Metas de Enfermería

Metas de Enfermería

FEBRERO 2007 N° 1 Volumen 10

Instruments based on indirect measures for ICU: TISS and NEMS

Section: Medicion trabajo enfermero

How to quote

Subirana Casacuberta M, Solà Arnau I. Instrumentos basados en medidas indirectas para UCI: TISS y NEMS. Metas de Enferm feb 2007; 10(1): 15-20


1Mireia Subirana Casacuberta, 2Ivan Solà Arnau


1Diplomada en Enfermería. Profesora asociada. EUE Hospital de la Santa Creu i Sant Pau de Barcelona, adscrita a la UAB. Servicio de Epidemiología.2Licenciado en Psicología y Psicoterapia. Centro Cochrane Iberoamericano.

Contact address

St. Antoni Maria Claret, 171. 08041 Barcelona.

Contact email: msubirana@santpau.es


This article, the sixth in a series describing instruments used to measure workload in nursing care, depicts two of the eight instruments created for application in intensive care units. These instruments: Therapeutic Intervention Scoring System (TISS) and the Nine Equivalents for Nursing Manpower Use (NEMS) were based on indirect measures. TISS, described for the first time in 1974, was designed to classify critical patients according to the severity of their condition. The first study quantified nursing workloads using the TISS score, was written by Cullen and published in 1977. One of the major criticisms of the TISS is related to the multiplicity of versions elaborated using the original instrument as a start point. NEMS can be considered as an evolution of the TISS, as it is an instrument designed to measure workloads in nursing based on a simplification of the TISS 28. The first publication dates back to 1997.


TISS; NEMS; intensive care; critical care; instruments; management; workloads; Systematic reviewindirect measurement

Versión en Español


Instrumentos basados en medidas indirectas para UCI: TISS y NEMS