Critical Care Nurses Inadequately Assess SAPS II Scores of Very Ill Patients in Real Life
Background. Reliable ICU severity scores have been achieved by various healthcare workers but nothing is known regarding the accuracy in real life of severity scores registered by untrained nurses. Methods. In this retrospective multicentre audit, three reviewers independently reassessed 120 SAPS II...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2012/919106 |
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| author | Andreas Perren Marco Previsdomini Ilaria Perren Paolo Merlani |
| author_facet | Andreas Perren Marco Previsdomini Ilaria Perren Paolo Merlani |
| author_sort | Andreas Perren |
| collection | DOAJ |
| description | Background. Reliable ICU severity scores have been achieved by various healthcare workers but nothing is known regarding the accuracy in real life of severity scores registered by untrained nurses. Methods. In this retrospective multicentre audit, three reviewers independently reassessed 120 SAPS II scores. Correlation and agreement of the sum-scores/variables among reviewers and between nurses and the reviewers’ gold standard were assessed globally and for tertiles. Bland and Altman (gold standard—nurses) of sum scores and regression of the difference were determined. A logistic regression model identifying risk factors for erroneous assessments was calculated. Results. Correlation for sum scores among reviewers was almost perfect (mean ICC = 0.985). The mean (±SD) nurse-registered SAPS II sum score was 40.3±20.2 versus 44.2±24.9 of the gold standard (𝑃<0.002 for difference) with a lower ICC (0.81). Bland and Altman assay was +3.8±27.0 with a significant regression between the difference and the gold standard, indicating overall an overestimation (underestimation) of lower (higher; >32 points) scores. The lowest agreement was found in high SAPS II tertiles for haemodynamics (k = 0.45–0.51). Conclusions. In real life, nurse-registered SAPS II scores of very ill patients are inaccurate. Accuracy of scores was not associated with nurses’ characteristics. |
| format | Article |
| id | doaj-art-0b5b5a2f6097413ab37b253d8bffdc4d |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-0b5b5a2f6097413ab37b253d8bffdc4d2025-08-20T03:54:28ZengWileyCritical Care Research and Practice2090-13052090-13132012-01-01201210.1155/2012/919106919106Critical Care Nurses Inadequately Assess SAPS II Scores of Very Ill Patients in Real LifeAndreas Perren0Marco Previsdomini1Ilaria Perren2Paolo Merlani3Intensive Care Unit, Department of Intensive Care, Regional Hospital, 6500 Bellinzona, SwitzerlandIntensive Care Unit, Department of Intensive Care, Regional Hospital, 6500 Bellinzona, SwitzerlandIntensive Care Unit, Department of Intensive Care, Regional Hospital, 6500 Bellinzona, SwitzerlandIntensive Care Unit, Department of of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals and University of Geneva, 1211 Geneva, SwitzerlandBackground. Reliable ICU severity scores have been achieved by various healthcare workers but nothing is known regarding the accuracy in real life of severity scores registered by untrained nurses. Methods. In this retrospective multicentre audit, three reviewers independently reassessed 120 SAPS II scores. Correlation and agreement of the sum-scores/variables among reviewers and between nurses and the reviewers’ gold standard were assessed globally and for tertiles. Bland and Altman (gold standard—nurses) of sum scores and regression of the difference were determined. A logistic regression model identifying risk factors for erroneous assessments was calculated. Results. Correlation for sum scores among reviewers was almost perfect (mean ICC = 0.985). The mean (±SD) nurse-registered SAPS II sum score was 40.3±20.2 versus 44.2±24.9 of the gold standard (𝑃<0.002 for difference) with a lower ICC (0.81). Bland and Altman assay was +3.8±27.0 with a significant regression between the difference and the gold standard, indicating overall an overestimation (underestimation) of lower (higher; >32 points) scores. The lowest agreement was found in high SAPS II tertiles for haemodynamics (k = 0.45–0.51). Conclusions. In real life, nurse-registered SAPS II scores of very ill patients are inaccurate. Accuracy of scores was not associated with nurses’ characteristics.http://dx.doi.org/10.1155/2012/919106 |
| spellingShingle | Andreas Perren Marco Previsdomini Ilaria Perren Paolo Merlani Critical Care Nurses Inadequately Assess SAPS II Scores of Very Ill Patients in Real Life Critical Care Research and Practice |
| title | Critical Care Nurses Inadequately Assess SAPS II Scores of Very Ill Patients in Real Life |
| title_full | Critical Care Nurses Inadequately Assess SAPS II Scores of Very Ill Patients in Real Life |
| title_fullStr | Critical Care Nurses Inadequately Assess SAPS II Scores of Very Ill Patients in Real Life |
| title_full_unstemmed | Critical Care Nurses Inadequately Assess SAPS II Scores of Very Ill Patients in Real Life |
| title_short | Critical Care Nurses Inadequately Assess SAPS II Scores of Very Ill Patients in Real Life |
| title_sort | critical care nurses inadequately assess saps ii scores of very ill patients in real life |
| url | http://dx.doi.org/10.1155/2012/919106 |
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