。
LT 中无血制品输注可降低总工作量和器官特异性工作量，除代谢、止血、免疫和基本支持需求外。King's-TISS 评分未分析应用粘弹性止血试验和凝血因子浓缩物给药。
