Nursing Information System Saskatchewan

Nursing Information System Saskatchewan (NISS) facilitates the effective and efficient collection, organization and communication of relevant patient information by authorized care providers. The documentation system includes a methodology to determine nursing workload. NISS is a client-based program provided to organizations that subscribe to this service.

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Overview |  How was NISS Developed? |  Program Cost |  Program Benefits |  Program Resources

NISS Program Overview

A strong, systematic documentation system is critical to effective nursing practice, both to allow health-care providers to communicate with one another about the care each patient, client, or resident has received, and to ensure that care is consistent, thorough, and has met legal and professional standards. Nursing Information System Saskatchewan© (NISS), first developed by the Hospital Systems Study Group (HSSG) in the 1980s, provides nurses in well over half of Saskatchewan’s health-care facilities with a consistent, easy-to-use documentation system which includes flowcharts and checklists to help evaluate all aspects of clients’ health-care needs. The system also has the capacity to classify patients and calculate the workload and staffing that each one requires. Employers who make use of this tool are able to systematically predict staffing needs based on the types of patients needing care.

NISS can also help ensure that users are meeting legal requirements for health record documentation as well as the requirements of Accreditation Canada and the Canadian Institute for Health Information’s Management Information System.

Program Development

NISS’s system for classifying patients has roots that date back to the early 1970s, when HSSG developed a workload classification that became widely used across Canada and the United States.

In 1980, a nursing task force was formed by representatives from HSSG, Saskatchewan Health, the Saskatchewan Registered Nurses’ Association, long-term care, mental health, and small, medium and large hospitals. Initially planning to develop a computerized nursing information system, the group soon recognized that the large number of existing systems in use across the province posed too great an obstacle, so they decided to focus first on a paper-based system.

The group remained active until 1994, building the many clinical components of NISS for documenting and calculating workloads for medical, surgical, ambulatory, post-anaesthetic, operating room, newborn and long-term care, as well as pediatrics, obstetrics, and psychiatry. For each of these population groups, the system lays out a five-step process covering assessment, diagnosis, planning, implementation of care, and evaluation. NISS became a SAHO program in 1995 with the merger of HSSG and SAHO, and since then the ongoing enhancements and revisions have been guided by system users. 

In 1984 alone, facilities using NISS grew from 17 to 59. By the early 1990s, more than 130 employers were using NISS in Saskatchewan, and more than 170 in other provinces. 

Today, the system is in use in more than 160 of the province’s acute and long-term care facilities. It is used in all but three hospitals, in the majority of the long-term care facilities, and in all but one mental health facility.

All 12 of the former health regions and the Athabasca Health Authority have NISS service agreements in place and are using NISS to varying degrees. Six of those former health regions (Kelsey Trail, Sunrise, Heartland, Keewatin Yatthe, Cypress, and Sun Country) are using NISS in all of their acute and long-term care sites. NISS is also used by 34 facilities across Alberta, Ontario, Newfoundland and Labrador, Northwest Territories, and Nunavut. The system’s spread across the country can be attributed both to word of mouth and to Accreditation Canada, which has long recommended it to organizations in need of a nursing documentation system.


Program Cost

The cost of the program today includes an annual fee per facility and an additional fee per bed for facilities with more than 50 beds. 3sHealth provides initial and ongoing system education on a fee-for-service basis. Services covered by the annual fee include support by phone and email, and regular updates to the user manuals. The system is maintained by 3sHealth. For information on current fees contact 3sHealth.

Program Benefits

To Patients: 
Allows for patient input into care, ensures continuity of care, documents progress in achieving outcomes, and facilitates an inter-disciplinary approach to care and effective communication between agencies and care providers.

To Care Providers: 
Is consistent with nursing knowledge and philosophy, meets professional practice standards and follows the nursing process, meets legal recommendations for documentation in health records, supports a conceptual model for nursing practice and provides a documentation system that incorporates flow sheet recording and charting by exception.

To Management: 
Ensures a consistent systematic approach to patient care, incorporates a workload measurement methodology based on patient needs to provide information about staffing requirements, meets Accreditation Canada standards and Canadian Institute for Health Information’s Management Information System reporting requirements, uses cumulative data for short- and long-term planning for staff, supplies and equipment, and provides a process and a tool to evaluate care.

To Educators: 
Provides a framework for curriculum development and ongoing education and reduces orientation time.

To Researchers: 
Provides a common format for recording patient care in all facilities and information that can be used as the basis for developing expanded nursing knowledge, new skills, routines and standards of care. 

To Health Authorities:
Provides a common format for recording patient care in all facilities, enables central printing and purchasing of forms, and facilitates communication between agencies to ensure continuity of care when a patient is transferred.