Therapeutic intervention scoring system used in the care of patients in pentobarbital-induced coma to determine nurse-patient ratios

Geraldine L. Myles, Marc Malkoff, Anne G. Perry, Richard D. Bucholz, Camilo R. Gomez

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Critical care patients generally require extensive interventions, thereby consuming a large percentage of healthcare resources. Induced pentobarbital coma for the management of increased intracranial pressure is one such intervention, required to maintain patient stability. Quantification of these interventions, as well as the amount of nursing work required, has not been addressed in the literature. OBJECTIVE: To use the Therapeutic Intervention Scoring System to analyze and quantify how interventions affect nurse-patient ratios in the management of patients in pentobarbital coma for refractory increased intracranial pressure. METHODS: The medical records of patients with subarachnoid hemorrhage from aneurysmal rupture and subsequent increased intracranial pressure, in whom pentobarbital coma was salvage therapy, were reviewed retrospectively. The Therapeutic Intervention Scoring System was used to quantify the number of interventions required before, during, and after coma induction. The data were analyzed and daily Therapeutic Intervention Scoring System scores correlated with serum pentobarbital levels. Typically, a critical care nurse can manage a patient caseload of 40 to 50 Therapeutic Intervention Scoring System points. By quantifying the interventions, the score reflected the amount of care required to manage the patient in barbiturate coma. RESULTS: The intensity of interventions correlated with the level of coma, length of time in coma, and associated complications. CONCLUSIONS: The scores indicated the intensity of interventions used in pentobarbital coma and the use of resources. Nursing care and complications involved with this therapy were quantified and nurse-patient ratios were established.

Original languageEnglish (US)
Pages (from-to)74-79
Number of pages6
JournalAmerican Journal of Critical Care
Volume5
Issue number1
StatePublished - Jan 1 1996

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Pentobarbital
Coma
Patient Care
Nurses
Intracranial Pressure
Therapeutics
Critical Care
Salvage Therapy
Therapeutic Uses
Subarachnoid Hemorrhage
Nursing Care
Medical Records
Rupture
Nursing
Delivery of Health Care
Serum

All Science Journal Classification (ASJC) codes

  • Critical Care

Cite this

Therapeutic intervention scoring system used in the care of patients in pentobarbital-induced coma to determine nurse-patient ratios. / Myles, Geraldine L.; Malkoff, Marc; Perry, Anne G.; Bucholz, Richard D.; Gomez, Camilo R.

In: American Journal of Critical Care, Vol. 5, No. 1, 01.01.1996, p. 74-79.

Research output: Contribution to journalArticle

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