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Critical Care Research and Practice
Volume 2012, Article ID 919106, 9 pages
http://dx.doi.org/10.1155/2012/919106
Research Article

Critical Care Nurses Inadequately Assess SAPS II Scores of Very Ill Patients in Real Life

1Intensive Care Unit, Department of Intensive Care, Regional Hospital, 6500 Bellinzona, Switzerland
2Intensive Care Unit, Department of of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals and University of Geneva, 1211 Geneva, Switzerland

Received 12 September 2011; Revised 24 December 2011; Accepted 13 January 2012

Academic Editor: Benoit Vallet

Copyright © 2012 Andreas Perren et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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 4 0 . 3 ± 2 0 . 2 versus 4 4 . 2 ± 2 4 . 9 of the gold standard ( 𝑃 < 0 . 0 0 2 for difference) with a lower ICC (0.81). Bland and Altman assay was + 3 . 8 ± 2 7 . 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.