TISS-28 — Therapeutic Intervention Scoring System
Measures ICU nursing workload and patient acuity. TISS-28 is a simplified 28-item version. Score reflects interventions required in 24 hours.
Score interpretation
Low nursing workload. Step-down/monitoring level appropriate.
→ Consider transfer to step-down unit. One nurse can care for 2–3 patients.
Moderate workload. Close monitoring required.
→ HDU or ICU-step care. Nurse:patient ratio 1:1–1:2.
High workload. ICU-level care required.
→ ICU admission. 1:1 nursing. Daily organ support review.
Very high workload. Complex multi-organ support.
→ Specialist ICU. May require >1 nurse. Senior critical care review.
Interpretation bands for the TISS-28. Apply clinical judgement and local guidance.
References
- Miranda DR et al. Simplified Therapeutic Intervention Scoring System: the TISS-28 items — results from a multicenter study. Crit Care Med. 1996;24(1):64-73.
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Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.